"Of all the things that I have lost, I miss my mind the most"
Mark Twain, American Humorist and Author of the Adventures of Tom Sawyer and the Adventures of Huckleberry Finn, on memory loss and dementia
Dementia is a term that describes the loss of cognitive functions such as thinking, understanding and memory, due to the damage of brain cells often associated with aging. According to the World Health Organization 35.6 million worldwide suffer from Dementia and in India 3.7 million people have Dementia.
Dementia is a disease that can bring grief to a family if it isn't handled correctly.
We at NeuroGen Brain and Spine Institute assure you that with us dementia is a manageable condition. We bring to you a novel, revolutionizing therapy for dementia- Stem cell therapy for dementia. Along with the therapy, we also conduct a rehabilitation program which includes occupational therapy, physiotherapy and psychological assessments to provide our patients with a complete care system in a friendly and warm environment.
Believe that each moment in life is worth living. We at NeuroGen BSI strive to make that belief a fact.
What is Dementia?
Dementia is a general term for a decline in the mental ability severe enough to interfere with daily life. It results in loss of brain function hampering thinking and social abilities.
Dementia in itself, is not a specific disease. It is a descriptive term for a collection of symptoms that can be caused by a number of disorders that affect the brain. Although memory loss is a common symptom of dementia, a person having memory loss does not mean that the individual is suffering from dementia. Dementia is diagnosed only if two or more brain functions such as memory, language, reasoning, judgment etc are affected without loss of consciousness.
What are the causes of dementia?
Dementia is caused by damage to brain cells. This damage interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior and feelings can be affected.
Dementia can be classified into different types depending upon their common features. The commonly used classification includes:-
Cortical dementia affecting only the outer layer (cortex) of the brain
Sub cortical dementia that affects the lower layer of the cortex
Progressive dementia, which gets worse over time, gradually interfering with more and more cognitive abilities.
Primary dementia that do not result from any other disease.
Secondary dementia that occurs as a result of a physical disease or injury.
Progressive dementia is generally seen in individuals with Alzheimer's disease, Lewy body dementia and vascular dementia. Alzheimer's disease is the most common type of progressive dementia. Other disorders such as Huntington's disorder, Traumatic Brain Injury, Multiple sclerosis and Parkinson's disease can also lead to dementia. Some dementias that occur are however reversible, and are seen in the case of immune disorders, metabolic disorders, nutritional deficiency and reactions to certain medications.
What are the symptoms associated with Dementia?
Dementia symptoms include difficulty with many areas of normal brain functioning including, emotional behavior and personality, language, memory, perception and thinking and judgment (cognitive skills). Typical symptoms seen in an individual with dementia include:-
- Memory loss
- Difficulty communicating
- Difficulty with complex tasks
- Difficulty with planning and organizing
- Difficulty with coordination and motor functions
- Problems with disorientation, such as getting lost
- Personality changes
- Inability to reason
- Inappropriate behavior
What are the treatment options for dementia?
While treatments to reverse or halt disease progression are not available for most of the dementias, patients can benefit to some extent from treatment with available medications and other measures, such as cognitive training.
The treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer's disease, there is no cure and no treatment that slows or stops its progression. But there are certain drug treatments that may temporarily improve symptoms. Most of the drugs currently approved by the U. S. Food and Drug Administration (FDA) for AD fall into a category called cholinesterase inhibitors. These drugs slow the breakdown of the neurotransmitter acetylcholine, which is reduced in the brains of people with AD. There are currently four cholinesterase inhibitors approved for use in the United States: tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl). These drugs temporarily improve or stabilize memory and thinking skills in some individuals Several dementia symptoms and behavior problems may be treated initially using nondrug approaches, such as modifying the environment of the patients, modifying our responses and tasks. Physical therapy and occupational therapy can help the patients to cope with behavioral changes and ways to adapt to movements and daily living activities as their condition changes.
The primary cause for the occurrence of dementia is loss of brain cells. At present, the pharmacological treatment is not able to prevent, cure or halt the progression of the disease. Medications along with supervised therapy can improve the symptoms of an individual affected with dementia but cannot replace or repair the loss of neurons that occurs. But now with novel stem cell therapy, we can aim for controlling the progression of the disease.
How stem cell therapy works in dementia
Stem cell therapy can create new cells to repair damage and replace lost cells in the brain providing a more definite therapy option for dementia. Several clinical trials have shown that bone marrow derived mesenchymal stem cells, can interact with the host brain cells and release several molecules that promote the formation of new nerve cells as well as help to create an environment that support their survival. They are also involved in neuro protection, angiogenesis and several other metabolic activities that may together help to improve the reasoning, thinking and memory abilities of individuals suffering from dementia.
Stem cells have been shown to secrete an array of neurotrophins, growth factors and other supportive substances. This can help in improved survival of the neurons through facilitation of neuroprotective responses such as angiogenesis, axonal guidance and regeneration, which may further result in improved cognitive function.
Autologous Hematopoietic Stem Cell Transplantation along with NeuroRehabilitation can result in significant improvements and can definitely help in delaying the progression in the case of dementia.
The NeuroGen Outcome
At NeuroGen BSI we come across individuals suffering from various types of dementia such as Vascular, Alzheimer's and Fronto temporal dementia. Each of these cases requires individual care and a customized approach just for them. We aim to provide just that for our patients in a environment that is healthy and enriching for them.
Following our stem cell therapy combined with our extensive Neurorehabilitation program under the guidance of our team of expert doctors and therapists, our patients have shown functional and symptomatic improvements in their conditions. Improvements seen in these cases are with respect to following commands, appropriate emotional responses, more cooperation, reduced crying spells, improved sitting tolerance and compliance to therapies improved. Major improvements are also seen in cognitive functioning with respect to memory, attention, concentration, mathematical abilities and reasoning. These positive changes are recorded objectively on the neuropsychological test of Mini Mental Status Examination (MMSE).
Our patients are now able to maintain a routine and are more independent in their activities of daily living. On the physical assessment improvements in fine motor activities, localization of objects improved, oromotor control and swallowing movements are also seen.
The most important observation is that after Stem Cell Therapy, the progression of the disease is halted and the patients are able to live a life of fulfillment.
The improvements that our patients show are further envisaged by the enhancements seen in the metabolism of the affected brain areas in the PET –CT scans of the individual affected. This throws light on the fact that the transplanted stem cells have the potential to improve the damaged areas resulting in further clinical and functional changes.
Objective Radiological improvements after stem cell therapy in Dementia
Pre stem cell therapy SPECT scan showing overall hypometabolism in the brain, with purple areas depicting areas of hypometabolism and orange areas as areas of normal metabolism
Post stem cell therapy SPECT scan showing increase in the orange area, which is the area of normal metabolism and reduction in the purple area.
Stem cell Therapy has a lot of potential to halt the progression of dementia. It is safe treatment and improves the quality of life of these elderly patients for whom there is no other treatment option available.