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Alzheimer’s disease is the sixth leading cause of death in the United States and it kills more than the combined deaths from breast and prostate cancers because of the lack of a cure. Current treatment options are only slowing down the symptoms like one experimental treatment from the Ohio State University that involves brain implants or deep brain stimulation. But what are the significant risks of deep brain stimulation?
The experimental treatment uses deep brain stimulation, a neurosurgical procedure involving the implantation of a neurostimulator. The neurostimulator developed by the researchers at The Ohio State University Wexner Medical Center is made of thin electrical wires, which are designed to be implanted into the brain’s frontal lobe. The frontal lobe has four parts responsible for attention, memory, motivation, motor skills, and more.
“We have many 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,” said Dr. Douglas Scharre, a co-author of the study and the Director of the Division of Cognitive Neurology at Neurological Institute of Wexner Medical Center at OSU.
Symptoms of AD appear slowly as the disease progresses. Early signs of AD are associated with memory, such as forgetting about recent conversations or events, forgetting names of places and objects, having problems thinking about the right word, expressing a poor sense of judgment, finding it difficult to make a decision, and becoming less flexible.
When the disease advances, several new symptoms start to develop including confusion and disorientation, impulsive and obsessive behavior, sleep disturbances, mood swings with signs of anxiety and depression, and hallucinations. A person suffering an advanced stage of AD requires assistance in performing daily tasks and someone to take care of their needs like hunger, thirst, and hygiene.
In the late stage, Alzheimer’s disease can cause difficulty in eating and swallowing, difficulty in moving around, significant weight loss, incontinence, loss of speech, and problems in both short-term and long-term memory. People with the late-stage AD cannot be left alone as they need full-time assistance and care.
The implants made by the researchers are intended to slow down the decline in problem-solving and decision-making in AD patients. One of the three participants, an 85-year-old woman from Delaware, suffered from organizational and planning skills prior to joining the clinical trial. But after the surgery, she was able to prepare meals, organize outing, and plan ahead according to weather
Deep brain stimulation is also used in other medical conditions, such as Parkinson’s disease, dystonia, and Meige syndrome. The procedure is also known to be effective in treating essential tremor nerve disorder, reducing the tremor episodes by 80 percent. Success and helpfulness of DBS vary from patient to patient. Some patients suffer from neuropsychiatric side effects of the procedure. Side effects, such as apathy or lack of emotion, hallucinations, hypersexuality, cognitive problems, depression, and euphoria, can be experienced by patients. Recalibration can reverse and correct the side effects. Other potential risks are related to the surgery including:
- Risk of puncturing a blood vessel in the brain. A punctured blood vessel can lead to a cerebrovascular accident or stroke, or a stroke-like syndrome characterized by weakness, sensory loss, visual problems, numbness, and other neurological symptoms.
- Risk of infection to the brain. Infection may occur after the implantation that causes clinicians to administer antibiotics. The common indicator of brain infection is an abscess in the organ that requires immediate medical attention to reduce the risk of complications. The abscess caused by meningitis can be treated with antibiotics, while an abscess larger than two centimeters will need surgery.
- Risk of another surgery due to technical failure. The device may break or malfunction and needs immediate medical intervention for replacement. Prolonging the breakage or malfunction can cause psychiatric effects including memory issues and frequent laughter.
The greatest issue a patient and their family may face with DBS is the device’s failure to deliver the expected benefits. Some patients experience health improvements while others experience additional or severe symptoms. The risks associated with deep brain stimulation are not expressed to discourage patients. The risks express the potential of what may also happen to the patient during and after the surgery, vital information that should be discussed with the patient and the family. Opting for risking brain surgery should carefully be discussed with a neurologist or neurosurgeon.
Researchers at OSU plans create non-surgical applications that can stimulate the frontal lobe of the brain, which are less invasive yet slow down the symptoms of AD.
[메디컬리포트=Ralph Chen 기자]