Deep brain stimulation of the fornix as a therapeutic approach for Alzheimer’s disease: Systematic Review

Abstract

INTRODUCTION: Alzheimer’s disease (AD) is a disorder characterized by cognitive impairment. The brain network in DA can be interrupted by deficiencies in glucose metabolismo. Deep brain stimulation (DBS) is used in Parkinson’s disease (PM), once it modulates motor circuits. Considering this potential, the benefits of this approach in DA must be evaluated1,2. OBJECTIVE: To investigate the potential benefit of stimulating the cerebral fornix (CF) through DBS for patients with AD. METHODS: Controlled and randomized clinical trials (ECCR), in English, performed on humans, in the last 5 years, indexed on PubMed, were selected from the keywords “Deep brain Stimulation” and “Alzheimer Dementia”. This review was registered on PROSPERO by protocol 254506 and the PRISMA recommendation was used to improve its organization. RESULTS: Deeb W et al. (2019) conducted an ECCR on 42 patients with AD receiving DBS in CF, anterior commissure, corpus and sub-corpus callosum, demonstrating that in 48% of them, old experiences were reported. Furthermore, the memories became better as the stimulation increased. Lozano AM et al. (2016), in turn, developed an ECCR on 6 patients receiving DBS in CF, showing increases in glucose metabolism in some cerebral areas after 12 months, contrasting to the expected reduction in AD, especially in > 65 years. It’s noteworthy that the multicenter and double-blind ECCR by Ponce FA (2016) showed the safety of DBS in CF as therapy for AD, similar to that verified in the MP. CONCLUSION: The analyzed evidences suggest a potential cognitive benefit of DBS in the therapeutic management of AD.