Alzheimer's disease is considered a global challenge of the century.
Alzheimer's disease is a thief. It comes and takes away the most precious
memories with which people identify themselves. It is a very clever thief.
People whom it affects don't even remember what they have lost—they just feel
lost; lost in space and time.
Alzheimer's can
affect anybody: intellectuals, professors, artists, musicians and handymen. My
mother's Alzheimer's motivated me to start the very first Repetitive
Transcranial Magnetic Stimulation (rTMS) treatment for Alzheimer's in Canada.
The treatment is a
non-invasive procedure that doesn't involve any medication. This technology has
been used to successfully treat depression, and it is also being studied for a
number of other neurological conditions (for example, Parkinson's, concussion
and stroke).
In rTMS,
an electromagnetic coil is placed on the scalp and uses magnetic pulses to
cause neurons (nerve cells) in the brain to activate. The goal is to train the
neurons to perform better in the future. The rTMS treatment has no, or only
mild side effects: some people report a slight headache that is easily treated
with a pain relief pill. And the risk of seizure is very low. (Individuals with
a history of epilepsy and/or seizures are excluded from rTMS treatments for
that reason.)
'I
remember'
Our very
first patient was a challenging 82-year-old lady at a relatively advanced stage
of Alzheimer's, who hated the treatment. Every time I asked her if she had
children, she said: "Not yet; I'm still in my twenties!"
On the
seventh day of the treatment, in the middle of session, she asked us to stop.
Her husband tried to calm her and convince her to continue, saying:
"Didn't you want to remember our children?"
She
replied: "But I do remember Susan, Sam and Dona; why do I need this stupid
treatment?"
That
moment was what I had dreamed to see in my late mother: the way she used to be,
even for a few minutes. That patient's cognitive state did not show any
significant improvement over the course of treatment. However, her short moment
of memory retrieval encouraged me to continue the rTMS treatment study on
others as well—particularly on those at earlier stages of Alzheimer's.
One thing to note and remember is that Alzheimer's is a
progressive degenerative disease. If we intervene to plateau the state of the
patient or slow the progression, that is indeed an improvement and can be
considered a positive effect of the treatment.
In our pilot study,
we gave a maintenance treatment every three months, to seven of our initial 10
participants, for up to a year and a half. Our results showed that as long as patients were
receiving the treatment, they did not decline. Some improved slightly.
As soon as we
stopped the treatment (due to lack of funding), all patients started to show
some decline. Three of them declined so severely that, within three months of
stopping treatment, they ended up in a nursing home and passed away within a
year.
Overall,
our pilot study and
similar small-sample studies around the globe showed encouraging results of
rTMS treatment on Alzheimer's, especially when it was applied at early and
moderate stages.
Encouraging
steps to new Alzheimer's treatment
As a
result of those pilot studies, the Weston Brain Institute has now funded the
very first large placebo-controlled double-blind study of rTMS treatment on
Alzheimer's. This is a collaboration of three universities: University of
Manitoba, McGill University and Monash University. The team includes engineers,
psychiatrists, clinical psychologists, neurologists and statisticians.
The study
is to investigate the effect of rTMS treatment on Alzheimer's patients at early
and moderate stages. All participants have to be diagnosed by one of the study
doctors. And there are several assessments for before and after treatment to
assess the efficacy of the treatment and how long it may last.
While
this current study is an encouraging step towards finding new treatment methods
for Alzheimer's, there are several other parameters in the rTMS treatment
protocol whose investigation is not currently funded. They include: the method
by which rTMS pulses are delivered, the location of the stimulation and the
duration of treatment. Our current study investigates only the standard
protocol of rTMS treatment. We hope after some preliminary results to apply
for, and receive, more funding to continue the research.
The
number of people affected by Alzheimer's disease is on the rise. Alzheimer's
not only steals precious aspects of life from affected individuals but also
from their families. Alzheimer's forces the relatives of a patient to
hopelessly watch a tragedy progress over a prolonged period of time, day after
day.
Alzheimer's
disease is a multifold condition that requires a multidisciplinary approach for
its treatment. It is only through our collective
efforts that we can hope to find a solution for such a grim and dreadful
disease. Despair may fly on the wings of morning; out of the heart of darkness
comes the light.
Provided
by: The Conversation
https://medicalxpress.com/news/2017-09-experimental-brain-technology-rewind-alzheimer.html
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