The success of a recent phase I clinical trial seems to indicate that a brain implant could slow down cognitive decline in Alzheimer's.
In total, the study authors note, about 5.4 million adults live with this condition. It is characterized by progressive memory loss and the impairment of other cognitive functions tied to conducting daily activities.
There is currently no cure for Alzheimer's disease, so treatments focus on managing its symptoms. It is particularly important for people living with this condition to be able to carry out their day-to-day activities for as long as possible, in order to maintain a good quality of life.
A recent clinical trial conducted by specialists at the Ohio State University Wexner Medical Center in Columbus tested the efficiency of implants for deep brain stimulation in helping people with Alzheimer's to keep living independently for longer.
Dr. Douglas Scharre and colleagues' method requires implanting very thin electrical wires into the brain's frontal lobes, which are associated with working memory and executive functioning, which makes that area of the brain crucial in decision-making.
Electrical signals are emitted through the implanted wires so as to stimulate the relevant brain networks. The electric pulsations are controlled by a device implanted in the chest.
"The frontal lobes are responsible for our abilities to solve problems, organize and plan, and utilize good judgments," explains Dr. Scharre.
"By stimulating this region of the brain, the Alzheimer's subjects' cognitive and daily functional abilities as a whole declined more slowly than Alzheimer's patients' in a matched comparison group not being treated with [deep brain stimulation]."
Dr. Douglas Scharre
This marks the first time that a deep brain stimulation device has been used in the treatment of Alzheimer's disease, and the results of the non-randomized phase I clinical trial have been published in the Journal of Alzheimer's Disease.
A new therapy to improve quality of life
The researchers recruited three individuals diagnosed with Alzheimer's disease who agreed to have the deep brain stimulation wires implanted, in the hope that the deterioration of their cognitive functions would be slowed down.
As Dr. Scharre explains, "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."
"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," he adds.
After conducting a promising pilot study — which indicated that deep brain stimulation of the frontal lobes could slow down the decline of functional abilities among people diagnosed with Alzheimer's — Dr. Scharre teamed up with Dr. Ali Rezai, who was formerly based at Ohio State University but who is now at the Rockefeller Neuroscience Institute at West Virginia University in Morgantown.
Dr. Rezai specializes in neuromodulation — that is, the technique of stimulating various neural areas in order to regulate or improve their function.
"Alzheimer's and dementias are devastating diseases affecting patients and their families. It is crucial to explore new options to help improve function, daily care, and quality of life for these patients," says Dr. Rezai, explaining the motivation behind the research.
Encouragingly, all three participants who volunteered to have the devices implanted experienced a significant improvement of the disease symptoms.
One participant, a woman aged 85, had been unable to successfully engage in certain daily activities — such as preparing her own meals — prior to this intervention.
Following a period of 2 years during which she received deep brain stimulation, the participant was able to take initiative in planning and preparing simple meals, organizing outings, bringing an appropriate sum of money if going out, and choosing which clothes to wear according to the weather. In short, she was able to regain her independence in many aspects of her life.
Her husband, happy with this progress, notes that she "has had Alzheimer's disease longer than anybody else [he] know[s]," which is "really a positive thing because it shows that we're doing something right."
The next step for the researchers will be to look into less invasive, non-surgical ways of applying deep brain stimulation, so as to make access to this treatment easier for people living with Alzheimer's disease.
Below, you can watch a video in which one of the couples involved with the current clinical trial share their story.