Sometimes the smallest things can make the biggest difference – literally. And while it sounds like something out of a science-fiction novel, it’s possible that, in the future, a tiny chip will make a huge difference in the lives of individuals with Alzheimer’s disease and other dementias.
A recent study done by researchers at Ohio State University has shown that deep brain stimulation can be used to help slow the decline of decision-making and problem-solving skills in people living with dementias, specifically Alzheimer’s disease.
“This study is very exciting because of how the researchers approached the problem,” says Matthew Sarnelli, Executive Director at YourLife™ of Palm Beach Gardens of YourLife™ of Palm Beach Gardens. “Instead of focusing on one specific dementia system, such as memory loss, the treatment focused on improving the function of a specific part of the brain. Even though many people believe dementia to be a ‘memory disease,” it’s actually much more than that. Alzheimer’s disease and other related dementias are fundamentally diseases of the brain, and by taking that approach to treatment, we may be able to affect not just memory loss but also other functions like planning, focused attention, problem solving, organization, decision making and more.”
What Is Deep Brain Stimulation?
Deep Brain Stimulation (DBS) has been used for many years to treat disorders such as major depression, obsessive-compulsive disorder, Parkinson’s disease, chronic pain and others. The procedure works by surgically implanting a neurostimulator (also known colloquially as a ‘brain pacemaker’) directly into the brain. This ‘pacemaker’ then sends electrical impulses to specific targets.
While the reason why DBS works is still unclear, what is clear is that it has significant therapeutic benefits for many disorders that are otherwise resistant to treatment. Scientists speculate that the electrical impulses somehow cause brain cells to work better, or they help to block signals that are interfering with normal brain function. Regardless of the hows and whys, DBS has been shown to directly change brain activity in a controlled manner, and it also has the added benefit of being reversible (unlike other brain treatments that change the physical makeup of the brain).
The Ohio State University study, which was published January 2018 in the Journal of Alzheimer’s Disease, was undertaken to evaluate how DBS would work in the frontal lobe of Alzheimer’s patients and to determine how safe the treatment would be. Previous studies to determine the effect of DBS on memory problems have produced mixed results, making the Ohio State study groundbreaking for two major reasons: first, this was the only use of DBS to treat dementias via a specific targeted brain region; and second, it treated a part of the brain that affects activities of daily life, which the Ohio State researchers felt was a rarely studied dimension of Alzheimer’s.
“We have many memory aides, 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,” wrote study co-author Dr. Douglas Scharre, Director of the Division of Cognitive Neurology at Ohio State’s Wexner Medical Center’s Neurological Institute. “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.”
In the study, scientists implanted neurostimulator devices in the frontal lobes of three patients with Alzheimer’s disease. The frontal lobe is considered to be part of the brain that deals with “executive functions” such as judgement, problem-solving, planning and attention, all functions that are greatly affected by Alzheimer’s disease and dementia. A group of approximately 100 Alzheimer’s patients without DBS served as a control.
Each of the three participants had brain examinations at the beginning of the study, along with tests that measured their mental skills and abilities. Over the next 24 months, researchers adjusted and fine-tuned the devices and measured how the participants’ symptoms progressed. At the end of the study, researchers found that the DBS patients had less of a decline in their executive functions compared to the control group.
Implications & Future Research
While this is exciting news, researchers are cautioning that more intensive studies will need to be done with larger groups of patients. It’s also important to note that DBS is not slowing down or reversing the effects of Alzheimer’s disease; rather, it’s a treatment to target specific symptoms that affect daily activities.
Researchers believe that focusing on these symptoms may be a more realistic and effective goal than reversing or slowing memory loss, because by the time an individual has been diagnosed with Alzheimer’s disease, memory cells are often already greatly compromised or destroyed. While the brain’s frontal part is also affected, this happens later on in the disease progression, which means a treatment such as this may be able to intervene in time to help protect those abilities and improve an individual’s quality of life.
Future research will be focused on stimulating the frontal lobe through nonsurgical methods to see if there are less-invasive treatments that could be as effective or used in conjunction with DBS. Since Alzheimer’s disease and dementias are complicated diseases, a comprehensive approach will require multiple treatments that also include medication and other preventative measures.
While it is too early to request this treatment for yourself or your loved one from your doctor, there are opportunities to test new procedures by taking part in research studies. For those interested in taking part in these studies and clinical trials, please visit the Alzheimer’s Association’s Trial Match: https://www.alz.org/research/clinical_trials/find_clinical_trials_trialmatch.asp
For more information on new and innovative treatments for Alzheimer’s disease, dementia and other memory issues, as well as how we can provide a safe, fulfilling life for you or a loved one, please contact our team at YourLife™ of Palm Beach Gardens at 561-246-6102.
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