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Researchers from the Ohio State University Wexner Medical Center have developed a surgical implant similar to a heart pacemaker which targets Alzheimer’s patients. The deep brain stimulation implant slows the decline of the patient and retains the functionality of the brain longer while improving the quality of life.
The brain pacemaker targeted to slow the decline specifically in problem-solving and decision-making skills of these patients, Science Daily reported. To determine if a DBS could improve the cognitive, behavioral, and functional abilities in patients, the researchers surgically implanted for the first time thin electrical wires into the patient’s frontal lobes.
Dr. Douglas Scharre, the director of the Division of Cognitive Neurology at Ohio State University Wexner Medical Center, noted that there are a lot of memory aids, tools, and pharmaceutical treatments to help Alzheimer’s patients. However, there is none to help improve their judgment, make good decisions, or boost their skills to selectively focus attention on the task at hand and avoid distractions.
He said these skills are needed in performing everyday tasks like making the bed, choosing the food to eat, and having meaningful socializing with family and friends. Scharre explained that the frontal lobes are responsible for human abilities to solve problems, organize and plan, and utilize good judgments.
If that part of the brain is stimulated, the decline in the cognitive and everyday functional abilities of the Alzheimer’s patients, as a whole, declined more slowly compared to groups not implanted with a DBS.
Also for Parkinson’s patients
Dr. Ali Rezai, a neurosurgeon who specializes in neuromodulation and heads the Rockefeller Neuroscience Institute at West Virginia University, has collaborated with Scharre in treating patients with Alzheimer’s and other dementias. He said that DBS has been used successfully to treat over 135,000 Parkinson’s diseases patients worldwide.
According to New Scientist, depending on the current, the wires can boost activity in brain cells that are nearby or reduce it. The wires are used to reduce the excessive firing of discrete clusters of nerve cells that control movement in Parkinson’s disease patients. Because what causes Alzheimer’s is unknown, the disease is a less obvious target for the DBS treatment.
He said that the brain implant which suggested that it will improve the executive and behavioral deficits of Alzheimer’s patients should be studied further. Rezai cited the case of 85-year-old LaVonne Moore of Delaware, Illinois, who joined the study in 2013. At that time, she could not even prepare meals. Two years after deep brain stimulation, Moore could now independently begin preparations of a simple meal, assemble the ingredients, and cook the dish.
Her DBS was implanted three and a half years ago, but since then, her dementia has worsened. But Tom Moore, her husband, noted that the condition has slowed more slowly than he had expected, BBC reported.
Although LaVonne has had the diseases longer than anybody he knows, Moore said it is really more of a positive thing than negative since it shows they were doing something right.
The Journal of Alzheimer’s Disease reported that there were two other patients who have been implanted with the brain pacemaker. However, only one of them appeared to significantly benefit from the DBS.
The three started the study with a score of 4 or 5 on a symptom rating scale from 0 to 18. After two years, their score went up by three points which indicated their condition became slightly worse. However, in another comparison, 96 Alzheimer’s patients who were at a similar age and stage of the disease as the three had scores that went up by six points.
The next step for the Ohio State scientists is to explore non-surgical ways to stimulate the frontal lobe as a less-invasive treatment option that would slow down the symptoms of Alzheimer’s disease. The disease, because it is the most common form of degenerative dementia, has affected more than 5 million Americans. The Alzheimer’s Association estimated that by 2050, the number of Alzheimer’s patients in the US could go up to 16 million.
Professor Andres Lozano, a neurosurgery expert who has been holding DBS trials in Alzheimer’s patients in Canada, said there is a desperate need for a novel treatment for the neurodegenerative ailment. He added that the brain implant seems bold and aggressive to some, but it is promising and studies indicated that the procedure is safe.
Lozano disclosed that they have Parkinson’s disease patients with the brain implant for 30 years with no problem, BBC reported. But he said that he is not talking about treating the degeneration because of Alzheimer’s but looking at changing the downstream consequences by turning parts of the brain back on.
Dr. Carol Routledge, from Alzheimer’s Research UK, said that there was no comparison in the study against a dummy treatment. She said that while signs of benefits are worthy of follow-up, there is a need for more robust investigation in larger trials on the full benefits and cost-effectiveness of the treatment.
[메디컬리포트=Vittorio Hernandez 기자]