In an Ohio State University study, patients with Alzheimer’s disease showed promising responses to a deep-brain-stimulation (DBS) device, sometimes called a “brain pacemaker,” that was implanted in their frontal lobe. The three subjects experienced a slowing down of the decline in their executive functioning and daily life-skills, compared to others with similar disease progression who did not have the device. While DBS has previously been tested with Alzheimer’s patients specifically to improve their memory, this is the first time it has been used in an effort to boost executive function.
Executive brain functions include sustaining attention, solving problems, making plans and forming judgements. These skills are needed to perform daily self-care tasks and participate in social interactions. Alzheimer’s patients typically experience a decline in these functions along with significant memory loss. In an effort to stimulate the frontal lobe, which is associated with these mental abilities, the DBS device was implanted into an area of the lobe known as the ventral striatum. The “brain pacemaker” is made of thin wires and a battery that can send electrical impulses into the brain.
"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," Co-author Dr. Douglas Scharre, director of the Division of Cognitive Neurology at Ohio State's Wexner Medical Center's Neurological Institute, said. He added that these executive functions are essential to routine activities such as selecting meals, cleaning up a home or spending time with loved ones.
The three patients in the study were given DBS for a minimum of 18 months. They were repeatedly given cognitive function tests at set intervals. These DBS participants were found to show less of a decline in their scores than about 100 individuals of similar age who were also experiencing impairment from Alzheimer’s and who didn’t have DBS.
All three patients showed a lower level of cognitive decline. They also completed the study “without significant adverse effects,” the abstract explains. Two of the subjects showed a significantly and “meaningfully” lower rate of decline in cognitive function. One 85-year-old even showed an improvement in daily life skills and decision making ability; she was able to progress from not cooking for herself to making her own simple meals.
Because this was such a small study, it should now be run with larger groups, Neurosurgeon Michael Schulder of North Shore University Hospital, who was not involved with this research, said. He explained that DBS, which has also been used to treat other neurological conditions, works in somewhat mysterious and unknown ways – it may help brain cells function or block signals that keep them from working normally.
“Frontal network modulation to improve executive and behavioral deficits should be furthered studied in [Alzheimer’s disease],” the study’s authors conclude.
“Deep Brain Stimulation of Frontal Lobe Networks to Treat Alzheimer’s Disease,” was published in the Journal of Alzheimer's Disease Jan. 30, 2018.
