Stimulate or degenerate: deep brain stimulation of the nucleus basalis Meynert in Alzheimer dementia

Abstract

Objective: Deep brain stimulation (DBS) is a therapeutically effective neurosurgical method originally applied in movement disorders. Over time, the application of DBS has increasingly been considered as a therapeutic option for several neuropsychiatric disorders, including Gilles de la Tourette syndrome, obsessive compulsive disorder, major depression and addiction. Latest research suggests beneficial effects of DBS in Alzheimer dementia (AD). Because of the high prevalence and the considerable burden of the disease, we endeavored to discuss and reveal the challenges of DBS in AD.

Methods: Recent literature on the pathophysiology of AD, including translational data and human studies, has been studied to generate a fundamental hypothesis regarding the effects of electrical stimulation on cognition and to facilitate our ongoing pilot study regarding DBS of the nucleus basalis Meynert (NBM) in patients with AD.

Results: It is hypothesized that DBS in the nucleus basalis Meynert could probably improve or at least stabilize memory and cognitive functioning in patients with AD by facilitating neural oscillations and by enhancing the synthesis of nerve growth factors.

Conclusions: Considering the large number of patients suffering from AD, there is a great need for novel and effective treatment methods. Our research provides insights into the theoretical background of DBS in AD. Providing that our hypothesis will be validated by our ongoing pilot study, DBS could be an opportunity in the treatment of AD.

Keywords: ACh; AD; Acetylcholine; Alzheimer dementia; Alzheimer disease; BFA; BFCN; Basal forebrain area; Basal forebrain cholinergic neurons; DBS; Deep brain stimulation; Deep-brain stimulation; MCI; Mild cognitive impairment; NBM; NGF; Nerve growth factor; Nucleus basalis Meynert.