Declining or loss of memory has always been the talk of the town. Efforts are made to strengthen memory and to prevent age-related memory changes, but there is more to the brain besides memory.
Only a few talk about the other executive functions of the brain, including the capacity to solve problems, the wisdom to make decisions, and the attentional control.
Patients with neurocognitive disorders like Parkinson’s disease, Alzheimer’s disease, epilepsy, etc. may have their executive functions compromised. Such patients benefit from deep brain stimulation, also called the implantation of brain pacemaker.
Just as the pacemaker in the heart compensates for the lost electrical activity, a similar pacemaker-like device can stimulate the nervous tissue with electrical signals.
Dr. Douglas Scharre, the co-author of the study published in the Journal of Alzheimer’s Disease on patients with DBS implant and the director of the Division of Cognitive Neurology at Ohio State’s Wexner Medical Center’s Neurological Institute, said:
“We have many memory aides, tools and pharmaceutical treatments to help Alzheimer’s patients with memory, but we don’t have anything to help with improving their judgments, making good decisions, or increasing their ability to selectively focus attention on the task at hand and avoid distractions, these skills are necessary for performing daily tasks such as making the bed, choosing what to eat and having meaningful socializing with friends and family.”
How does DBS work?
DBS system includes a neurotransmitter to be placed beneath the skin of the chest, programmed to create electrical impulse; a lead with electrodes to be placed inside the areas of the brain passing through a hole in the skull; and extension wire that connects the above two from scalp to chest.
As shown in the image above, pulse stimulator is the neurotransmitter for generating continuous electrical impulses, an extension wire originating from the transmitter passes beneath the skin, behind the ear to the scalp, and within the skull to connect the transmitter to the electrodes. This system is meant to correct abnormal brain activity in patients with neurocognitive disorders.
Unlike the surgeries done for neurocognitive disorders, like pallidotomy, both the patient and the physician can control/program the DBS externally. After being implanted, the patient has a handheld controller to switch the device on or off. The concerned physician can program its electrical activity via a wireless device, giving the physician opportunity to modify the programming according to the patient’s status.
Has the DBS system proven to be successful?
As Dr. Nader Pouratian, the director of UCLA’s Neurosurgical Movement Disorders Program said:
“We have excellent large, long-term studies showing that overall, those who are candidates for the surgery experienced significant improvement in their quality of life, well beyond what patients receive from the available medications. This is not a cure, but it’s quite clear that patients spend much more of their day in a better condition — able to participate in many more activities and to enjoy their lives more.”
DBS implantation surely improves the quality of life, but it is still an invasive procedure. The medical world is accelerating faster than ever towards non-invasive approaches. Therefore, the researchers, in the future, hope to come up with the nonsurgical methods of stimulating the brain.
The new non-invasive technique with similar functions, called temporal interference (TI) stimulation, is carving its path to reach the human brain in the foreseeable future.