Can a brain pacemaker help Alzheimer’s patients?

LaVonne and Tom Moore 
We know that most treatments for Alzheimer’s disease focus on improving memory.
 
So our team of physicians and researchers at The Ohio State University Wexner Medical Center decided to try something different. We wanted to see if we could slow the decline of problem-solving and decision-making skills in these patients.
 
There are plenty of memory aids, tools and pharmaceutical treatments to help Alzheimer’s patients with memory. But we don’t have anything to help with improving their judgments, making good decisions, or increasing their ability to selectively focus attention on the task at hand and avoid distractions.
 
These skills are necessary in performing daily tasks such as making the bed, choosing what to eat and having meaningful socializing with friends and family.
 
Our team of neurologists and neurosurgeons wanted to determine if using a brain pacemaker could improve cognitive, behavioral and functional abilities in patients with this form of dementia.
 
Thin electrical wires were surgically implanted into the frontal lobes of the brains of patients with Alzheimer’s disease as part of a clinical trial.
 
The deep brain stimulation (DBS) implant is similar to a cardiac pacemaker device, except that the pacemaker wires are implanted in specific regions of the brain rather than the heart.
 
This is the first use of DBS in Alzheimer's disease in a behavioral regulation brain region target.
 
Findings of the study are published online in the Journal of Alzheimer’s Disease.
 
The deep brain stimulation (DBS) implant is similar to a cardiac pacemaker device, except that the pacemaker wires are implanted in the brain rather than the heart.
 
The frontal lobes are responsible for our abilities to solve problems, organize and plan, and utilize good judgment. By stimulating this region of the brain, the study participants’ cognitive and daily functional abilities as a whole declined more slowly than Alzheimer’s patients in a matched comparison group who weren’t being treated with DBS.
 
The pilot study found that DBS targeting frontal brain regions can reduce the overall performance decline typically seen in people with mild or early stage Alzheimer’s.
 
Alzheimer’s disease is the most common form of degenerative dementia, affecting more than 5 million Americans. By 2050, this number could rise as high as 16 million, according to the Alzheimer’s Association.
 
The disease – which has no cure and isn’t easily managed – becomes progressively disabling with loss of memory, cognition and worsening behavioral function, in addition to a gradual loss of independent functioning.
 
All three study participants showed improvement.
 
For example, when LaVonne Moore entered the study in 2013, she wasn’t doing any meal preparation. After two years of deep-brain stimulation, she could independently initiate preparation of a simple meal, assemble ingredients and cook the meal.
 
She was able to organize an outing, including arranging transportation and destination, planning for the weather and bringing the needed money. She also regained independence to select her clothing, researchers noted.
 
Our findings suggest that using DBS to modulate the brain’s frontal network should be further studied in patients with Alzheimer’s disease to improve their executive and behavioral deficits.
 
Ohio State researchers also want to explore non-surgical methods to stimulate the frontal lobes, which would be a less invasive treatment option to slow down the symptoms of Alzheimer’s disease. 
 
Dr. Douglas Scharre is co-author of the study and director of the Division of Cognitive Neurology at Ohio State’s Wexner Medical Center’s Neurological Institute.
 

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