Effectiveness of DBS as a treatment for Alzheimer’s disease: Meta-analysis

Deep Brain Stimulation Pub Date : 2025-01-26 DOI:10.1016/j.jdbs.2025.01.001

Julia Scaramal Mello , Gabriela Ilias Bechara , Paulo Henrique Pires de Aguiar

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Abstract

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.