Partial improvement in performance of patients with severe Alzheimer's disease at an early stage of fornix deep brain stimulation

Deep brain stimulation is a therapy for Alzheimer's disease (AD) that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ClinicalTrials.gov (NCT03115814) on April 14, 2017.

[Epidemiology of stroke in urban and rural areas, Tianjin, China: a six-year prospective research]

This paper researched the morbidity and mortality rates of stroke in Tianjin by a six-year prospective study. The result showed that there were no significant differences of the stroke morbidity and mortality rates between urban and rural areas in Tianjin. The morbidity and mortality rates of stroke significantly increased parallel with age in two areas, which were 443.86 and 248.20 per 10(5) in urban, 402.05 and 190.22 per 10(5) in rural areas respectively. The difference in type was not found. Mortality rate of cerebral hemorrhage was significant higher than that of cerebral infarction among age group 45 and above in urban and 55-years above in rural areas. October peak was noticed in morbidity and mortality rates of stroke both in urban and rural areas.