Deep brain stimulation: Expanding its reach to new patients

LA Times
Electrical therapy, used for years to treat Parkinson's and other movement disorders, may soon tackle depression and more.
By Andreas von Bubnoff

June 1, 2009
Under the skin, a battery is surgically implanted -- generally within the upper chest. From the battery, wires snake up to the head, to tickle different targets deep inside the brain.

Such is the hardware for deep brain stimulation -- the equivalent of a cardiac pacemaker for the mind.

Until recently, deep brain stimulation was approved in the U.S. only to treat certain movement disorders, primarily those of Parkinson's disease, for which it diminishes tremors and rigidity and improves mobility. To date, more than 60,000 patients worldwide have had the devices implanted.

But now use of the technique seems set to mushroom.

This year, the Food and Drug Administration granted a so-called humanitarian device exemption for the treatment to be used in severe cases of obsessive-compulsive disorder -- the first approval of deep brain stimulation therapy for any psychiatric condition.


Large clinical trials are also in the works for use of deep brain stimulation for epilepsy and depression, and experimental studies in the U.S. and elsewhere -- still in their early stages -- are exploring the treatment for obesity, traumatic brain injury, severe chronic pain, Alzheimer's disease, anorexia, tinnitus and addiction.

There are discussions too on the possible use of deep brain stimulation to treat hypertension.

"The field is taking off," says Dr. Ali Rezai, director of functional neurosurgery at the Cleveland Clinic, who has been involved in research on movement disorders, traumatic brain injury, obsessive-compulsive disorder and severe depression, among others.

Some researchers warn, however, that with all this activity -- pushed in part by the industry that makes the brain-stimulation devices -- the field may be moving too fast.

"There is so much progress that's been made and so much potential -- you would hate to lose that potential," says Dr. Joseph Fins, chief of the division of medical ethics and a professor at Weill Cornell Medical College in New York.

Here's a look at deep brain stimulation as it moves beyond Parkinson's disease. (See the related story about reservations scientists have about the growth of the field, and go online at latimes.com/health for a look at less-explored applications such as traumatic brain injury and obesity.)

Obsessive- compulsive disorder

In studies with a total of 26 patients with severe obsessive-compulsive disorder, 60% of those whose device was turned on demonstrated "very much improved" symptoms after months of deep brain stimulation as measured by interviews and questionnaires, says Dr. Benjamin Greenberg, an associate professor at Brown University Medical School and Butler Hospital in Providence, R.I., who was one of the...read the whole story


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Dealing with a loved one’s dementia

Leeza Gibbons on the depression she faced while caring for her mother
TODAY books

In her book “Take Your Oxygen First,” Leeza Gibbons shares the story of her mother, who was diagnosed with Alzheimer’s disease. With the help of medical professionals, Gibbons provides a guide for caregivers to take care of themselves first. An excerpt.

Leeza: Bad news has no regard for timing. Your bubble of domestic bliss is not immune, nor is your job or career. I was happily mothering my children and producing and hosting my own talk show on Paramount’s Stage 26 when Mom's stage went dark. My anxiety spread to every aspect of my life and as much as I tried to present a facade of calm and acceptance, my persona never lasted past my driveway and once home, I became as tightly wound up as an angry fist. I snapped at the kids, withdrew from my husband and stayed up until dawn searching and searching for the latest treatments, the slimmest hope.

As Mom declined, I was trapped on a tilt-a-whirl of emotion. I managed to convince myself that if I just did more, she would be O.K. The talk show ended its run and I immediately went on to the next stop on my career train, hosting the nightly entertainment news magazine Extra. I was all coifed and poised in front of the camera as I delivered the latest celebrity headlines, but the minute the lights went out on the stage, I fell apart. I spent most afternoons leaving through the back door of the lot to wander the neighborhood streets trying to reclaim some control over myself. But bad news can't be controlled and I realized that I was no match for its increasing shadow over my life. My marriage was strained to the breaking point and I was depressed. I needed to let go of the way things were and accept this beast which had pulled up a chair to my dinner table.

I sought the help of a therapist. It turned out to be more than a lifeline, it was the exploration I needed to reclaim my sanity. Robert, my therapist, provided a safe sanctuary in which to share my feelings. Jamie Huysman, the co-author of this book, was my tether to what would become a new life and a new sense of purpose. He was the friend who always had time for me, who never judged and who always reminded me to be kind to myself. When I was unsure, he was certain. When I was a squishy ball of frayed nerves, he was solid, strong and firm in his belief that I could make a difference. Jamie showed me how to fulfill the promise I made to my mother, to tell her story so that others might be........read the whole article

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Making Your Home Safer for a Loved One with Alzheimer's

Expert Tips to Adapt a Home for Alzheimer's Disease
By CARI NIERENBERG
ABC News Medical Unit

After someone is diagnosed with Alzheimer's disease, the first thing the patient and their loved ones want to know is how to treat this progressive, degenerative brain disease.

But the next thing they want to know more about is safety -- a huge issue, since adults with Alzheimer's and dementia have a much higher risk of injuring themselves around the home than their healthier counterparts.

Although safety becomes a primary concern, people often don't know where to begin or the practical things they can do in their homes. Plus, making a caregiver aware of these options can be a challenge.

"We need to find a balance between.................read the whole story

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Still hope for those with Alzheimer's

Huntsville Times

In one of today's most famous love stories, "The Notebook," author Nicholas Sparks portrays a love between Allie and Noah that withstands her parents' disapproval, her engagement to another man and even later her Alzheimer's disease.

When my great-aunt was diagnosed with Alzheimer's two years ago, I watched her inevitable downward spiral into oblivion with helplessness and confusion, much as Noah must have watched his beloved wife gradually relinquish her abilities to perform simple tasks such as cooking, cleaning and dressing.

My great-aunt began brewing coffee at 2 a.m., pacing aimlessly around her house and panicking at the first sign of sundown. Her attention span diminished to that of a young child, and she no longer had the patience to sit and watch her beloved Alabama football games on television. My aunt was eventually moved into a facility with trained nurses.

Her communication skills disappeared much too quickly, and when her lips no longer formed words, she found other methods of expression. My family refused to give up on her. Whenever I visit, we piece together puzzles she loves, and I encourage her to play songs on the piano from memory.

My aunt still remembers her baptism, smiles at the mention of her famous red velvet cake and kisses us when we visit.

One of her deepest desires in life was to have..........read the whole story

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Impact of Alzheimer's disease growing

Fort Myers News-press.com

Impact of Alzheimer's disease growing
Alzheimer's disease has joined cancer as the word that people do not want to utter aloud for fear it might happen to them. Alzheimer's disease is second only to cancer as the illness we worry most about getting Ironically, the projected number of new cases of Alzheimer's disease exceeds that of breast and prostate cancer combined. The Centers for Disease Control's Web site lists Alzheimer's disease as one of the top 10 leading causes of death. The CDC reports that "notably, mortality rates for Alzheimer's disease are on the rise, unlike heart disease and cancer death rates which are continuing to decline."

Alzheimer's disease affects approximately 5 million Americans. The number of estimated cases in Lee County exceeds 22,000. In virtually every neighborhood across our community, someone is touched by Alzheimer's disease.

Despite these grim facts about the disease, there is hope for the future. The attention that Alzheimer's disease is receiving in the media is paramount in helping raise awareness and emphasize the need for continued research and care.

The news also brings hopeful information about current research and progress toward early detection, better treatments and strategies for prevention.

The Alzheimer's Project introduced by HBO this month is a wonderful example of the positive message we can deliver about what's happening with treatment and research for Alzheimer's disease.

HBO's Web site nicely summarizes the goal of the project with these words "While there is no cure for the disease, The Alzheimer's Project shows there is now genuine reason to be optimistic about the future."

Recent news stories and heightened awareness also call attention to the significance of supporting families who are caring for someone with Alzheimer's disease. Treatment, research, and care are each equally important in addressing the impact of Alzheimer's disease on our society and the health care system.

The Alzheimer's Project, which is a ......read the whole article

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Memorial Day-a perfect time to honor folks with dementia

healthnews-stat.com

Dementia,including Alzheimer disease, affects about one in 13 seniors,many of them veterans. As you remember our war heroes on Memorial Day,think about what you can do for them.They did so much for us.
Veterans who suffer from various forms of dementia, including Alzheimer disease, often have very specific care needs. It is important that these veterans are cared for by people who understand their condition and have the appropriate instruction and skills.

Therefore encourage family members of veterans to gain the training they need to care for their loved one with dementia.

For those in nursing homes and other institutions, make sure veterans with dementia are visited often.

All people, including those with memory loss, need human contact. They need to be hugged. They need to hear your voice. They may not know you but as long as you know who they are, that's all that matters.

Talk to them about their service to our country. Often they will share stories with you because their time in the service made a huge impression on them

Tell them how proud you are of them. Thank them for their service. This is sure to make them feel good. Most likely, it will make them smile

Smile with a veteran. Laughter is wonderful medicine...

Sing patriotic songs with a veteran with dementia. Often they will be able o sing many familiar songs even though, they may not be able.......read the whole article

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Alzheimer's, dementia day care works to improve memory, skills

Nashua Telegraph

It's estimated that as many as 5.2 million people in the U.S., mostly 65 or older, have Alzheimer's.

The disease is the most common form of dementia, a term used to describe a group of brain disorders that cause memory loss and make it harder to carry out daily tasks, according to AlzheimersRx Treatment.com.

The Mailbag is hoping to make daily tasks easier for patients, as well as for some dedicated day-care volunteers.

Plugging in to help



"I volunteer at a day-care program....read the whole article

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