With the ever-increasing numbers of baby boomers crossing the crest of the hill and looking at nothing but a downhill run toward old age, the debilitating threat of Alzheimer's disease looms ever more ominous.
But the medical profession is not about to let that happen, and Inova Alexandria Hospital has joined in that struggle.
John W. Cochran, M.D., F.A.C.P., is conducting a trial site to test the Eunoe COGNIShunt. It is a new procedure specifically designed to thwart the predatory onslaught of the disease that robs an individual of his “self.”
"It's kind of like the spinal fluid equivalent of a Jiffy Lube," Cochran explained. "By draining the spinal fluid, it cleans it. After the procedure we have seen some improvement in intellectual capability."
The COGNIShunt is a little tube that is inserted into a small hole in the head, according to Cochran. "It relates to flow, not pressure. It allows the fluid to flow to the abdomen, where it is absorbed," he explained.
Dr. Cochran has performed two such procedures so far at Inova Alexandria Hospital. "But, its too early to know the long-range results at this stage," he cautioned.
"Potential patients must have Alzheimer's. They cannot have had a lot of strokes to be considered for this experimental treatment," Cochran said. "Their progress is followed, and they are retested at three-week intervals. If it isn't working, they will continue to decline. Others will display definite improvement."
The COGNIShunt System, developed by Eunoe Inc., Redwood City, Calif., is "an implanted, flow-controlled shunt, designed to increase the flow of cerebrospinal fluid (CSF) and improve clearance of neurotoxins from the CSF that are believed to contribute to the progression of the disease," according to Kathy Witz Sweeney, director, public relations, Mentos Life Science.
"Recent clinical research suggests that impaired clearance of extracellular fluids in the brain and the resulting accumulation of neurotoxic proteins may play a significant role in the progression of Alzheimer's disease," said Cochran, a principal with Cochran, Eberly, Howe, P.C., Alexandria.
"Current FDA-approved treatments improve symptoms but are not thought to delay the underlying progression of the disease. Eunoe's approach is a new way of treating, and perhaps delaying, that progression," Cochran said. The potentially neurotoxic substances in CSF are replaced by fresh CSF, according to Eunoe.
Eunoe, a San Francisco Bay-area medical device company, focuses on the treatment of neurological disorders through the management of CSF fluid. The COGNIShunt System is an implanted, flow-controlled shunt, designed to increase flow of CSF and improve clearance of potential neurotoxins from fluids bathing the brain.
INOVA ALEXANDRIA Hospital is one of 25 sites testing the device and procedure throughout the United States. Eunoe plans to enroll at least 256 patients across the nation.
"Early data from the Eunoe Phase I/II feasibility study support that the COGNIShunt System is well-tolerated in Alzheimer patients," said C. Raymond Larkin Jr., Eunoe CEO.
This new experimental testing by Eunoe "is a Phase III multicenter clinical trial designed to evaluate the safety and efficiency of COGNIShunt," Larkin noted. Alexandria is the 20th site under way.
"It is hoped that there will be an average of 10 patients per site," Cochran acknowledged. "I've done 60 other procedures dealing with dementia. This is one of the most promising."
A native of Pennsylvania, Cochran has been a resident of, and has practiced medicine in, Northern Virginia since 1978. His medical specialties include neurology, neurophysiology and sleep disorders.
Cochran has been named as one of the Washington area's top physicians by Washingtonian Magazine since 1991, and by Washington Consumer Checkbook as one of their "Area's Outstanding Specialists" since 1993. He is a member of a wide array of national and state medical associations.
"It is my philosophy that the patient is boss in the final determination of what is done both diagnostically and therapeutically," he said. "I see my role as one of evaluating my patient and giving them all their options."
A graduate of Thomas Jefferson University/Jefferson Medical College of Philadelphia, Dr. Cochran is chairman of medicine at Inova Alexandria Hospital and chief of neurodiagnostics at Inova Fairfax Hospital.