Deep Brain Stimulation for Disorders of Memory and Cognition
- 656 Downloads
The next several decades will see an exponential rise in the number of patients with disorders of memory and cognition, and of Alzheimer’s disease in particular. Impending demographic shifts, an absence of effective treatments, and the significant burden these conditions place on patients, caregivers, and society, mean there is an urgent need to develop novel therapies. Deep brain stimulation (DBS) is a neurosurgical procedure that is a standard-of-care for many patients with treatment-refractory Parkinson’s disease, dystonia, and essential tremor. DBS has proven to be an effective means of modulating activity in disrupted motor circuitry, and has shown promise as a modulator of other dysfunctional circuits, including for mood and anxiety disorders. The deficits in Alzheimer’s disease and other disorders of memory and cognition are also beginning to be thought of as arising from dysfunction in neural circuits. Such dysfunction may be amenable to modulation using focal brain stimulation. A global experience is now emerging for the use of DBS for these conditions, targeting key nodes in the memory circuit, including the fornix and nucleus basalis of Meynert. Such work holds promise as a novel therapeutic approach for one of medicine’s most urgent priorities.
KeywordsDeep brain stimulation Alzheimer’s disease Memory Cognition Dementia
- 11.Deep brain stimulation for movement disorders: products and procedures. Available at: http://professional.medtronic.com/pt/neuro/dbs-md/prod/. Accessed March 23, 2014.
- 25.Parent A. Limbic system. In: Parent A (ed.) Carpenter's human neuroanatomy. 9th ed. Williams & Wilkins, Baltimore, MD, 1996, pp. 744-794.Google Scholar
- 28.ADvance DBS-f in Patients With Mild Probable Alzheimer's Disease. Available at: http://clinicaltrials.gov/ct2/show/study/NCT01608061. Accessed March 25, 2014.
- 29.Koubeissi MZ, Kahriman E, Syed TU, Miller J, Durand DM. Low-frequency electrical stimulation of a fiber tract in temporal lobe epilepsy. Ann Neurol 2013 Apr 24 [Epub ahead of print].Google Scholar
- 30.Mesulam MM, Mufson EJ, Levey AI, Wainer BH. Cholinergic innervation of cortex by the basal forebrain: cytochemistry and cortical connections of the septal area, diagonal band nuclei, nucleus basalis (substantia innominata), and hypothalamus in the rhesus monkey. J Comp Neurol 1983;214:170-197.PubMedCrossRefGoogle Scholar
- 36.Birks J. Cholinesterase inhibitors for Alzheimer's disease. Cochrane Database Syst Rev 2006:CD005593.Google Scholar