Deep brain stimulation is a neurosurgical procedure that has been shown to be an effective form of treatment for several disorders, including Parkinson’s disease. A new study found that deep brain stimulation may also be helpful when it comes to treating Alzheimer’s disease and related forms of dementia
Learn more about the treatment method and the groundbreaking new study on brain stimulation.
Deep Brain Stimulation: An Overview
Deep brain stimulation (DBS) is a neurosurgical procedure where electrodes are implanted in certain parts of the brain. These electrodes send electrical impulses to specific parts of the brain to change brain activity. The impulses can regulate abnormal impulses or affect certain cells and chemicals in the brain.
Controlled by a pacemaker-like device under the skin, DBS has been beneficial for a number of disorders including Parkinson’s disease, essential tremor, chronic pain, major depression and obsessive-compulsive disorder.
It is important to note that there are potential serious neuropsychiatric side-effects from deep brain stimulation, which range from apathy to hallucinations and compulsive gambling to hyper-sexuality and depression. These side effects are usually temporary and potentially reversible. Electrodes may also become displaced during surgery causing personality changes, but this can also be fixed and identified through a CT scan.
Using Deep Brain Stimulation to Create New Brain Cells
The study, conducted at the Nanyang Technological University in Singapore, implanted DBS electrodes in rats. The electrodes were programmed to target the ventromedial prefrontal cortex, which is a part of the brain responsible for a higher level of cognitive function. Researchers noticed a significant improvement in the ability of the rats to perform memory tasks after constant stimulation of the ventromedial prefrontal cortex. They also saw new neurons being formed in the brain, compared to the control group.
This groundbreaking result means that new brain cells can be created through DPS, which can improve memory retention. The increase in neurons may also reduce anxiety and depression, commonly felt by people living with varying forms of dementia.
Ajai Vyas, Assistant Professor at NTU’s School of Biological Sciences said:
“The findings from the research clearly show the potential of enhancing the growth of brain cells using deep brain stimulation. Around 60% of patients do not respond to regular anti-depressant treatments and our research opens new doors for more effective treatment options.”
Dr Lim Lee Wei, associate professor at Sunway University Mayalsia and researcher added to the enthusiasm of his colleague stating:
“Memory loss in older people is not only a serious and widespread problem, but signifies a key symptom of dementia. At least one in 10 people aged 60 and above in Singapore suffer from dementia and this breakthrough could pave the way towards improved treatments for patients.”
Did you know that deep brain stimulation could be used to treat dementia? What are your thoughts on it as a treatment for memory loss? Share your thoughts with us in the comments below.
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Please leave your thoughts and comments
By Michael Plontz
A family member has just been diagnosed with an illness that will eventually require round-the-clock care. Of course you want to be the one giving that care. This decision is usually made without hesitation; of course we want to be our loved one’s caregiver. Who else could take better care of them? However, when the reality of your decision sinks in, your head will be swimming with uncertainty, anxiety, and maybe even fear. Certainly you will have many questions. Welcome to Caregiving 101, a primer for first-time caregivers.
First of all, arm yourself with knowledge. An old maxim states that “Knowledge is power,” and it’s true. Knowledge will empower you to take the best care of your loved one and yourself. Learn all that you can about your loved one’s condition, illness or disease. There are local branches of national organizations like the Alzheimer’s Association and the Cancer Society all over the country. Use them as a tool to find out all about your loved one’s present condition and what the future may hold for both of you.
Another reason to learn is to take better care of your loved one. You may educate yourself through health care manuals, books and videos. The Internet is also a good source of information, but navigate carefully through that material because not all of it is valid. Also, ask lots of questions of your health care professionals. They are the best people to show you proper techniques like transferring, lifting and bathing. When you learn all that you can, you will be more confident in your caregiving abilities.
Caregiving can be an isolating experience, so it’s helpful to talk to others who are, or have been, in your shoes. You will feel that you are a part of a growing community of caregivers. You may also learn about options and community resources that you were not aware of from other caregivers. These people can also help with difficult decisions concerning your loved one. Determining your responsibilities will probably be one of the first things you struggle with, so talk to others who’ve been there before.
You must remember to take regular breaks from your caregiving responsibilities. You can’t be good to someone else if you’re not good to yourself. Use your relatives. They can help in several ways—financially, socially, and as respite support. If relatives are unavailable or do not exist, try community services like a volunteer group at your local church. Try and follow these guidelines for caregiving breaks: take half-an-hour a day to practice yoga, meditation, needlepoint, reading, etc.; spend a couple of hours a week away from the house at the mall, coffeehouse, library, etc.; monthly you should have an evening out with friends, go to a play or concert, etc.; on a yearly basis you should go on a well-planned (and well-deserved) vacation. These guidelines will help in avoiding “caregiver burnout.”
Your community most likely has organizations about which you never gave a second thought until now. These may include, but are not limited to, Meals on Wheels, day care centers, and home care agencies. If applicable, contact your local Area Agency on Aging for a list of services and organizations. Your local medical supply store may have gadgets and devices to enhance your loved one’s abilities, at the same time making your life a little easier. You might also inquire about local, state or federal programs that might provide financial aid for you and your loved one. As needs increase, so do costs. Understanding which programs can help and what you can afford, will allow you to plan for the future.
One way to deal with the emotional roller coaster you may experience is to get your feelings down on paper. Some journal entries might address the following subjects: How do you feel now? What are your fears and/or concerns? What outcomes would you like? What losses have you noticed so far? What changes in your relationship with your loved one have cause you to feel sad? What changes have given you comfort? Journaling is a healthy way to put your feelings “out there” and to possibly alleviate some of the anger, frustration and helplessness you may be feeling.
Caregiving need not be a lonely and emotionally debilitating experience. According to the latest statistics on caregiving for the National Family Caregivers Association, nearly half of the U. S. population has a chronic condition. From that number 41 million are limited in their daily activities while 12 million are unable to live independently or even leave the house. One can deduce from these numbers that there are millions of family caregivers out there. So keep in mind that you are not alone, and best of luck to you and your loved one.
Tim, diagnosed with Frontotemporal dementia in 2012, living with HIV
Working in information technology and then for many years as a part of a management team, my career was very important to me. At the end of 2009, however, I realized that I was having trouble focusing on my job, and one day after a lunchtime walk, I felt like I had lost sight in one of my eyes. Thinking it was due to stress, I didn’t tell my partner Ron. I explained it away.
In early 2010, I took a work trip to Denver. During that week I had issues typing and communicating. When I met with my boss to discuss the trip, I had trouble speaking. That’s when I decided to see a doctor. “After talking to you, I think you need to go to ER right now,” he said. I found out that I had had a stroke, and doctors suspected that several mini- strokes had also occurred, which accounted for my vision loss.
Despite having some answers, I didn’t have them all. After returning to work a couple of months later, I was still struggling to do my job, which resulted in my being demoted. In January 2012, I was laid off. Due to all of the anxiety I was experiencing, I started seeing a therapist, who suggested that I make lists of coping strategies, but I never made the connection in my head to actually complete the tasks.
While in therapy, I was also undergoing testing and not sharing the results with Ron. I would come home and say “everything is fine” very nonchalantly. Ron knew everything wasn’t. “Either you are not communicating properly or you are just not telling me something,” he said. From then on Ron accompanied me to my appointments. We learned that the results of the testing indicated that there was a problem, but no conclusive diagnosis. Ron crusaded to find out what was really going on. Eventually, in 2012, after many tests and much anxiety, I was diagnosed with Frontotemporal dementia (FTD), which is caused by progressive cell degeneration that affects the frontal and temporal lobes of the brain.
Ron is my everything. He is my advocate, my only support, and my protector. If it wasn’t for him, I probably would not have received a diagnosis. I don’t even realize how many times a day he helps me make decisions. He’s good at subtly guiding me, as I can get very easily lost in a task. He is always looking out for my best interest. Because of FTD, I don’t have a perception of what repercussions exist due to my actions. I can’t even imagine what my life would be if I did not have him here.
Having been HIV positive for 25+ years, I treat the diagnosis of dementia like HIV; it doesn’t define who I am or what I can do. I don’t let the dual diagnosis control my life. I present myself first – work experience, life experience – and eventually my story unfolds. When I introduced myself to Congressman Cory Booker, I said, “Something you might not know about me is that I was diagnosed with dementia in 2012.” It was amazing how his constitution changed. “I wouldn’t have known,” he replied. It changed his whole perspective.
I tell people who I speak with on Peer-to-Peer Outreach Program calls that they have to look at their diagnosis as a new adventure. (Peer-to-Peer Outreach is a program of the Alzheimer’s Association that connects newly-diagnosed individuals with others living with Alzheimer’s and other dementias via telephone in order to share their experiences.) It’s a new challenge in your life. You will find different ways to accomplish tasks and you will find talents that you never had before. I never used to be able to speak in front of people. Because of my diagnosis, I can now give a speech. I still have challenges, I still have anxiety, but I have been able to do things I couldn’t do before as well.
As a care partner, Ron has a thankless job. I don’t always acknowledge what he does for me. Some doctors have suggested that the word dementia not be used in front of me and I appreciate that Ron is so honest with me about the diagnosis. Individuals living with dementia deserve to have advocates. You need someone who will go to battle for you. Ron does that for me.
I was losing direction and I needed to find a new outlet, so Ron encouraged me to get involved with the Alzheimer’s Association. Being an Early-Stage Advisory Group (ESAG) member has allowed me to let people know that their life is not over – that life is what you make of it. If I had a tagline like the women do on the Real Housewives reality shows, mine would be: “Get to know me first. I am more than my diagnosis.”
Ron, Tim’s care partner
I knew something was wrong long before Tim received a diagnosis. As his advocate, I helped coordinate his medical team and began making plans for the future. We went to an elder care lawyer (who was very helpful) and sold our home that we spent 10 years renovating .A lot of people wait too long to plan. The sooner you do that the better.
Dementia happened to Tim much earlier than it does for most. He was hoping to work up to 15 more years, build funds for retirement and travel. We moved from the suburbs to a 55+ community, and we live a very different life here. Tim and I have attended support groups through the Alzheimer’s Association, but I have also found support in our community by connecting with other caregivers. While other community members are older and their experiences more varied, their support is still valuable. Almost all of the people that are involved in support groups and services in the community are much older than us and it’s hard to relate to one another. Prepare yourself, because as a care partner, you have to realize it will only become even more intense.
You have to seek out advice. You have to be realistic. It won’t get any better. You have to take advantage of every moment together and celebrate what you have. Your relationship will change greatly. There are times when it’s difficult, and it’s usually little things that push you over the edge. You get by, but it’s very difficult. It is very hard to see your loved one diminish in front of you. I love Tim, but he isn’t who he used to be. As a care partner, you sometimes feel like you have the weight of the world on your shoulders.
It is a heavy journey and it is a process, but you do what you can do. It’s not all gloom and doom, but it has been difficult reflecting on the past three years. Neither of us have a career anymore. We had to sell our home and settle into a new place. Amongst all that, we were working on getting Tim’s diagnosis. I lost both of my parents and Tim’s brother and father passed away – we’ve had so much happen. But we don’t give up. You have to make the best of your situation. I want other care partners and caregivers to know that they shouldn’t give up their whole identity. You have to do things for yourself. Our situation is what it is. You have to try and take in every moment you have and hold on to what you can.
As a member of the Alzheimer’s Association 2014 National Early-Stage Advisory Group (ESAG), Tim Kaufman raises awareness of the financial impact of the disease and the value of an accurate and early diagnosis. He also addresses the needs of lesbian, gay, bisexual and transgender (LGBT) individuals living with dementia. Tim and his partner Ron live in Southampton, New Jersey.
Dementia, Alzheimer’s, senility, forgetfulness. All of these words point to an experience. But do they point to the same one? Are they different? Are they the same?
I often hear these words thrown around interchangeably. Here I hope to give some etymological clarity. Aging in America is confusing. By using clear language, I hope we can communicate more effectively about our experiences. Through sharing experiences we also share wisdom to age more playfully.
I work in the field of psychology, which uses the DSM as its diagnostic manual. It is based on this that I will share the different types of dementia, or as it is now clinically called, neurocognitive disorder.
This brings us to our first language issue — dementia or NCD are interchangeable and are overarching terms for all that will follow. Below are all types of dementia or subtypes of NCD.
After someone is determined to be experiencing dementia, a subtype allows the experience to be further defined according to the known or presumed cause as well as the main characteristics, timeline, and symptom set of the dementia.
Knowing a subtype can help give behaviors meaning and offer understanding, as well as offering a way to share best practices for living with dementia. There is a wealth of research on each of these. Below is a very basic overview meant to be used as a starting point of understanding.
1. Alzheimer’s disease — Alzheimer’s is named for the doctor who found the pathologies believed to be the cause. Although the exact cause for the behaviors labeled as Alzheimer’s is still unknown, it is thought to be inherited genetically. Alzheimer’s varies from other dementias in that it’s progression is steady and gradual. For a diagnosis of probable Alzheimer’s (probable because the tangles from which its name is derived can only be verified during a postmortem brain autopsy) there must be a decline in memory, learning and one other domain.
2. Frontal Temporal Dementia (FTD) or Frontotemporal lobar degeneration — This dementia is named for the part of the brain it affects most — the frontal lobe. FTD seems to appear suddenly and then progresses gradually. There is a behavioral and language variant. The behavioral variant is marked by disinhibition and changes in social behavior. The language variant results in a dramatic change in language ranging from speech production to word comprehension.
3. Lewy Body Disease — This type is also named for its assumptive cause — lewy bodies in the brain. Those with Lewy Body disease experience fluctuating cognition levels. This disease is also marked by detailed visual hallucinations. These hallucinations are not psychosis. Unfortunately, antipsychotics are often given to treat these hallucinations. These drugs are contraindicated or not recommended for people with a Lewy Body diagnosis and can make symptoms worsen. Lewy Body also has features of parkinsonism. There are more physical changes associated with Lewy Body than other dementias.
The remaining types are named for their cause; their exact symptoms vary based on the area of the brain which was damaged and how extensive the damage is.
4. NCD due to vascular disease — The onset usually coincides with a cerebrovascular event — a disruption of blood supply to the brain, such as a stoke.
5. NCD due to traumatic brain injury — There must be evidence of an injury to the brain such as an impact to the head, either at a single moment or repeated over time such as multiple concussions from playing a contact sport.
6. Substance or medication induced — Damage has been done to the brain through the use of substances or medication. The symptoms remain after usual duration of intoxication or withdrawal.
7. Due to HIV infection — There is evidence of HIV infection and the dementia is not better attributed to another type.
8. Due to Prion disease — There is evidence of prion disease as well as rapid progression of NCD symptoms.
9. Due to Parkinson’s Disease — Parkinson’s is present before the NCD.
10. Due to Huntington’s Disease — Huntington’s is diagnosed before NCD, or there is family history or genetic testing to support the diagnosis.
In addition to these 10 types there are also the diagnoses of “NCD due to another medical condition” as well as “NCD due to multiple etiologies,” meaning that more than one of these types are present at the same time.
Every person is unique and so is their experience of dementia.
Understanding these broad categories can help us to share experiences and find helpful resources. Only a medical doctor or licensed mental health professional can offer a diagnosis. These same people can be very helpful in connecting you to local resources such as support groups, therapeutics, educational programs and medical resources.