A research team at Ohio State University’s Wexler Medical Center reports promising results in a recent study on slowing the decline of cognitive skills associated with dementia. The findings appear in the current issue of the Journal of Alzheimer’s Disease.
Currently, there is no such device as a “brain pacemaker,” but the study strongly suggests that such a device may be helpful to Alzheimer’s patients. Dr. Ali Rezai, a prominent neurosurgeon who assisted with the study, notes that a similar approach has been successful in treating Parkinson’s Disease.
The “proof of concept” treatment involved the implantation of thin electrical wires into the frontal lobe of the brain, the region involved in the regulation of behavior. The patients were then subject to deep brain stimulation (DBS). The device works in the same way as a cardiac pacemaker; wires are connected to a pulse generator, which is implanted under the skin. The difference is that the wires are directed to specific areas of the brain rather than the heart.
The study’s lead author, Dr. Douglas Scharre, points out that current treatments for Alzheimer’s medications are designed to work on brain chemicals that regulate memory. The limitation of this approach is that such medications do not address all the consequences of the disease, which affects judgment and the ability to plan ahead. These are the issues that pose the greatest challenge for caregivers.
The new approach is based on a theory that electrical stimulation of key regions of the brain could lead to the formation of new synapses (connections between neurons). Subjects who participated in the study were implanted with the device for an 18 month period. While the treatments did not stop the progression of the disease, DBS did slow the process significantly. One patient actually demonstrated some improvement; the 85-year-old woman was able to regain skills that she had previously lost, including the ability to cook, select clothing and plan for outings. Dr. Rezai says, “Our findings suggest that frontal network modulation to improve executive and behavioral deficits should be further studied in patients with Alzheimer’s.”
While the results of the study give some reason for optimism, Dr. Scharre warns that DBS treatments, were they to become widely available, would not be appropriate for all patients, particularly those who may have other health issues. Study participants reported side effects that included hot flashes, heart palpitations and burning sensations on their skin, although these were mitigated by making adjustments to the electrical current.
Presently, there are no immediate plans to expand the research. The next step will be to create a double-blind study in which patients given DBS are compared to those given a placebo device. The researchers will also be looking for less invasive methods for this kind of treatment.