Deep brain stimulation for dementias.

Document Type

Article

Abstract

OBJECTIVE The aim of this article is to review the authors' and published experience with deep brain stimulation (DBS) therapy for the treatment of patients with Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). METHODS Two targets are current topics of investigation in the treatment of AD and PDD, the fornix and the nucleus basalis of Meynert. The authors reviewed the current published clinical experience with attention to patient selection, biological rationale of therapy, anatomical targeting, and clinical results and adverse events. RESULTS A total of 7 clinical studies treating 57 AD patients and 7 PDD patients have been reported. Serious adverse events were reported in 6 (9%) patients; none resulted in death or disability. Most studies were case reports or Phase 1/2 investigations and were not designed to assess treatment efficacy. Isolated patient experiences demonstrating improved clinical response after DBS have been reported, but no significant or consistent cognitive benefits associated with DBS treatment could be identified across larger patient populations. CONCLUSIONS PDD and AD are complex clinical entities, with investigation of DBS intervention still in an early phase. Recently published studies demonstrate acceptable surgical safety. For future studies to have adequate power to detect meaningful clinical changes, further refinement is needed in patient selection, metrics of clinical response, and optimal stimulation parameters.

Medical Subject Headings

Alzheimer Disease; Basal Nucleus of Meynert; Deep Brain Stimulation; Dementia; Humans; Parkinson Disease; Treatment Outcome

Publication Date

8-1-2018

Publication Title

Neurosurgical focus [electronic resource]

ISSN

1092-0684

Volume

45

Issue

2

First Page

8

Last Page

8

PubMed ID

30064323

Digital Object Identifier (DOI)

10.3171/2018.5.FOCUS18172

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