Study Takes New Look at Deep Brain Stimulation for Alzheimer’s
A study published last month in the Journal of Alzheimer’s Disease gives new hope, and a new twist, on the potential use of Deep Brain Stimulation to slow the progression of functional impairment associated with Alzheimer’s Disease.
A surgical procedure that has been FDA-approved for the treatment of Parkinson’s Disease and essential tremor since 1997, Deep Brain Stimulation (DBS) involves the implantation of electrodes which send electrical impulses to specific areas of the brain. It has since been researched in the treatment of a variety of other neurological and psychiatric conditions. Several earlier studies of DBS for Alzheimer’s Disease have targeted brain regions associated with memory and with cognition, resulting in improved memory, and cognitive scores which stabilized or improved. This most recent study, run by researchers at the Ohio State University Wexner Medical Center, takes a different look at the causes of functional daily-life problems that chip away at the independence of a patient with Alzheimer’s and increase the demand for caregiver involvement: not memory or cognition, but executive functioning.
Problem solving, decision making, organizing and planning, and self-monitoring are all crucial activities for independence. When these skills decline as a result of the progression of Alzheimer’s Disease, there is a pronounced impact on the daily life of the patient and their loved ones. An increased need for assistance, direction, monitoring, and eventually safety measures grow as the patient’s ability to pay attention, utilize working memory, stay on-task, and self-regulate their behavior shrinks.
Recognizing the critical importance of these executive functioning tasks on the day-to-day management of an individual’s life, and the degree to which decline in these abilities affects the patient, caregivers, and systems of care, the researchers at Ohio State University designed a new approach for DBS to target the frontal networks of the brain. Electrodes were implanted in the ventral capsule/ventral striatum, and a host of scans and neurocognitive tests were repeated before and at various intervals after the surgery.
All three of the participants and their families consistently reported improvements in energy, attention, and problem-solving. They all showed less decline overtime than matched comparison groups, as well. No serious adverse effects were noted, and the patients generally tolerated the procedure well.
Researchers are, of course, seeing the results of this small study as a call for further investigation into the role that DBS can play in preserving independence and quality of life for patients with Alzheimer’s Disease. Though much more work is needed, this is a promising step in a new direction, bringing hope to patients and caregivers.
Scharre, D. W., Weichart, E. B., Nielson, D., Zhang, J., Agrawal, P., Sederberg, P. B., Knopp, M. V., Rezai, A. R. (2018). Deep Brain Stimulation of Frontal Lobe Networks to Treat Alzheimer’s Disease. Journal of Alzheimer’s Disease, vol. 62, no. 2. Retrieved from https://content.iospress.com/articles/journal-of-alzheimers-disease/jad170082.