Neuromodulation for Cognitive Disorders: In Search of Lazarus?

Azmi, Hooman

doi:10.4103/0028-3886.302469

Cited by 1 publication

(15 citation statements)

References 113 publications

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“…25 In transcranial pulse stimulation, short ultrasound pulses are believed to alter cell ion channels, thereby impacting neurotransmitter levels. 40 A recent pilot study of 35 patients with probable AD found that this technique improved memory performance when evaluated with the Consortium to Establish a Registry for Alzheimer's Disease scoring system, while reporting no major side effects -a promising preliminary result for the technique. 43 The other target for ultrasound stimulation, blood brain barrier (BBB) opening, has more published studies in humans thus far and is a reversible process modulated by the intensity of the ultrasound frequency.…”

Section: Ultrasound Stimulationmentioning

confidence: 99%

“…41 It is thought that when there is an imbalance between the production and the clearance of the beta-amyloid peptide, which happens via the BBB, progressive dysfunction of the brain can occur. 40 In a phase I safety study, it was reported that although the technique was deemed safe, AD-specific outcome measures were unchanged before and after the procedure in 5 patients with AD. 42 Currently, there are a few devices that use ultrasound technology and are being investigated for their use in patients with AD.…”

Section: Ultrasound Stimulationmentioning

confidence: 99%

“…Ultrasound stimulation is a noninvasive approach whereby targeted and accurate stimulation of different regions in the brain can be accomplished. 40 Given the ability to be accurate with the technology, ultrasound technology is generally referred to as focused ultrasound when it is targeting a precise brain region. 25 Ultrasound stimulation can be of high or low intensity, with low intensity being the level used to adapt neural circuits with pulsed or continuous sonication.…”

Section: Ultrasound Stimulationmentioning

confidence: 99%

“…25,41 Regarding the target of the technology, transcranial pulse stimulation targets both shallow and deep brain regions or the technology can be used to impact the permeability of the blood brain barrier. [40][41][42] Low-intensity-focused ultrasound has shown positive results in the treatment of epilepsy and mood disorders, leading to the exploration in AD. 25 In transcranial pulse stimulation, short ultrasound pulses are believed to alter cell ion channels, thereby impacting neurotransmitter levels.…”

Section: Ultrasound Stimulationmentioning

confidence: 99%

“…43 The other target for ultrasound stimulation, blood brain barrier (BBB) opening, has more published studies in humans thus far and is a reversible process modulated by the intensity of the ultrasound frequency. 40 By altering the permeability of the BBB, neural activity can be temporarily altered. 44 Additionally, altering the permeability of the BBB has shown to be a promising approach to improve drug delivery, suggesting a potential for this technology to be used in conjunction with pharmaceuticals.…”

Section: Ultrasound Stimulationmentioning

confidence: 99%

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Neuromodulation Technologies for the Treatment of Alzheimer Disease

Gunn¹,

Grobelna²

2021

cjht

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There are not very many effective treatment options for Alzheimer disease most of the options have side effects and temporarily reduce symptoms rather than delay disease progression. Effective treatments with minimal side effects that prevent and reduce the severity of Alzheimer disease are needed. Neuromodulation techniques have recently emerged for the treatment of Alzheimer disease, with the hope of filling some of these treatment gaps. Two invasive and 8 noninvasive techniques are described in this Horizon Scan, some with more published evidence than others. Deep brain stimulation, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and transcranial alternating current stimulation have more published studies involving patients with Alzheimer disease. Technologies at an earlier stage of development and with fewer studies providing an evidence base include vagus nerve stimulation, ultrasound stimulation, electromagnetic stimulation, photobiomodulation, infrared stimulation, and auditory stimulation. The evidence regarding neuromodulation techniques is mostly promising; however, most studies are preliminary or include fewer than 50 participants. Given the heterogeneous nature of Alzheimer disease and the variety of methods in which the different neuromodulation technologies can be used, more research is needed to determine the effectiveness and relative effectiveness of neuromodulation techniques and devices. Limitations in the research include limited evidence on the long-term effects and cost-effectiveness of the techniques in the treatment of Alzheimer disease, as well as the clinical significance of the results in the published studies thus far. Despite the limited evidence, the results emerging from the literature are hopeful for many people living with Alzheimer disease. Importantly, the lack of reported serious side effects is a hopeful start for many who currently experience difficulties with pharmaceuticals. Given the heterogeneous nature of Alzheimer disease, the increased variety in treatment options also offers hope in potentially finding more effective treatments for individuals living with the debilitating disease.

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Section: Ultrasound Stimulationmentioning

confidence: 99%