REVIEW
Introdução: A Doença de Alzheimer (DA) é o tipo mais comum de demência. Sua fisiopatologia envolve disfunção sináptica focal, alterando as funções de circuitos cognitivos e reguladores de memória, resultando em amnésia anterógrada, mudanças comportamentais, linguagem e alterações cognitivas. Seus tratamentos farmacológicos têm eficácia limitada e são acompanhados por efeitos adversos. A estimulação cerebral profunda (DBS) é uma alternativa terapêutica segura para casos refratários de doenças neuropsiquiátricas, envolvendo a implantação estereotáxica de eletrodos em uma região específica do cérebro. Objetivo: Realizar uma revisão sistemática da literatura recente sobre a intervenção terapêutica da DBS no tratamento da DA. Com base nessa compilação, discutir os principais alvos e parâmetros de estimulação, bem como destacar os efeitos dessa intervenção nos pacientes, a fim de avaliar as perspectivas desse procedimento. Métodos: Foi realizada uma busca sistemática nas bases de dados eletrônicas MEDLINE, Biblioteca Virtual em Saúde (BVS) e Cochrane Library, no período entre 2010 e abril de 2022. Os artigos foram analisados, descrevendo os efeitos terapêuticos da DBS na DA. Resultados: O estudo analisou os parâmetros atuais da DBS para a DA, como alvos potenciais, frequência de estimulação e outros parâmetros. Os possíveis mecanismos de ação da DBS também foram avaliados. Conclusão: Os resultados iniciais são promissores e reafirmam a segurança e os benefícios da DBS para a DA. O campo da neuromodulação está em constante evolução, e avanços na tecnologia da DBS provavelmente estabelecerão novas diretrizes terapêuticas no futuro.
Introduction: Alzheimer’s Disease (AD) is the most common type of dementia. Its pathophysiology involves focal synaptic dysfunction, altering the functions of cognitive and memory-regulating circuits, resulting in anterograde amnesia, behavioral changes, language, and cognitive alterations. Its pharmacological treatments have limited efficacy and are accompanied by adverse effects. Deep Brain Stimulation (DBS) is a safe therapeutic alternative for refractory cases of neuropsychiatric diseases, involving the stereotactic implantation of electrodes in a specific brain region. Objective: To conduct a systematic literature review of recent research on the therapeutic intervention of DBS for AD treatment. Based on this compilation, to discuss the main targets and stimulation parameters, as well as to highlight the effects of this intervention on patients, in order to evaluate the prospects of this procedure. Methods: A systematic search in the MEDLINE electronic database, Virtual Health Library (VHL), and Cochrane Library was conducted between 2010 and April 2022. The articles were analyzed, describing the therapeutic effects of DBS in AD. Results: The study analyzed current DBS parameters for AD, such as potential targets, stimulation frequency and other parameters. The potential mechanisms of action of DBS were also evaluated. Conclusion: The initial results are promising and reaffirm the safety and benefits of DBS for AD. The field of neuromodulation is continually evolving, and advances in DBS technology are likely to establish new therapeutic guidelines in the future.
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¹MS, Medical student, Faculdade de Medicina de Marília – FAMEMA, Marília, SP, Brazil
²PhD, Adjunct professor, Universidade Estadual Paulista – UNESP, Marília – SP, Brazil
Received Jan 25, 2024
Corrected May 25, 2024
Accepted May 27, 2024
