title: Modulation of mind: therapeutic neuromodulation for cognitive disability.
abstract: Neuromodulation using deep brain stimulation (DBS) has become an established therapy for the treatment of certain disorders such as Parkinson's disease and tremors. Recent advances in surgical and imaging techniques further decrease the surgical risk associated with these procedures. Symptoms such as tremor, bradykinesia, rigidity and gait disturbances can be significantly controlled with DBS. This results in an opportunity to decrease anti-parkinsonism medications, and their dyskinetic side-effects. Following the success of DBS in the management of movement disorders, the role of this therapy is being extensively studied in more complex disorders that involve cognition and behavior. The inherent complexity in cognitive circuitry makes neuromodulation using DBS more difficult than in movement disorders. The goal of DBS surgery in these diseases is not only to slow the cognitive decline, but also restoration of function and ultimately improvement in the quality of life. DBS as a treatment for patients with advanced dementia holds significant promise in delaying or reversing the progressive cognitive decline by enhancing connectivity in the memory networks. In appropriately selected patients this potentially reversible surgical therapy can lead to a significant improvement in the quality of life and reduce the burden on patients, families and the healthcare system. This review focuses on the recent and future studies involving neuromodulation for cognitive disorders such as Alzheimer's disease and Huntington's disease.
authors.affiliation: Center of Neuromodulation, Department of Neurosurgery, Wexner Medical Center, Ohio State University, 480 Medical Center Drive, Columbus, OH 43210, USA; Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: Zion.zibly@osumc.edu.
authors.forename: Zion
authors.initials: Z
authors.lastname: Zibly
authors.affiliation: Center of Neuromodulation, Department of Neurosurgery, Wexner Medical Center, Ohio State University, 480 Medical Center Drive, Columbus, OH 43210, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Shaw
authors.affiliation: Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Sagi
authors.initials: S
authors.lastname: Harnof
authors.affiliation: Center of Neuromodulation, Department of Neurosurgery, Wexner Medical Center, Ohio State University, 480 Medical Center Drive, Columbus, OH 43210, USA.
authors.forename: Mayur
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Center of Neuromodulation, Department of Neurosurgery, Wexner Medical Center, Ohio State University, 480 Medical Center Drive, Columbus, OH 43210, USA.
authors.forename: Christian
authors.initials: C
authors.lastname: Graves
authors.affiliation: Center of Neuromodulation, Department of Neurosurgery, Wexner Medical Center, Ohio State University, 480 Medical Center Drive, Columbus, OH 43210, USA.
authors.forename: Milind
authors.initials: M
authors.lastname: Deogaonkar
authors.affiliation: Center of Neuromodulation, Department of Neurosurgery, Wexner Medical Center, Ohio State University, 480 Medical Center Drive, Columbus, OH 43210, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Rezai
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology / Q000601:surgery; D003072:Cognition Disorders / Q000503:physiopathology / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000941:ethics / Q000379:methods*; D006801:Humans; D019635:Neurosurgical Procedures / Q000379:methods
keywords: Alzheimer’s disease; Area 25; Cognition; Deep brain stimulation; Huntington’s disease; Memory; Nucleus accumbens