Title : Transcranial pulse stimulation for treatment-resistant depression: A case series
Abstract:
Depression, a prevalent condition, has reached unprecedented levels in certain countries, such as Germany, as indicated by the most recent data. Depending on the severity of the condition and the patient's individual preferences, different treatment options are available. However, treatment-resistant depression can pose significant challenges for both patients and healthcare providers. Transcranial pulse stimulation (TPS), an alternative non-invasive brain stimulation (NIBS) method based on shock waves, has been available for several years and is CE-certified for the treatment of Alzheimer's dementia. This innovation facilitates precise and non-invasive modulation of subcortical brain regions, previously requiring surgical intervention. The objective of this case series is to examine the safety and effectiveness of TPS in patients diagnosed with treatment-resistant depression. A total of five patients (gender ratio female to male 3:2) who met the criteria for treatment-resistant depression underwent a total of six treatments within a 14-day period. Each session consisted of 6,000 pulses at an energy level of 0.25 millijoules per millimeter and a frequency of 4 Hertz. The application of pulses in the frontal, parietal, and precuneus regions was facilitated by neuro-navigation, based on individual MRI scans. Furthermore, the shell region of the nucleus accumbens was targeted with 300 pulses on both sides due to its involvement in the pathophysiology of depression. The Beck Depression Inventory (BDI-II) was utilized to evaluate the severity of depressive symptoms prior to the initial and subsequent treatment sessions. Apart from a temporary feeling of pressure in the area of the temples in one patient, none of the patients experienced any side effects during and after the treatment. A reduction in the BDI-II total score was observed in all patients in the pre-post comparison.
