Deep brain stimulation could help with Alzheimer’s
Published: Thursday, December 27, 2012 at 12:19 p.m.
Last Modified: Thursday, December 27, 2012 at 12:19 p.m.
Dr. Kelly Foote, a neurosurgeon at the University of Florida and Shands, has started giving people a different answer when they ask him if deep brain stimulation could benefit Alzheimer's disease patients. Now he says "maybe," instead of a flat-out "no."
Foote's revised opinion is based on potentially compelling evidence: Recently, his colleagues at Johns Hopkins performed the first DBS procedure in an Alzheimer's patient, as part of a multicenter clinical trial in which UF is participating.
"What we're doing is fundamentally exciting," Foote said, adding that using DBS in Alzheimer's patients opens the door to using it in patients with other neuro-degenerative disorders caused in part by the atrophy, or shrinkage, of a neural network inside the brain.
With Alzheimer's, patients' hippocampus, the memory and learning center, gets smaller as the metabolic activity controlling its circuitry declines.
DBS appears to increase the metabolic activity of that circuitry. A preliminary study of 6 patients who underwent the procedure in Canada showed promising results in 2010. Scientists discovered the potential for DBS in Alzheimer's accidentally: Researchers thought they could treat morbid obesity by stimulating the brain's hunger center, which is also located in the hippocampus. That didn't work, but the patient on whom they tried described vivid memories from his past when his brain was stimulated.
DBS as a procedure is not new: Doctors have used it to treat patients with Parkinson's disease, dystonia, obsessive compulsive disorder and even depression — and Foote and neurologist Michael Okun, the directors of UF's Center for Movement Disorders and Neurorestoration, have been at the forefront of those advances.
The way DBS works is that doctors drill a hole in the skull and then place a lead that delivers electric current to the part of the brain they want to stimulate — in this case, the fornix, a bundle of neurons that carries signals to and from the hippocampus. Doctors then place a pulse generator below the patient's clavicle programmed to deliver the electric current to the brain through the lead.
To benefit from DBS, patients have to be newly diagnosed — before the disease has done too much damage.
Okun is also careful to point out that DBS is not a cure for the disease but could treat symptoms.
Kristine Crane is a Gainesville Sun staff writer.