Acta Neurologica Indonesia
Vol. 2 No. 03 (2024): Acta Neurologica Indonesia

Transcranial Pulse Stimulation as a New Navigated Focal Brain Therapy for Vascular Cognitive Impairment: Case Report

Andrie Gunawan (Department of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)
Amanda Tiksnadi (Department of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusu)
Dyah Tunjungsari (Department of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia)
Christine Kathy Putri Sari (Departement of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital)



Article Info

Publish Date
13 Oct 2024

Abstract

Introduction: To evaluate the cognitive function of vascular cognitive impairment (VCI) after transcranial pulse stimulation (TPS) sessions Case Report: TPS is a non-invasive brain stimulation method. Stimulation was administered using NEUROLITH TPS generator (Storz Medical AG) with 3 Hz ultrashort pulses at 0.25 mJ mm-2 energy density over 12 sessions (6000 pulses per session), three times/week. Target areas included the bilateral DLPFC (1600 pulses per hemisphere), parietal regions (P3, P4) (800 pulses per hemisphere), and precuneus (PCu) (1200 pulses). Cognitive function tests were conducted before the first and after the last TPS session, including MMSE, MoCa-Ina, 15 Boston Naming Test Patient, Digit Span, CERAD (Visuoconstruction, Delayed Memory, Recognition, Verbal Fluency), and Trail Making Test A & B. Discussion: Case 1 was a 48-year-old man with VCI and dysphasia post-stroke infarct (10 months prior), affecting the left caudate nucleus, left lentiform nucleus, and left internal capsule. The patient presented memory and executive function issues but preserved recognition. Case 2 was a 62-year-old man with VCI and anomic aphasia, following a cerebral infarction 5 months prior affected the left putamen, corona radiata, internal capsule, and globus pallidus. After 12 sessions, Case 1 showed amplification in working memory but had executive function challenges. Case 2 demonstrated improvement in immediate memory, recognition, and visuoconstruction, but had lingering issues with delayed verbal, visual memory, and executive function. Conclusion: TPS stimulation of areas for cognitive function appears to enhance memory, recognition, and other cognitive function. TPS may be a novel add‐on therapy for VCI post-stroke patients.

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Journal Info

Abbrev

journal

Publisher

Subject

Medicine & Pharmacology Neuroscience Public Health

Description

Acta Neurologica Indonesia is the official publication of the Department of Neurology, Faculty of Medicine, Universitas Indonesia under Directorate of Administration, Data, and Product Management of Research and Innovation Universitas Indonesia. This journal is published in trimonthly cycle with ...