The “brain pacemaker” that could slow Alzheimer’s decline

Alzheimer’s is the most common cause of neurodegenerative dementia among older adults. Dementia is the loss of cognitive functioning – thinking, remembering, and reasoning – and behavioral abilities to such an extent that it interferes with a person’s daily life and activities. The effects of the disease are devastating for both patients and their families.

While most treatments for Alzheimer’s disease focus on improving memory, researchers at The Ohio State University Wexner Medical Center conducted a study aimed at slowing the decline of problem solving and decision-making skills in these patients. In a medical first, surgeons implanted thin electrical wires into the frontal lobes of the brains of patients with Alzheimer’s disease to determine if using a brain pacemaker could improve cognitive, behavioral, and functional abilities in patients with this form of dementia.

The deep brain stimulation (DBS) implant is similar to a cardiac pacemaker device, except that the pacemaker wires are implanted in the brain rather than the heart: a battery pack in the chest sends electrical currents through the wires.

Figure modified from ShutterStock and Servier Medical Art by Servier, https://smart.servier.com/
Figure modified from ShutterStock and Servier Medical Art by Servier, https://smart.servier.com/

We have a lot of tools and treatments to help Alzheimer’s patients with memory, but we don’t have anything to help them with daily tasks such as making the bed, choosing what to eat and socializing with friends and family” said Dr. Douglas Scharre, co-author of the study and director of the Division of Cognitive Neurology at Ohio State’s Wexner Medical Center. “The frontal lobe is responsible for things like problem solving, organization and good judgment. By stimulating this region of the brain, patients’ cognitive functionality declined more slowly than a typical Alzheimer’s patient”.

All three patients who received DBS tolerated it well and slowed the progression of their symptoms, including LaVonne Moore, 85, of Delaware, Ohio, who was unable to cook meals or dress herself without help before the implant. Three and a half years later, she regained independence to plan outings and select her own clothing, and she’s still able to play her favorite hymns on the piano. Her husband, Tom Moore, 89, says her Alzheimer’s disease has progressed, but more slowly than he expected.

Tom Moore takes care of his wife LaVonne, who has Alzheimer’s disease. An implanted pacemaker that sends electrical stimulation to LaVonne’s brain slowed the progression of her symptoms, allowing her to retain functionality longer. Photo credit: Ohio State University
Tom Moore takes care of his wife LaVonne, who has Alzheimer’s disease. An implanted pacemaker that sends electrical stimulation to LaVonne’s brain slowed the progression of her symptoms, allowing her to retain functionality longer. Photo credit: Ohio State University

CAUTION STILL NEEDED

Dr. Scharre said the pilot study shows promise in enabling Alzheimer’s patients to retain mental function for longer – improving their quality of life. However, experts are rightly prudent in expressing their excitement, as only three participants took part in the study and more research is needed. Dr. Doug Brown, Director of Research and Development at the Alzheimer’s Society, states: “Given that we haven’t had any new treatments for dementia in over a decade it’s encouraging to see techniques from other diseases being tested for dementia. But it will need further more in depth research before we can draw any firm conclusions”.

Prof. Massimo Filippi, Full Professor of Neurology and Director of Neuroimaging Research Unit at the Vita-Salute San Raffaele University, states: “Although the findings of the present study are very preliminary, they are promising as DBS may help lessen clinical symptoms in the lack of a primary prevention of the disease. As neurodegeneration develops gradually and the earliest brain changes occur years, probably decades, before clinical onset of the disease, DBS effect should be explored in subjects at increased risk for the development of Alzheimer’s disease, such as patients with mild cognitive impairment and positive biomarkers suggesting the presence of Alzheimer’s disease pathology.

The researchers now plan to explore non-surgical methods to stimulate the frontal lobe – which would be a less invasive option to slow down the symptoms of Alzheimer’s disease.

Il Prof. Massimo Filippi
Il Prof. Massimo Filippi

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