Julia Scaramal Mello , Gabriela Ilias Bechara , Paulo Henrique Pires de Aguiar
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The goal is to perform a systematic review with meta-analysis to determine whether DBS is effective as a treatment for Alzheimer's disease based on the available literature.</div></div><div><h3>Methods</h3><div>The search was conducted in PubMed, Cochrane, and EMBASE using the terms \"DBS\" AND \"Alzheimer's disease.\" Articles were included if they met the eligibility criteria: they had to have been published within the last 13 years, be written in English, and discuss both DBS and Alzheimer's disease. Case reports and animal studies were excluded.</div></div><div><h3>Results</h3><div>8 articles were included after an independent review by 2 reviewers. Data extraction and analysis indicated that patients with mild AD showed less worsening on the ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale) following DBS. The most studied DBS targets were the fornix, followed by the nucleus basalis of Meynert and the ventral capsule/ventral striatum. Additionally, some studies reported improved local metabolism as shown by PET imaging. For the meta-analysis, the change from baseline for the ADAS-Cog scale shows no significant difference in correlation values (5.28 scores) and the studies exhibit heterogeneity. Regarding the MMSE scale, the analysis revealed was - 1.0 (95 % CI − 2.54 to 0.53; I² = 0 %), indicating that DBS, over one year of stimulation, delayed the progression of Alzheimer’s disease on that scale.</div></div><div><h3>Conclusion</h3><div>Preliminary findings suggest that DBS may be effective in treating AD, but more homogenous studies must be conducted to confirm its effectiveness.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"8 ","pages":"Pages 15-19"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of DBS as a treatment for Alzheimer’s disease: Meta-analysis\",\"authors\":\"Julia Scaramal Mello , Gabriela Ilias Bechara , Paulo Henrique Pires de Aguiar\",\"doi\":\"10.1016/j.jdbs.2025.01.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Alzheimer's disease (AD) currently lacks a successful treatment despite being one of the most costly forms of dementia. Deep brain stimulation (DBS) has been used for over three decades as a key treatment for diseases such as Parkinson's due to the neuromodulation achieved by targeting specific brain areas. The hypothesis shows that DBS can modify pathological pathways by modulating local neuronal activity. Consequently, some studies have investigated the effectiveness of DBS as a treatment for Alzheimer's disease. The goal is to perform a systematic review with meta-analysis to determine whether DBS is effective as a treatment for Alzheimer's disease based on the available literature.</div></div><div><h3>Methods</h3><div>The search was conducted in PubMed, Cochrane, and EMBASE using the terms \\\"DBS\\\" AND \\\"Alzheimer's disease.\\\" Articles were included if they met the eligibility criteria: they had to have been published within the last 13 years, be written in English, and discuss both DBS and Alzheimer's disease. Case reports and animal studies were excluded.</div></div><div><h3>Results</h3><div>8 articles were included after an independent review by 2 reviewers. Data extraction and analysis indicated that patients with mild AD showed less worsening on the ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale) following DBS. The most studied DBS targets were the fornix, followed by the nucleus basalis of Meynert and the ventral capsule/ventral striatum. Additionally, some studies reported improved local metabolism as shown by PET imaging. For the meta-analysis, the change from baseline for the ADAS-Cog scale shows no significant difference in correlation values (5.28 scores) and the studies exhibit heterogeneity. Regarding the MMSE scale, the analysis revealed was - 1.0 (95 % CI − 2.54 to 0.53; I² = 0 %), indicating that DBS, over one year of stimulation, delayed the progression of Alzheimer’s disease on that scale.</div></div><div><h3>Conclusion</h3><div>Preliminary findings suggest that DBS may be effective in treating AD, but more homogenous studies must be conducted to confirm its effectiveness.</div></div>\",\"PeriodicalId\":100359,\"journal\":{\"name\":\"Deep Brain Stimulation\",\"volume\":\"8 \",\"pages\":\"Pages 15-19\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Deep Brain Stimulation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2949669125000016\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Deep Brain Stimulation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2949669125000016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
尽管阿尔茨海默病（AD）是最昂贵的痴呆症之一，但目前尚无成功的治疗方法。脑深部刺激（DBS）作为帕金森病等疾病的关键治疗方法已经使用了30多年，这是由于通过针对特定的大脑区域实现神经调节。该假说表明DBS可以通过调节局部神经元活动来改变病理通路。因此，一些研究调查了DBS作为治疗阿尔茨海默病的有效性。目的是通过荟萃分析进行系统评价，以确定DBS是否有效治疗阿尔茨海默病。方法在PubMed， Cochrane和EMBASE中使用“DBS”和“阿尔茨海默病”进行搜索。符合资格标准的文章被纳入：它们必须在过去13年内发表，用英语写作，并且讨论脑起搏器和阿尔茨海默病。排除病例报告和动物研究。结果8篇文献经2位审稿人独立评审后纳入。数据提取和分析表明，轻度AD患者在DBS后ADAS-cog（阿尔茨海默病评估量表-认知亚量表）的恶化程度较轻。研究最多的DBS靶点是穹窿，其次是Meynert基底核和腹侧被膜/腹侧纹状体。此外，一些研究报道PET成像显示局部代谢改善。对于meta分析，ADAS-Cog量表从基线的变化显示相关值无显著差异（5.28分），研究表现出异质性。关于MMSE量表，分析显示为- 1.0(95 % CI - 2.54至0.53；I²= 0 %)，表明在一年的刺激下，DBS在该尺度上延缓了阿尔茨海默病的进展。结论初步结果提示DBS治疗AD可能有效，但仍需更多的同质性研究来证实其有效性。
Effectiveness of DBS as a treatment for Alzheimer’s disease: Meta-analysis
Introduction
Alzheimer's disease (AD) currently lacks a successful treatment despite being one of the most costly forms of dementia. Deep brain stimulation (DBS) has been used for over three decades as a key treatment for diseases such as Parkinson's due to the neuromodulation achieved by targeting specific brain areas. The hypothesis shows that DBS can modify pathological pathways by modulating local neuronal activity. Consequently, some studies have investigated the effectiveness of DBS as a treatment for Alzheimer's disease. The goal is to perform a systematic review with meta-analysis to determine whether DBS is effective as a treatment for Alzheimer's disease based on the available literature.
Methods
The search was conducted in PubMed, Cochrane, and EMBASE using the terms "DBS" AND "Alzheimer's disease." Articles were included if they met the eligibility criteria: they had to have been published within the last 13 years, be written in English, and discuss both DBS and Alzheimer's disease. Case reports and animal studies were excluded.
Results
8 articles were included after an independent review by 2 reviewers. Data extraction and analysis indicated that patients with mild AD showed less worsening on the ADAS-cog (Alzheimer's Disease Assessment Scale-cognitive subscale) following DBS. The most studied DBS targets were the fornix, followed by the nucleus basalis of Meynert and the ventral capsule/ventral striatum. Additionally, some studies reported improved local metabolism as shown by PET imaging. For the meta-analysis, the change from baseline for the ADAS-Cog scale shows no significant difference in correlation values (5.28 scores) and the studies exhibit heterogeneity. Regarding the MMSE scale, the analysis revealed was - 1.0 (95 % CI − 2.54 to 0.53; I² = 0 %), indicating that DBS, over one year of stimulation, delayed the progression of Alzheimer’s disease on that scale.
Conclusion
Preliminary findings suggest that DBS may be effective in treating AD, but more homogenous studies must be conducted to confirm its effectiveness.
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