Dr. Walter Koroshetz, MD

I'm Walter Koroshetz, the director of the National Institute of Neurological Disorders and Stroke at the U.S. National Institutes of Health. The National Institute of Neurological Diseases and Stroke, otherwise knows as NINDS has as their mission to understand how the nervous system works and then to use that knowledge for better treatments for patients who are suffering from neurological disorders and stroke.
The National Institute of Neurological Disorders and Stroke is working in a broad spectrum of neuroscience now, both clinical and basic. But there are three major projects that have come upon us in the last couple of years, the first of which is the brain initiative, and the goal of the brain initiative is to better understand circuit activity, how information is processed in the brain.
The second one is what we call the HEAL Initiative and that stands for Helping to End Addiction Long-term. And our role at NINDS in that is to try and develop nonaddictive treatments for pain that would reduce the terrible crisis the U.S. is currently in with the opioid epidemic and opioid overdose disorders. The National Institute of Drug Abuse is pioneering the part of the HEAL Initiative that's directed primarily at opioid overuse.
The third project is a project which is managed heavily by the National Institute of Aging and the goal there is to do research that will decrease the crisis that is growing in America as the population ages of dementia. And at NINDS, our piece is primarily involved with the vascular contribution to dementia, the frontotemporal dementias, and the dementia that occurs in Parkinson's or what we call Lewy body disease.
Well, I think that the project that has been going on the longest and not that long, since 2014, is called the brain initiative, and that has really revolutionized how people look at circuits in the brain. So I would say that for the decades in which I grew in neuroscience, it was heavily on a molecular basis because there really weren't the tools to understand how the networks in the brain acted to create the behaviors.
So we concentrate on the molecules which we could put our handles on... had handles on. But now there are tools where we can actually see the activity of hundreds of thousand of neurons at a time in awake behaving animal and there are technologies now where we can record over the surface of the brain from patients who have say, deep brain stimulators or being monitored to understand where the epilepsy is coming from.
And that is giving us incredible information about how brain networks work. One example in the latter case is a paper by Dr. Eddie Chang, who's a neurosurgeon at San Francisco where they're able to record the activity over the speech area, the motor speech area in patients undergoing epilepsy monitoring and from that activity, they were able to predict what the patient wanted to say even though they didn't make any sounds.
So just an example of the kind of things coming out of the brain initiative now. Well, one of the major advances in technology has been coming out of what we call the brain cell census project. So on one hand, it's basically a library of all the different cell types in the brain, but more importantly, not only do we know what the different cell types are now from this major project, but we have genomic access to specifically the cell types.
And because the transcriptome information gives us a way in which we can have a genomic key, the enhancers, the cell specific enhancers, give us a genomic key so that we can activate or deactivate particular cell types in the brain and really just try to understand how they play a part in any network activity.
So I'd say it's a cell specific ability to modulate the nervous system and monitor the nervous system that has really revolutionized neuroscience.