#68 A conversation with Prof. Dr Citak | TPS: Transcranial Pulse Stimulation | Long Covid

For millions worldwide, the end of an acute COVID-19 infection was not the end of the battle. The emergence of **Long Covid** and **Neuro-COVID** has left patients struggling with debilitating brain fog, chronic fatigue, and sensory loss. Traditional medicine often offers few answers, but a revolutionary approach called **Transcranial Pulse Stimulation (TPS)** is offering new hope. This non-invasive procedure, initially designed for dementia, is now being repurposed to stimulate the brain's natural healing mechanisms, helping patients regain cognitive clarity and sensory function.

In this featured discussion, Leila from Tidal Faces sits down with the renowned **Prof. Dr. med. Musa Citak** to explore how regenerative medicine and low-energy shockwaves are transforming the landscape of neurological recovery. Whether you are a patient seeking relief or a medical enthusiast, this video provides the science-backed answers you’ve been looking for.

Video Chapters & Key Topics

The Regenerative Vision of Prof. Dr. Musa Citak

Prof. Dr. Musa Citak brings a unique perspective to neurology. Starting his career as an orthopedic surgeon, he transitioned into the world of regenerative medicine after identifying the limitations of conventional surgery for chronic pain management [00:55]. His expertise in **extracorporeal shockwave therapy (ESWT)**—traditionally used for kidney stones and tendon injuries—laid the foundation for his work with the brain.

Dr. Citak emphasizes that "healing is the best medicine." This philosophy led him to explore how low-energy acoustic pulses could be used to stimulate cellular repair in the central nervous system. His practice in Hamburg and Bochum has become a beacon for patients seeking non-drug-based interventions for complex neurological disorders.

The Origins and Evolution of Transcranial Pulse Stimulation

TPS was initially developed and approved for the treatment of **Alzheimer's dementia**. The goal was to reach deep brain structures that are otherwise inaccessible to non-invasive therapies. Dr. Citak shares a personal anecdote about his mother’s dementia diagnosis, which spurred him to bring the TPS device into his practice to test its efficacy firsthand [02:18].

While the results for dementia were promising, the real breakthrough for Neuro-COVID occurred by chance. A family member suffering from typical Long Covid symptoms—loss of taste, loss of smell, and severe concentration issues—underwent the treatment. Within six weeks, their symptoms fully reversed [03:27]. This established TPS as a viable **Neuro-COVID treatment** for patients experiencing post-viral neurological decline.

The Science of Mechanotransduction: How Shockwaves Heal the Brain

How exactly can a sound wave repair brain function? The answer lies in **mechanotransduction** [07:05]. When low-energy acoustic pulses penetrate the skull, they apply a mechanical stimulus to the brain cells (neurons). This stimulus triggers a cascade of biological responses:

• Release of Growth Factors: Stimulation of VEGF (Vascular Endothelial Growth Factor) and BDNF (Brain-Derived Neurotrophic Factor) to support nerve growth and vascular health.
• Nitric Oxide Release: This induces vasodilation, significantly improving blood circulation in localized brain areas.
• Stem Cell Activation: The pulses encourage the migration and activation of stem cells to areas requiring repair.
• Improved Neuroplasticity: TPS enhances the brain's ability to reorganize itself by forming new neural connections.

By activating these pathways, TPS acts as a "catalyst for healing," allowing the body to use its own energy to repair damaged tissues without the need for systemic pharmaceutical interventions.

TPS vs. Traditional Neurological Medications

Addressing Long Covid: The "Brain Fog" Solution

One of the most persistent symptoms of **Long Covid** is cognitive impairment, colloquially known as "brain fog." Patients describe it as a literal cloud over their thoughts, preventing them from focusing or remembering simple tasks. Dr. Citak explains that in many post-COVID cases, the brain is suffering from chronic neuro-inflammation or metabolic disturbances [09:21].

TPS is uniquely suited for these "inflammatory" conditions. Unlike degenerative diseases like Parkinson's where the goal is to slow progression, Neuro-COVID cases often show significant improvement and even full recovery because the brain's underlying structure is still intact; it simply needs a "reset" or "restart" provided by the acoustic pulses.

The Treatment Protocol: What to Expect

If you are considering TPS, the process is streamlined and patient-friendly. It typically involves a series of **six sessions** conducted over a short period, often two to three weeks [14:12]. Each session lasts approximately 20 to 30 minutes.

During the session, you remain fully awake and seated. A specialized gel is applied to the scalp to ensure the acoustic waves pass through efficiently. The doctor moves the handpiece over specific areas of the head. Patients hear a clicking sound but generally feel no pain [12:45]. It is a "lunchtime" procedure that allows you to return to your daily activities immediately, though many report feeling pleasantly tired afterward as the brain begins the regeneration process.

Unmatched Safety in Neuro-Therapy

One of the most compelling aspects of TPS is its safety profile. In over 1,000 cases handled by Dr. Citak, only about 5% to 10% of patients reported mild headaches, and another small percentage reported temporary fatigue [14:53]. These effects usually dissipate within 24 hours.

However, it is vital to note the **contraindications**. TPS is not performed on patients with active brain tumors or recent acute brain hemorrhages. This is why Dr. Citak requires a fresh MRI and basic blood work before beginning therapy [10:19]. This ensures that the acoustic energy is targeting an inflammatory or degenerative condition rather than aggravating an undiagnosed structural issue.

Investment in Your Cognitive Health: Costs and Results

Because TPS is an innovative and relatively new therapy, it is currently not covered by most standard health insurance providers in Germany. However, for many, the investment in their quality of life is invaluable. Dr. Citak estimates the cost of a full 6-session series at approximately **€2,000** (roughly €333 per session) [15:19].

While the cost may seem high to some, the return on investment can be life-changing. Dr. Citak mentions a journalist who had been unable to work for two and a half years due to Long Covid and was able to return to her profession after a single series of TPS treatments [11:17]. The results are typically not seen immediately; the "biological clock" of the brain means improvements usually manifest **4 to 6 weeks** after the final session.

Why TPS Therapy is the Future of Neuro-Regeneration

The success of TPS for Long Covid and Neuro-COVID suggests that we are just scratching the surface of acoustic wave therapy. Dr. Citak also highlights positive results for patients with **Parkinson’s, Depression, and Tinnitus** [15:05]. By moving away from chemical suppression and toward physical stimulation, doctors are unlocking the brain's inherent capacity to fix itself.

Patients often find themselves in an "unmet medical need" category when dealing with post-viral conditions. TPS bridges that gap, providing a scientifically grounded, non-invasive, and safe alternative to "watchful waiting" or ineffective medications. If your brain needs a "jump start," Transcranial Pulse Stimulation might be the answer.

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