Currents of Memory: Recent Progress, Translational Challenges, and Ethical Considerations in Fornix Deep Brain Stimulation Trials for Alzheimer’s Disease

Publication date: Available online 11 March 2017
Source:Neurobiology of Aging
Author(s): John Noel M. Viaña, James C. Vickers, Mark J. Cook, Frederic Gilbert
The serendipitous discovery of triggered autobiographical memories and eventual memory improvement in an obese patient who received fornix deep brain stimulation (fDBS) in 2008 paved the way for several Phase I and Phase II clinical trials focused on the safety and efficacy of this potential intervention for people with Alzheimer's disease. In this paper, we summarize clinical trials and case reports on fDBS for Alzheimer's disease and review experiments on animal models evaluating the physiological or behavioral effects of this intervention. Based on information from these reports and studies, we identify potential translational challenges of this approach and determine practical and ethical considerations for clinical trials, focusing on issues regarding selection criteria, trial design, and outcome evaluation. Based on initial results suggesting greater benefit for those with milder disease stage, we find it essential that participant expectations are carefully managed to avoid treatment disenchantment and/or frustration from participants and caregivers. Finally, we urge for collaboration between centers to establish proper clinical standards and to promote better trial results comparison.



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