title: Deep brain stimulation of the nucleus basalis of Meynert in Alzheimer's dementia.
abstract: Cholinergic neurons of the medial forebrain are considered important contributors to brain plasticity and neuromodulation. A reduction of cholinergic innervation can lead to pathophysiological changes of neurotransmission and is observed in Alzheimer's disease. Here we report on six patients with mild to moderate Alzheimer's disease (AD) treated with bilateral low-frequency deep brain stimulation (DBS) of the nucleus basalis of Meynert (NBM). During a four-week double-blind sham-controlled phase and a subsequent 11-month follow-up open label period, clinical outcome was assessed by neuropsychological examination using the Alzheimer's Disease Assessment Scale-cognitive subscale as the primary outcome measure. Electroencephalography and [(18)F]-fluoro-desoxyglucose positron emission tomography were, besides others, secondary endpoints. On the basis of stable or improved primary outcome parameters twelve months after surgery, four of the six patients were considered responders. No severe or non-transitional side effects related to the stimulation were observed. Taking into account all limitations of a pilot study, we conclude that DBS of the NBM is both technically feasible and well tolerated.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Kuhn
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Hardenacke
authors.affiliation: Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Lenartz
authors.affiliation: 1] Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany [2] Faculty of Economics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany [3] Center for Behavioral Brain Sciences, Magdeburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Gruendler
authors.affiliation: 1] Center for Behavioral Brain Sciences, Magdeburg, Germany [2] Institute of Psychology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Ullsperger
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Bartsch
authors.affiliation: Department of Neuroanatomy, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: J K
authors.initials: JK
authors.lastname: Mai
authors.affiliation: 1] Institute of Neuroscience and Medicine, Research Centre Juelich, Juelich, Germany [2] University Hospital of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Zilles
authors.affiliation: 1] Institute of Neuroscience and Medicine, Research Centre Juelich, Juelich, Germany [2] Department of Neurology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bauer
authors.affiliation: Institute of Neuroscience and Medicine, Research Centre Juelich, Juelich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Matusch
authors.affiliation: University of Cologne, Department of Geriatrics and St. Marien-Hospital, Cologne, Germany.
authors.forename: R-J
authors.initials: RJ
authors.lastname: Schulz
authors.affiliation: University of Cologne, Department of Geriatrics and St. Marien-Hospital, Cologne, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Noreik
authors.affiliation: Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany.
authors.forename: C P
authors.initials: CP
authors.lastname: Bührle
authors.affiliation: University of Cologne, Department for Radiology, Cologne, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Maintz
authors.affiliation: University of Cologne, Research Unit Ethics, Institute for the History of Medicine and Medical Ethics, Cologne, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Woopen
authors.affiliation: LVR Clinic Cologne, Department of Gerontopsychiatry, Cologne, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Häussermann
authors.affiliation: University of Cologne, Institute of Medical Statistics, Informatics and Epidemiology, Cologne, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Hellmich
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Klosterkötter
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Wiltfang
authors.affiliation: Department of Stereotaxy and Functional Neurosurgery, Klinikum Merheim, Cologne, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Maarouf
authors.affiliation: Department of Neuroanatomy, University of Düsseldorf, Düsseldorf, Germany.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Freund
authors.affiliation: Department of Functional Neurosurgery and Stereotaxy, University of Cologne, Cologne, Germany.
authors.forename: V
authors.initials: V
authors.lastname: Sturm
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000628:therapy*; D020532:Basal Nucleus of Meynert / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18