The Emory Brain Health Center has been selected to participate in the Adult Hydrocephalus Clinical Research Network’s study on the effectiveness of shunt treatment for idiopathic normal pressure hydrocephalus (iNPH). The $14 million, multi-site grant is funded by the NIH’s National Institute of Neurological Disorders and Stroke (NINDS) and is the largest grant ever awarded to study adult hydrocephalus.
According to the Hydrocephalus Association, iNPH is a complex disorder of the elderly caused by an excess accumulation of cerebrospinal fluid in the brain that affects as many as 700,000 people in the U.S. The only treatment is for a neurosurgeon to implant a permanent internal drainage system, called a shunt, into the brain to drain the excess cerebrospinal fluid.
However, not everyone in the medical community agrees shunt surgery is an effective treatment for iNPH, and, as a consequence, many patients who may benefit from shunt surgery do not receive it. The grant aims to prove conclusively whether or not shunt surgery for iNPH is beneficial.
“We hope our participation in this clinical trial will play an integral role in providing answers on whether shunting is an effective treatment for iNPH. With Emory’s world-renowned research in neurosurgery, this is a great opportunity for us to help impact patient treatment, while supporting the overall health care community,” says site principal investigator Daniel Barrow, MD, chair of the Department of Neurosurgery, Emory University School of Medicine.
Barrow along with George “Chip” Wilmot, MD, PhD, associate professor of neurology, and the Emory team will join 18 other health centers across the United States to conduct the study. It will be the first large-scale, multi-center, blinded, randomized controlled trial to evaluate the true response of shunting in patients with iNPH.
“I look forward to working with Dr. Barrow and our Emory team as we participate in this important study. This will be a great opportunity to learn more about treatment for hydrocephalus that will not only benefit our patients but those affected by iNPH across the world,” says Wilmot.
During the trial, 100 patients with iNPH who are undergoing shunt surgery will be randomly assigned to one of two groups, either with the shunt valve open (on) or closed (off) for the first three months after surgery, after which all shunts are in the open setting. The shunt valves can easily be adjusted to an open setting in the clinic with a simple tool that does not require additional surgery.
Evaluations before and after surgery will compare the response of iNPH symptoms such as slowed walking speed, impaired cognition, mood and bladder control at the end of three months in the two groups and will continue to follow the symptom response in all patients for the following year while all shunts are in the open setting.
About Brain Health at Emory University
As one of the nation’s premier research universities, Emory University is a leader in education, discovery and patient care related to the neurosciences. Faculty scholars, scientists, physicians and clinicians throughout the university collaborate on advancing knowledge associated with the brain and brain health. The Emory Brain Health Center combines neurology, neurosurgery, psychiatry and behavioral sciences, rehabilitation medicine and sleep medicine in a unique, integrated approach. Emory researchers are predicting, preventing, treating and curing diseases and disorders of the brain and addressing the growing global crisis associated with some of the most common ones. In addition, Emory’s neuroethics program explores the evolving ethical, legal and social impact of the neurosciences. Emory’s multidisciplinary approach is transforming the world’s understanding of the vast frontiers of the brain, harnessing imagination and discovery to address 21st-century challenges.