NeuroUp treatment protocol with Transcranial Pulse Stimulation TPS for stimulation of brain regions with reduced function in patients with Alzheimer’s disease

Is it possible to treat Alzheimer’s disease?

Alzheimer’s diagnosis is a very tiring process for both the patient and their relatives. Despite intensive research, the cure for Alzheimer’s has not yet been found; however, progress has been made in the fight against the disease. The quality of life and the right to self-determination of those affected by this disease should be preserved for as long as possible. Drug treatments in Alzheimer’s disease provide a very limited benefit in the progression of the disease. Transcranial Pulse Stimulation (TPS) – NEUROLITH as a revolutionary new treatment for Alzheimer’s Disease developed by the University of Wienna, Austria – University of Toronto in Canada and STORZ MEDICAL AG SWITZERLAND is the ONLY EFFECTIVE, SAFE, NON-INVASIVE treatment method approved the treatment of Alzheimer’s patients.

NeuroUp treatment protocol with Transcranial Pulse Stimulation TPS will be implemented for the first time in our country at NeuroUpclinic almost simultaneously with centers in developed countries around the world. The current treatment is currently used in Austria, Switzerland, Germany, England, Canada, Hongkong, Spain, Portugal, France and Denmark.

The TPS neural stimulation technique, developed by an international consortium led by Vienna, is the only technique that can activate deep regions of the brain in a targeted and non-invasive manner. Therefore, all diseases such as Parkinson’s, MS, Stroke, Neuralgia, in which it is still possible to restore impaired brain functions by activating functional neurons, are candidates for the new Transcranial Pulse Stimulation (TPS) treatment. Transcranial Pulse Stimulation (TPS) is already licensed for the treatment of Alzheimer’s. (CE Certificate)

Transcranial Pulse Stimulation TPS with NeuroUp treatment protocol

“NeuroUp™ is a non-invasive treatment that uses Transcranial Pulse Stimulation (TPS®) technology to improve the quality of life of those with mild to moderate Alzheimer’s.”

NeuroUp™ is a revolutionary new treatment for Alzheimer’s Disease!
The diagnosis of Alzheimer’s Disease brings many difficulties for both individuals with the disease and all relatives of the patient. Despite the best efforts of medical science, Alzheimer’s Disease is still incurable. Limited benefits have been obtained with some drugs in the fight against Alzheimer’s disease. It has been shown that drug treatments known as Acetyl Cholinesterase inhibitors can help stabilize mental performance and slow Alzheimer’s symptoms by working to prevent the breakdown of acetylcholine, a chemical in the brain believed to play an important role in memory and thinking functions. Similarly, NMDA receptor antagonists are also used as adjuncts.

As NeuroUpclinic, we provide services with the *NeuroUp * method, a non-invasive treatment that uses Transcranial Pulse Stimulation (TPS®) technology to improve the quality of life for patients suffering from mild to moderate AD, almost simultaneously with major neurology treatment centers around the world. In addition, we continue our efforts for the central application of all innovative treatments with approved effects in Alzheimer’s treatment in Turkey.

Basic information about TPS®

• It is used in mild-moderate Alzheimer’s patients.
Purpose: To develop/maintain the mental and physical abilities of Alzheimer’s patients.
• Acoustic ultrasonographic pulses produced outside the body are given to the brain regions that require treatment.
• It is a treatment method that does not require being in a hospital environment in outpatient clinic conditions.
• It is a safe treatment method. After the procedure, the patient can return to his/her normal life.
• Average treatment time is 30 minutes per session and one treatment period includes 6 sessions over 2 weeks.

A TPS treatment session is performed by our Transcranial Pulse Stimulation (TPS®) trained clinicians. Patients can continue their normal daily lives after a therapy session.
Transcranial Pulse Stimulation (TPS®) is safe. The patient sits comfortably in the treatment chair and can move freely at any time. Before treatment begins, the doctor enters patient data into the NEUROLITH® therapy system and applies ultrasound gel to the scalp or hair. It is not necessary to shave the patient’s head. Ultrasound gel is required to ensure optimal transmission of pulses. The patient then wears a pair of glasses so that the position of the head can be detected. During treatment, the doctor gently moves the handpiece over the respective areas of the scalp and skull. On one screen, both the doctor and the patient can see exactly which part of the brain has been reached.
A therapy session usually takes about 30 minutes. In general, a TPS® treatment series includes an average of 6 sessions, all occurring within 2 weeks.

What is Alzheimer’s disease (AH/AD)?

Alzheimer’s Disease (AD) is one of the most common types of dementia among older people. Due to the gradual deterioration of nerve and brain cells, patients may experience memory loss, problems with thinking, problem solving or language, problems with orientation, and can no longer cope with daily life without assistance.
Symptoms of Alzheimer’s Disease typically appear after age 65, with 8 out of 100 people over 65 years old and 1 in 2 people over 85 years of age with Alzheimer’s disease. After the age of 65, the incidence of disease increases twice every 5 years. However, it can also develop in people younger than this. This is called early-onset Alzheimer’s Disease.
Although it is thought that there are approximately 600,000 Alzheimer’s patients in Turkey, this number is expected to reach much higher with the aging of the population. Globally, it is estimated that one person is diagnosed with some form of dementia every three seconds. Currently, there are more than 44 million Alzheimer’s patients worldwide.

**IN 2050, TURKEY IS CONSIDERED TO BE THE 4TH COUNTRY WITH THE MOST ALZHEIMER’S PATIENTS IN THE WORLD**

NeuroPulse – How does Transcranial Pulse Stimulation (TPS®) work?

NeuroPulse TPS® is a treatment option approved since 2018 for use in patients with mild to moderate symptoms of Alzheimer’s Disease. TPS® stimulates various areas of the brain to improve the cognitive abilities of Alzheimer’s patients and to preserve these abilities for as long as possible. More than 1,500 treatment sessions have been performed with TPS® so far. Patients and their families report that TPS® treatments result in improved verbal ability, better memory, and an improved sense of direction.
Brain stimulation has been continued for decades with electromagnetic technologies, but there are important limitations and safety problems in its use in the brain in neurological diseases due to reasons such as incomplete targeting and heating and damage to the brain tissue.
It contains ultrasonography waves or acoustic pulses produced by the Storz Medical NEUROLITH® device unit and directed to the patient’s head. This is where the acoustic waves produce their effect with the targeted stimulation of the respective brain regions. This is a non-invasive procedure and acoustic impulses pass through the skin and skull without damaging them.
With Transcranial Pulse Stimulation, being able to safely stimulate ultrasonographically deep brain areas in a way that causes dramatic activity increases in local areas is a very important clinical development.
In this way, it has been possible to provide non-invasive deep brain stimulation, which can only be achieved surgically or with electrode implantation. Deep brain stimulation with ultrasonographic waves; Along with changes in cell membrane permeability, transmitters create changes in humoral and cell activity and this provides a long-term neuroplastic effect.

Using the Neurolith system, NeuroUp TPS® is currently the only drug-free treatment clinically proven to improve and protect cognitive ability and mood in Alzheimer’s patients.

How does NeuroUp TPS® improve cognitive ability?

NeuroUp TPS® consists of short acoustic pulses with an ultrasound frequency range that provides focused stimulation of the brain at a depth of approximately 5 cm. The key mechanism induced by TPS® is mechanotransduction, the ability of cells to convert mechanical forces into biological signals.
Simply put, acoustic pulses create chemical reactions in the body that have a biological effect on healing.

• Mechanotransduction
• Increase in cell permeability
• Stimulation of mechanically sensitive ion channels
• The release of nitric oxide (NO), which causes vasodilation, increased metabolic activity and angiogenesis, and has an anti-inflammatory effect.
• Stimulation of vascular growth factors (VEGF)
• Stimulation of BDNF (Brain-Derived Neurotrophic Factor)
• Migration and differentiation of stem cells

How does Transcranial Pulse Stimulation (TPS®) show its effect?

TPS® can stimulate deep brain regions and can reach up to 8 cm inside the brain.
Thanks to the short duration of TPS® stimulation, tissue heating is prevented. The patient does not remain still during the treatment and can move freely. TPS® treatment has been shown to significantly improve CERAD test performance and reduce Beck’s depression index in patients with mild to moderate dementia. More than 1500 treatments have been performed using the NEUROLITH® system, after which its clinical use has become more widespread.

An important study has shown that TPS® not only preserves the cognitive abilities of patients with mild to moderate Alzheimer’s disease, but also significantly improves them. Open-label single-arm trial data also showed that improvements lasted at least 3 months after completion of the TPS® treatment series. The level of consciousness increased by an average of 10 points on the CERAD scale. This was also confirmed by patients and their loved ones, who reported improved language and memory and indirectly increased social interaction, with some patients regaining an improved sense of direction that allowed them to shop independently again.

NeuroUp TPS® Treatment

A therapy session usually takes about 30 minutes. On average, six sessions are required over a 2 to 3 week period. After treatment, patients can resume their normal daily activities.
NeuroUp Boosters may be offered every 6 weeks following initial treatments as part of a cognitive maintenance program.

When does the response to treatment begin to appear?

NeuroUp TPS® results are visible in as little as two weeks. This improvement includes, on average, a 10% increase in the CERAD score, as well as significant improvements in orientation, self-awareness and general mental health.

What is the CERAD Scale?

The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) was developed by the National Institute on Aging in 1986 to develop standardized, validated measures for the assessment of Alzheimer’s Disease. The score is determined by a specialist psychologist using a series of tests. For example, a 70-year-old person without AD might have a score of 80, while someone with mild or suspected AD might have a score of about 39. A CERAD score can be as low as 18 in a person with Alzheimer’s disease.

Neuropsychological developments in Alzheimer’s disease after TPS treatment;
A) The patients’ cognitive status, the global outcome parameter for CERAD CTS (adjusted total score), improves significantly after TPS treatment.
B) CERAD logistic regression score (LR) also improved. LR focuses on tests that are important for Alzheimer’s-type dementia.
C) Memory
D) Improvement in verbal functions is evident after treatment.

How do we measure treatment results?

In addition to the CERAD Scale, patients are evaluated using additional tests following their treatment. These include:
MMSE: It is the most commonly used test for complaints about problems with memory or other mental abilities.
ADAS-COG: A neuropsychological assessment used to determine the severity of cognitive symptoms of dementia.
Global Deterioration Scale: Developed by Dr. Barry Reisberg, this scale provides caregivers with an overview of the stages of cognitive function for those suffering from primary degenerative dementia such as Alzheimer’s Disease.

Does NeuroUp TPS® have any side effects?

NeuroPulse TPS® has no known side effects.
Patients can continue their daily activities immediately after their treatment. Some patients report a feeling of heaviness or a mild headache, but this is felt more on the scalp than on the head and typically goes away within 20 minutes.

Is Transcranial Pulse Stimulation (TPS®) Safe?

NeuroPulse TPS® was developed by Storz Medical AG and is Medical CE marked. Founded in 1987, Storz Medical AG is an independent partner company of the Karl Storz Group, a German medical device manufacturer.
In the mid-90s, Storz Medical discovered the effectiveness of sound waves in the treatment of peripheral neurological diseases such as post-traumatic spasms, spastic paralysis and polyneuropathy. In 2014, the first treatment of Alzheimer’s patients with sound waves was carried out in close cooperation with clinical partners in Germany and Austria.In 2018, Transcranial Pulse Stimulation (TPS®) with the NEUROLITH® system is the first and only procedure of its kind authorized for the treatment of the central nervous system of patients with Alzheimer’s Disease.

What are the Advantages of Transcranial Pulse Stimulation (TPS®)?

• It is 6 treatment sessions in 2 weeks.
• The treatment is applied sitting down (30 minutes).
• It is painless and has no side effects.
• It is a personalized treatment based on MRI data.
• Supportive cognitive training is not required.
• No shaving required
• The patient does not have to stay still during the treatment.

BodyTrack® – Real-time treatment documentation

Neuro-pulse provides automatic visualization of the treated areas. The use of personalized MRI data allows certain features of the patient’s brain to be taken into account. The visualization of target regions on loaded MRI scans is automatically updated whenever the position of the stimulating device changes. The applied energy is highlighted in color.
BodyTrack® software is a unique tool for visualization and control of applied TPS® beats and treatment progress.

Benefits of BodyTrack® software

• Use of personalized MRI data
• 3D visualization of MRI data (axial, coronal, sagittal)
• Color visualization of the treatment area
• Real-time visualization of the distribution of TPS® alerts
• Continuous visualization and documentation of applied energy and treatment progress

The perfect solution to facilitate Alzheimer’s treatment

NEUROLITH® – An innovative system with convincing design features. The special ergonomic shape of the TPS® handpiece minimizes hand fatigue to make it easier to work the therapy directly on the patient. The attachment surface easily adapts to any head shape, making treatment with focused strokes simple and efficient.

Advantages of NEUROLITH®

• Focused stimulation of deep cerebral regions
• Personalized 3D visualization of the patient’s head
• 3D infrared camera system for precise brain monitoring
• USB interface for importing MRI data
• Archiving of patients and their data

Diagnosis and Treatment Process

1) Those who show signs of dementia noticed by the patient himself/herself or his/her relatives, and patients who have been diagnosed with Alzheimer’s Disease by another physician before, apply to the Neuro Up Clinic team and make an appointment.
2) An initial interview is made with one of our NeuroUp TPS® specialists and a neurological examination is performed together with this interview. The medications that the patient takes regularly are reviewed.
3) In addition to the examination, biochemical tests to support the diagnosis are performed. For a more tailored and personalized approach, an MRI scan is done that will map the areas of the brain that need treatment.
4) Neuropsychiatric tests are applied by our clinical neuropsychologist for the cognitive evaluation of the patient before treatment, and the stage of the disease is determined. The suitability of the patient for treatment is decided.
5) The treatment process is started for the patient who is eligible for treatment, at the days and times determined for six 30-minute treatments, spread over 2 weeks, by our Neurology doctors.
6) One week after the treatment, our clinical neuropsychologist together with our neurologist will measure the change/improvement in brain function and cognitive abilities with a second evaluation.
7) If later deemed necessary, a NeuroBooster maintenance treatment program may be recommended.