title: Alzheimer's disease: The role for neurosurgery.
abstract: Dementia, most commonly caused by Alzheimer's disease (AD), affects approximately 35 million people worldwide, with the incidence expected to increase as the population ages. After decades of investigation, AD is now understood to be a complex disease that affects behavior and cognition through several mechanisms: Disrupted neuronal communication, abnormal regional tissue metabolism, and impaired cellular repair. Existing therapies have demonstrated limited efficacy, which has spurred the search for specific disease markers and predictors as well as innovative therapeutic options. Deep brain stimulation (DBS) of the memory circuits is one such option, with early studies suggesting that modulation of neural activity in these networks may improve cognitive function. Encapsulated cell biodelivery (ECB) is a device that delivers nerve growth factor to the cholinergic basal forebrain to potentially improve cognitive decline in AD patients. This review discusses the pathogenesis of AD, novel neuroimaging and biochemical markers, and the emerging role for neurosurgical applications such as DBS and ECB.
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Julio Leonardo Barbosa
authors.initials: JL
authors.lastname: Pereira
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Downes
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA ; HCor Neuroscience, São Paulo, Brazil.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Gorgulho
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Vishal
authors.initials: V
authors.lastname: Patel
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Dennis
authors.initials: D
authors.lastname: Malkasian
authors.affiliation: Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA ; HCor Neuroscience, São Paulo, Brazil.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Salles
keywords: Alzheimer's disease; deep brain stimulation; dementia; encapsulated cell biodelivery; limbic circuit; neurosurgery; stereotactic surgery