The first patient has been recruited into a ground breaking interventional study using Deep Brain Stimulation to improve cognitive deficits in patients with a form of dementia called Dementia with Lewy Bodies (DLB).
In contrast to Alzheimer’s disease, DLB is characterised by fluctuations in cognitive ability as well as Parkinsonism (a movement disorder) and visual hallucinations.
The research team funded by the NIHR Queen Square Dementia Biomedical Research Unit twill test whether using Deep Brain Stimulation, which involves implanting leads with electrodes at the end into target sites in the brain, can improve cognitive impairments associated with DLB.
Principal Investigator Dr Tom Foltynie said: “DLB is characterised by a fluctuation in ‘good and bad days’, which clinically is of interest as it means on a good day things aren’t too bad. This means that the ‘hard wiring’ might still be okay and that there is a ‘software’ problem on the bad days. This is where we think we can intervene and boost this failing system with electrical stimulation via Deep Brain Stimulation.”
Patients with DLB have reduced amounts of the chemical ‘acetylcholine’, and this reduction causes disruption of perception, thinking and behaviour. Acetylcholine acts as a neurotransmitter and comes from an area at the base of the brain called the ‘nucleus basalis of Meynert’. It is this nucleus which is degenerating in DLB – although nerve fibres may still be intact they are not pumping out as much acetylcholine and stimulating the cortex as they do in normal health.
Dr Foltynie said: “We know that if you lose the acetylcholine nerve cells from the nucleus basalis of Meynert memory problems will follow. We also know that if this area is stimulated, it can boost memory function. This makes us think that this is the localized region which is responsible for the deficits we see in DLB patients. Low frequency stimulation will hopefully induce these cells to pump out a little more acetylcholine than they may otherwise have been doing.”
The team plan to recruit six patients into this initial study to learn more about the performance of the nucleus basalis of Meynert within neurodegenerative disease.
Dr Foltynie said: “This study may give us a clue as to what kind of patient or what kind of symptoms might be helped by nucleus basalis of Meynert Deep Brain Stimulation to then inform a future study that could be properly powered”.
