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Cognito Therapeutics develops novel disease modifying therapies for neurodegenerative diseases
Steven Loeb speaks with Brent Vaughan, Chief Executive Officer at Cognito Therapeutics, a company developing novel disease modifying therapies for neurodegenerative diseases based on neuromodulation.
The company is currently recruiting people to participate in a non-invasive wearable study device that delivers sensory stimulation and has the potential to slow the progression of Alzheimer’s disease, from the comfort of home. People who are interested can sign up here.
Our goal is to understand tech breakthroughs radically changing healthcare: the way we screen, diagnose and treat conditions and measure outcomes. And whether tech is helping or hurting our well-being physically and mentally.
Highlights from the interview:
- Vaughan joined Cognito in December 2020: before that he had been leading a company in the pediatric behavioral health space, working on autism and behavioral health indications, and earlier in his career he had been at a company where they developed two drugs through Phase Two in the Alzheimer's space. He sees some similarities with working in pediatrics and with seniors, including the need to focus more holistically on the family. The Alzheimer's population has an impact on the at-home care partner, which is oftentimes a family member or spouse, as well as the entire family. There's been lots of studies showing that the caregiver burden, which usually falls to a family member and Alzheimer's is in itself becoming an epidemic in our society.
- It's clear that Alzheimer's and MCI, which is a related precursor condition, is the largest unmet healthcare need. One of the reasons it's so hard to treat is we don't have a universal theory and understanding of the brain. We know what various parts of the brain do, but we don't actually understand the etiology and the functionality of the brain at a level that we do with cardiovascular disease. When we think about a lot of those diseases where we've been able to really fundamentally move the needle, we've started to get a crisp understanding of what the etiology is, what are the causative factors that in what their relative weightings is for, for disease development. Yet, when we look at Alzheimer's and dementia patients, they're a very heterogeneous group, because we just don't understand.
- Over the last couple decades, there’s been an increased focus on the amyloid protein that accumulates in the brains of Alzheimer's; this is the diagnostic characteristic that defines the disease. But it turns out there's many different forms of amyloid in the brain: there's the amyloid plaque that people have been focused on to talk about for a long time, but there's also more soluble forms of amyloid, which we're not as good at being able to visualize, and it turns out that they might have different roles in the disease. There are patients who are afflicted by Alzheimer's who don't show large accumulations of amyloid plaque and there are patients with amyloid plaque who do not exhibit the symptoms of Alzheimer's dementia. So, it's not a black and white outcome.
- Cognito puts its device on the patient while the EEG is running so it can see the brain immediately start to respond. It can see that it is are modulating the target in the patient while they're sitting in front of them and they can see that it's starting to regenerate the brain's ability to communicate across the brain with certain frequencies that are seen in healthy patients that are missing in Alzheimer's patients. Cognito has shown that by producing the right stimulation, it can get the brain to start to work towards the path of restoring the balance within the brain, and it does this with electrical activity across the brain, which immediately starts to impact brain function.
- Instead of using magnets or electrical stimulation, Cognito uses light and sound. By shining specific frequencies of light and having specific frequencies of sound, every time that sound or that light triggers the optic, or the auditory nerves, those nerves fire. If you could think of a light flashing at a certain frequency, every time that that light activates the optic nerve, the optic nerve fires an electrical impulse into the brain and by controlling and modulating the frequency of these light and sound stimulation, the device can actually get the brain to start naturally firing at this frequency.
- The product is a regulated medical device. Because of that, it will be prescribed by physician as part of the diagnosis, so people can think of it more like a drug in that the physician will see the patient and the physician will determine whether or not this is the right therapeutic modality, they will then prescribe it, and it will be fulfilled by the pharmacy. The goal is to be able to have broad insurer and payer coverage upon launch. Cognito has already started discussions with the major payers across the US and has a strategy for to carry those discussions on to CMS because the majority of its patients are Medicare patients.
- An advantage of at-home based treatments like Cognito is that it has a treatment modality that it believes can be can modify the trajectory of disease progression. Being able to do this with an at-home treatment, where patients aren't required to go into a hospital or into a clinic once every two weeks or once every month to receive their medication is, ultimately, going to be better for the patient, and better for the family. If we can have a therapy that treats the progression of disease, while allowing patients to have a healthy aging at home and in place, that's an important aspect of how we deal with and how we look at treating these patients going forward.
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