DBS, Alzheimer’s, and commercialization of the technology

Last month the National Health Service website Behind the Headlines (“We give you the facts without the fiction”) took up a story that had appeared in the Daily Mail about the use of deep brain stimulation (DBS) on people with Alzheimer’s disease. Behind the Headlines concluded:

“This was a small, early-stage clinical study that tested the safety of using deep brain stimulation to treat Alzheimer’s disease. Due to the preliminary nature of this research and the fact it did not compare DBS patients against a control group, the results can’t be universally applied to all patients with Alzheimer’s disease. The researchers have since started a larger-scale study (involving 50 people) to assess the benefits and effectiveness of the treatment.”

The article in the Daily Mail featured one of the study’s authors, Canadian neurosurgeon Andres Lozano:

“Describing the result as ‘amazing’, researcher Andres Lozano said: ‘Not only did the hippocampus not shrink, it got bigger – by 5 per cent in one person and 8 per cent in the other. Tests showed that their minds also seemed to be sharper than expected. Dr Lozano isn’t sure how the treatment works, but it may be through the electrical current driving the birth of new brain cells. And, in mice, deep brain stimulation triggers the production of proteins that encourage brain cells to form new connections.  Dr Lozano, of Toronto Western Hospital, is starting a bigger trial involving 50 people. Answering criticism about the practicalities of using brain surgery to treat a common disease, he pointed out that deep brain stimulation has already been used 90,000 times in Parkinson’s patients from around the world. He told New Scientist that Alzheimer’s is just five times more common than Parkinson’s. And added: ‘If it can be used in Parkinson’s, it can be used in Alzheimer’s.’”

Andres Lozano’s amazement at the results was originally reported in an article in the New Scientist.

What none of these articles, in the New Scientist, the Daily Mail, or Behind the Headlines, mentioned was Andres Lozano’s conflict of interest which appeared in the original write-up of the research, published last year in the Annals of Neurology (“A.M.L. holds intellectual property in the field of deep brain stimulation”) and which might go some way towards explaining his “amazement”. An article in Technology Review explains further:

“In deep brain stimulation, electrical pulses are delivered to a dysfunctional part of the brain via a surgically implanted electrode, stimulating neural activity.  The technology is being used or tested for a growing number of disorders, including medication resistant epilepsy, depression, and obsessive compulsive disorder. Neurosurgeon Andres Lozano, at the University of Toronto, became interested in its potential for treating Alzheimer’s thanks to an unexpected finding published in 2008. Researchers were testing to see if they could help a morbidly obese patient lose weight by stimulating a part of the brain that governs satiety. Follow-up tests revealed that the patient showed a significant improvement in memory.

Brain imaging revealed that the obesity treatment activated various brain structures involved in memory. Such structures have typically deteriorated in Alzheimer’s patients, and Lozano’s idea is to use deep brain stimulation to boost activity in the memory circuits that patients have left. Late last year, Lozano formed startup Functional Neuromodulation with Daniel O’Connell, founder of Neuroventures and now its CEO, to commercialize the technology.”

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