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    • CommentAuthorjav*
    • CommentTimeMay 31st 2008
     
    does anyone have any information on the electric shock treatment [deep brain stimulation] that can possibly help ad? my brother in law had heard about it and told me. this treatment was used on an obese man to try to treat his obesity and it seems it helped his memory to the point of him recalling an incident from 20 yrs earlier in vivid detail. the articial i read said it had been used on some ad patients and was promising. i have not heard of this before,but it seems like it would be something to look into. jav
    • CommentAuthorJane*
    • CommentTimeJun 1st 2008
     
    jav, I doubt very much that you could even get a Doctor to consider this for an Alzheimer patient. This is a very serious procedure. In fact I would not subject my own husband to this even if he were in the earlier stages of the disease.

    You can find some Doctors that would try anything. Maybe this man was so obese it was a threat to his life etc. But absolutely not for an Alzheimer patient. With the Electric Shock the patient will lose the short term memory for several weeks after the treatment. No good for what you need. Do not listen to every little test that someone tells you about.

    Jane
    • CommentAuthorfrand*
    • CommentTimeJun 1st 2008
     
    I don't know why I'm even willing to talk about this - in my 30's I was severly depressed and received shock treatment. Even now I have a lot of holes in my memory of my life to that point and wonder if those treatments were the cause. I can't even imagine why it would be used for AD.
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      CommentAuthorchris r*
    • CommentTimeJun 1st 2008
     
    My stopson had elec shock treatments when he was hospitalized many years ago for depression. I didn't think they still did that. He remembers it as being horrible, and still blames his father (my DH) for allowing it (altho in those days you trusted the doc). I would not do it with my DH now. I could lose what little life we have, and it could change personality.
    • CommentAuthoringe
    • CommentTimeJun 1st 2008
     
    Jav,
    I saw a program not so long ago that showed deep brain stimulation as a trial with Alzheimer patients. It is in the very early experimental stages and I believe it is something totally different from electro convulsive treatment which is used for severe depression. It is a nasty treatment used often as a last resort when drugs don't help and I can't see it used for AD.
  1.  
    I have a nurse friend who suffers from deep depression. She hates ECT but it has saved her sanity. It is not done the old horrible way. She is sedated and the "convulsions" are mild. However I don't see it being used for AD. It does cause short term memory deficits-so why make a bad thing worse.
    • CommentAuthorSunshyne
    • CommentTimeJun 1st 2008 edited
     
    Actually, electroconvulsive therapy (used to treat severe depression) is considered a valid treatment for AD patients with agitation and aggression that do not respond to conventional meds. There was a thread on this subject on the Alz Assn web site back in January.

    "just exhibit love" says that ECT is used almost every day where she works, for treating depression. Apparently, the way the treatment is done now is vastly different from the way it used to be done.

    That said, I wondered if "deep brain stimulation" is the same thing as ECT. I used Google Scholar to look up "deep brain stimulation" and AD, and got 764 hits in just the past two years (2006-2008). "electroconvulsive" and AD produced almost as many (704) but they were NOT the same papers. So then I tried searching for references that included both ECT and deep brain stimulation, and only got 87 hits -- so there was very little overlap. Several of the papers I glanced through compared the use of the two different types of treatment; others discussed one in depth and only mentioned the other.

    DBS is referred to as a "surgical intervention." It is among a series of NEW treatments that treat a very limited region of the brain. I think that electrodes are implanted in a specific region of the brain that is diseased. I had trouble finding full text for many of the scientific papers I located, but a 2006 paper I found (at http://www.psychiatrictimes.com/depression/article/10168/56231 ) describes several different brain stimulation methods. This paper is only on treating depression, but it makes it quite clear that ECT and brain stimulation are definitely different things; and that there are different types of brain stimulation as well, DBS being only one of them. It also says that DBS has been effective in treating depression that did not respond to ECT. "Patients selected for this procedure, both by Mayberg and the few other investigators studying direct subgenual stimulation, are severely and chronically ill and have not responded to any of the available treatment modalities including, in most instances, ECT. Mayberg and colleagues published the results from their first 6 patients in March 2005.9 The report garnered considerable media attention and interest from the medical community-and rightly so. Five of the 6 patients experienced substantial respite from their depressive symptoms, and 4 remained well after 6 months of treatment. Mayberg emphasizes that in the patients who responded, depressive symptoms lifted as soon as the stimulator was turned on. She pointed out that the depression relief had a distinctive quality. One patient reported having a greater sense of awareness of his surroundings, as if a veil had been lifted. Mayberg found it interesting that with subgenual stimulation, "we seem to be not adding something good but removing something bad."

    So then I looked for just the most recent papers on DBS and AD. I found several articles reporting that DBS may actually IMPROVE memory. For example, there was an interesting article on Medscape Today. "Deep Brain Stimulation May Enhance Memory Performance" at http://www.medscape.com/viewarticle/569554

    This appears to be very early stage research, and sometimes (often) things don't pan out as expected. Still, DBS is clearly NOT the same thing as electroshock therapy.

    I found an article that I think jav's brother was referring to -- the improvement in his memory was just something that the doctors tripped over while treating obesity. Other people, however, are seriously researching DBS and other forms of brain stimulation for treating Parkinson's (there are a LOT of those) and more recently, AD.
  2.  
    Some very impressive stuff here, but I do not think I would compare the healthy brain of an obese man whose memory improves after a treatment with the deseased brain of someone with AD. If researchers want to pursue this, I'm all for it, hope something good comes from it, but it would not have been w/my DH and I did some pretty radical stuff.
    • CommentAuthorSunshyne
    • CommentTimeJun 1st 2008
     
    Apparently, DBS is not all that radical. I've been poking around some more, and it seems that DBS has been used for more than a decade to treat a range of conditions including depression, chronic pain, Parkinson's disease and other movement disorders. It was originally developed in France, and first approved by the U.S. FDA as a treatment for tremor in 1997.

    It has been so successful in treating motor problems associated with Parkinson's disease that more than 40,000 patients worldwide rely on DBS. The electrodes are implanted under local anaesthesia while the patient is awake. They are controlled by pacemakers stitched into the patient's chest.

    The same general technique is now being studied for a host of intractable disorders. However, one has to know which areas of the brain might be involved in a particular disorder to try electro-stimulation. For Parkinson's disease, the electrodes are placed in the subthalamic nucleus; for depression, in area 25 of the cingulate cortex.

    What was so very interesting about the attempt to treat morbid obesity is that the region of the brain that was stimulated (the hypothalmus) controls appetite. It is not considered a seat of memory, yet stimulation there had a striking effect on the man's memory.

    Anyway, DBS is in the earliest stages of testing for treating AD. They are using the same equipment used for Parkinson's patients, but of course, memory loss is different from motor skill loss. They have seen promising results in the six patients in the trial, and now plan to begin larger clinical trials.

    One of the articles mentioned that the fornix "drives information to and from the brain's memory center, the hippocampus." The electrodes are being implanted in the hypothalmus, since brain-imaging studies have confirmed that stimulation there triggers activity in the neural circuit that encompasses the fornix and hippocampus. So the initial, unexpected result with the obesity test makes sense in light of the later imaging studies.

    Also, parallel experiments in rats have found that electrical stimulation can not only drive production of memory but also boost production of new brain cells. That's really VERY interesting.

    Of course, lots of treatments have appeared promising in early studies, but then failed to pan out later on. But I will definitely be keeping an eye on this.

    Thanks, jav!
    • CommentAuthorSunshyne
    • CommentTimeJun 1st 2008
     
    Oh ... forgot to mention that most of the AD studies are being done in Canada, by Andres Lozano, a professor of neurosurgery at the Toronto Western Hospital, Ontario.
    • CommentAuthoringe
    • CommentTimeJun 1st 2008 edited
     
    Sunshyne, the program I saw dealt in part with this research. One of the presenters mentioned we are at the science fiction stage in this research and a long way from general use. It is of course very intrusive and yet there are people who are willing to try anything and will volunteer for this research.
    • CommentAuthorSunshyne
    • CommentTimeJun 1st 2008 edited
     
    Inge, isn't that the truth. I can't believe how many people are being sucked in by the enbrel perispinal injection claims, and are not only willing to do something THAT intrusive, on a weekly basis no less, but pay megabucks for it as well -- without the treatment ever having undergone a single clinical trial, or the results ever even reproduced by another lab. From what I've seen so far, DBS is on much more solid scientific footing, and being studied in a much more careful, thorough, and properly controlled way.

    I went to the Clinical Trials.gov web site, by the way, and found 60 DBS clinical trials. Most are associated with Parkinson's and other movement disorders, depression, and Obsessive Compulsive Disorder ... but there are also trials on epilepsy, Cerebral Palsy, schizophrenia, Tourette Syndrome, lower urinary tract function, cluster headaches, amblyopia (lazy eye), and AD.

    In addition to being approved for treating Parkinson's, DBS has been approved for humanitarian use by the FDA in the treatment of chronic, intractable dystonia.