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Brain Pacemaker: New Hope For People With Dementia

The brain ‘pacemaker’ for Alzheimer's disease is helping patients to perform daily tasks and take care of themselves more independently than before.


 

 

A novel study has for the first time attempted to use deep-brain simulation to counter brain activity related to performing a function in patients of Alzheimer’s disease (AD) the cause of which is still poorly understood. Many previous studies have targeted the parts of brain which are thought to be involved in memory – since memory loss is the key symptom of Alzheimer’s disease (also called Dementia). Most medications and treatments are also focused on improving memory, however, huge change in thinking power and skills of the patients which happens in the course of AD, also needs to be similarly addressed. Since no new Alzheimer’s disease drug has been produced in the last decade or so, this potential innovative treatment offers hope to Alzheimer’s disease patients and to this field.

The study of human memory is still at a very early level but is nevertheless fascinating in whatever we know about it. Human memory is simply data. Memories are stored as microscopic chemical changes at the different connection points between billions of neurons in the human brain. Memory involves all structures and processes that are involved in the storage and subsequent retrieval of information from our brain. A patient suffering from Alzheimer’s disease starts showing signs of loss of short-term memory (e.g. a recent event). This is the most crucial symptom of AD, when information cannot be retrieved from the brain and this is termed as “memory loss”. This loss in retrieving information then affects thinking power and skills and daily functioning.

Alzheimer’s disease: affecting our elderly

Alzheimer’s disease has affected approximately 50 million people at the end of 2017 and this number is expected to cross 130 million by 2050. The elderly population is growing at a faster rate (in both developed and developing countries) because of more population (in developing countries) and overall higher life expectancy worldwide and AD is affecting this ageing population at a fast pace. It’s being estimated that someone in the world is affected by dementia every 3 seconds. Unfortunately, there are no treatments available for AD and there seems to be no cure in sight with many failures seen in the trial of potential drugs leading to pharmaceutical companies to abandon the such trials. Thus, it can be safely stated that development of new medications for Alzheimer’s disease is completely stalled as of end of 2017.

Simulating the brain: the brain pacemaker

This study, published recently in Journal of Alzheimer’s disease has conducted a novel experiment to improve the everyday capabilities and function of AD’s patients unlike most trials conducted earlier for AD have attempted to treat the memory loss exclusively. This technique called “deep brain simulation” has seen to be beneficial on patients of Parkinson’s disease (another neurological condition) and thus urged the researchers to try it for Alzheimer’s disease. There is no iota of doubt that Alzheimer’s disease is a very devastating condition which affects patients adversely and also their near and dear ones. Researchers feel that this new discovery may not be able to completely cure Alzheimer’s disease but can surely provide mental strength to patients to carry out most daily functional tasks on their own, be more independent with reduced help from the caregiver.

The deep brain simulation (device is called the ‘brain pacemaker’) is thought to affect the interaction of neurons in the brain thus affecting brain activity and involves implantation of small, thin electrical wires into the patient’s frontal lobe — a part of the brain associated with "executive functions”. These wires are connected to a battery pack which sends electrical impulses into the brain. The device continuously stimulates the frontal lobe in the brain, very similar to a cardiac pacemaker which stimulates the heart. The brain pacemaker basically increases “brain metabolism” in certain areas and increases the connection between neurons thus facilitating what is known as “functional connectivity”. This connectivity is thought to decrease steadily over the course of Alzheimer’s disease thus leading to decline in decision making and problem-solving skills.

The study led by Dr. Douglas Scharre at the Ohio State University Wexner Medical Centre, USA claims that the “brain pacemaker” can help patients to improve their judgments, be able to make sound decisions, increase their ability to focus on a particular daily task and avoid mental distractions. The researchers highlight the increased ability to do simple daily tasks like making the bed, choosing what to eat and well-meaning social interactions with family and friends. The main goal of the researchers was to slow down the progression of Alzheimer’s disease with a safe and stable device.

Impact of brain pacemaker on the future of Alzheimer’s disease’s treatment

This study still needs to accepted with caution since the study was done on only three patients, though the results were seen after a good duration of 2 years and these three participants were compared with a set of 100 other participants who had similar age and Alzheimer’s disease symptom levels but did not get the brain pacemaker implanted. Two among these three patients showed progress and included 85-year-old LaVonne Moore of Delaware, Ohio who showed great improvement in functional independence in daily tasks like cooking, getting dressed and planning outings. There was considerable improvement in many areas including decision-making, problem-solving, planning and focus and she expressed satisfactory outcome.

Though at a very elementary stage, this study nevertheless has generated encouragement for researchers in the Alzheimer’s disease field and also hope for millions of patients worldwide. It is quite clear the tackling Alzheimer’s disease will require more such multitude approaches which cover various features of this disease and its extremely important to lay emphasis on the overall quality of life of patients. Since, no new treatments have been discovered for AD in the past 10 years and also clinical trials are also stalled for any new AD drugs, such alternative approaches to treatment must be continued to be further researched upon to draw steady conclusions about how such treatments could work on an ensemble of patients.

Also, a larger multi-centre trial would be needed to be able to get more participants to evaluate the extent of this study. The authors maintain that a section of Alzheimer’s disease’s patients may benefit from the brain pacemaker, some others may not because every patients’ neurons will respond differently and some may not respond at all. So, a larger and more comprehensive trial will reveal a clearer picture. Nevertheless, such a device would definitely slow the progress of Alzheimer’s disease in most patients translating into an improved everyday functioning.

Source:

Scharre, DW et al. 2018, ‘Deep Brain Stimulation of Frontal Lobe Networks to Treat Alzheimer's Disease’, Journal of Alzheimers Disease, vol. 62, no. 2, DOI: https://doi.org/10.3233/JAD-170082

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Vol.1 Issue 2 February 2018

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