Michael P. Kilgard Healing the Human Brain: The Next Medical Revolution University of Texas at Dallas

Alzheimer’s Disease Affects 4 million Americans. 12 million predicted by 2040.

Hearing Loss 22 million Americans suffer irreversible hearing loss. 1 million are deaf.

Migraine and Chronic Pain 75 million Americans with chronic pain.

Substance Abuse 22 million Americans are drug or alcohol dependent.

Multiple Sclerosis – 400,000 Stroke - 700,000 each year Autism – 500,000 Head Injury - 750,000 each year Schizophrenia – 2,000,000 Epilepsy – 2,500,000 Depression – 19,000,000 Anxiety Disorders – 25,000,000

Anxiety disorder due to a general medical condition Panic disorder Phobia Separation anxiety disorder Obsessive-compulsive disorder Posttraumatic stress disorder Generalized anxiety disorder Adjustment disorder with anxiety Anxiety disorder not otherwise specified Anxiety No Yes No Yes

Electroconvulsive therapy

Most neurological and psychiatric disorders are neither preventable nor curable.

StaphylococcusStreptococcus

Penicillin Alexander Flemming

’s Present Pasteur Bacteria Flemming Penicillin 1 st Penicillin Treatment A Brief History of Antibiotics Death due to TB and pneumonia plummets

’s Present Pasteur Bacteria Flemming Penicillin 1 st Penicillin Treatment U.S. life expectancy: 47 years 77 years in 1900 today Jenner Cowpox Salk Polio Smallpox eradicated 1 polio in U.S. 1 diphtheria 34 tetanus 89 measles A Brief History of Antibiotics Death due to TB and pneumonia plummets A Brief History of Antibiotics and Vaccines

Easy and Hard Problems of Infectious Disease Staphylococcus vs. HIV / AIDS

Revolution 2.0

DNA X-ray diffraction pattern

DNAProtein

40,000 genes

What’s it all good for?

Phenylketonuria and Mental Retardation High blood levels of phenylalanine Abnormal brain development Mental retardation HEREDITY: Defective gene for Phenylalanine hydroxylase ENVIRONMENT: Eating proteins rich in the amino acid phenylalanine

Universal Newborn Testing for PKU If positive, change diet

Easy and Hard Problems of Molecular Medicine Phenylketonuria vs. Cancer High blood levels of phenylalanine Abnormal brain development Mental retardation HEREDITY: Defective gene for Phenylalanine hydroxylase ENVIRONMENT: Eating proteins rich in the amino acid phenylalanine

Revolution 3.0 ?

Healing the Brain…

Tools of Revolution Pharmacology Genetics Stem cells Functional brain imaging Transcranial magnetic stimulation Deep brain stimulation Computer-based training Psychotherapy

Are There Any Easy Problems in Clinical Neuroscience?

Possibly Easy Problem in Clinical Neuroscience Constraint-induced Rehabilitation

Relatively Easy Problems in Clinical Neuroscience Pediatric Amblyopia

Relatively Easy Problems in Clinical Neuroscience Pediatric Amblyopia Occlusion

Relatively Easy Problems in Clinical Neuroscience Pediatric Amblyopia Weakening

Relatively Easy Problems in Clinical Neuroscience Pediatric Amblyopia No Recovery

Relatively Easy Problems in Clinical Neuroscience Pediatric Amblyopia Reverse Patch

Relatively Easy Problems in Clinical Neuroscience Pediatric Amblyopia Restoration

Solvable Problems in Clinical Neuroscience Deafness

Hearing Loss 22 million Americans suffer irreversible hearing loss. 1 million are deaf.

16 channel rechargeable implantable pulse generator for treatment of chronic pain ANS – Plano, Texas Engineering Solutions to Neuroscience Problems

Cyberonics - Houston, Texas Vagus Nerve Stimulation Epilepsy, Depression 32,000 patients Engineering Solutions to Neuroscience Problems

Basal Ganglia Circuit X Parkinson’s Disease

Engineering Solutions to Neuroscience Problems 30,000 people

MRI and x-ray showing stimulating electrodes in thalamus of a patient with Parkinson’s Disease

Other tools Optical Imaging

Transcranial Magnetic Stimulation Other tools

What are the hallmarks of curable disorders? Single Cause Feedback or

Insult Dysfunction Disuse Neural Weakening

Stroke Motor Dysfunction Disuse Neural Weakening

MCI Cognitive Dysfunction Isolation Neural Weakening

Autism Language Dysfunction Isolation Neural Weakening

Today most neurological and psychiatric disorders are neither preventable nor curable. How will the world look when they are?

Medicine - Lifespan - Quality of Life Education - Level the field - Improved efficiency The coming Brain Revolution will significantly alter: Economy - Improved efficiency - New designs Justice System - Culpability - Treatment Philosophy - Greater understanding

Reprogramming the Human Brain Symposium April , 2007 Thanks to: