Deep brain stimulation used to slow down Alzheimer’s associated decline

Researchers have used deep brain stimulation (DBS) to ascertain if the technique can help slow down the decline of problem solving and decision-making skills in three people with Alzheimer’s disease.

Dr Douglas Scharre examines Alzheimer's patient LaVonne Moore

Alzheimer’s disease is an incurable form of degenerative dementia that becomes progressively disabling with loss of memory, cognition and worsening behavioural function, in addition to a gradual loss of independent functioning.

Whilst most treatments for Alzheimer’s disease focus on improving memory, researchers at the Ohio State University Wexner Medical Center aimed their focus at slowing the decline of cognitive and daily functional abilities by surgically implanting electrical wires into the frontal lobes of the brains of patients with the disease.

According to OSU, this is the first use of DBS in Alzheimer's disease in a behavioural regulation brain region target. Findings of the study are published online in the Journal of Alzheimer’s Disease.

“We have many memory aides, 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,” said Dr Douglas Scharre, co-author of the study and director of the Division of Cognitive Neurology at Ohio State’s Wexner Medical Center’s Neurological Institute.

“The frontal lobes are responsible for our abilities to solve problems, organise and plan, and utilise good judgments. By stimulating this region of the brain, the Alzheimer’s subjects’ cognitive and daily functional abilities as a whole declined more slowly than Alzheimer’s patients’ in a matched comparison group not being treated with DBS,” he said.

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, Scharre said.

Scharre collaborated with Dr Ali Rezai, a neurosurgeon who specialises in neuromodulation, to conduct this clinical trial.

“This DBS brain pacemaker technology is commonly used to treat Parkinson’s disease and tremor. Our study findings suggest that modulation of frontal lobe networks by DBS holds promise for improving connectivity, cognitive and functional performance, and should be further studied in Alzheimer’s disease,” said Rezai.

All three study participants showed improvement, including LaVonne Moore, 85, of Delaware, Ohio. After two years of deep-brain stimulation, she could independently initiate preparations of a simple meal, assemble ingredients and cook the meal.

She was able to organise an outing, including arranging transportation and destination, planning for the weather and bringing the needed money. She also regained independence to select her clothing attire, researchers noted.

Next, Ohio State researchers want to explore non-surgical methods to stimulate the frontal lobe, which would be a less invasive treatment option to slow down the symptoms of Alzheimer’s disease.

Commenting on the study, Dr Doug Brown, chief policy and research officer at Alzheimer’s Society, said: “Given that we haven’t had any new treatments for dementia in over a decade, it’s encouraging to see techniques from other diseases being tested for dementia, but it will need further, more in-depth research before we can draw any firm conclusions.”