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Healing the Human Brain: The Next Medical Revolution Michael P. Kilgard 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 Stroke Autism Head Injury Schizophrenia Epilepsy Depression Anxiety Disorders – 400,000 - 700,000 each year – 500,000 - 750,000 each year – 2,000,000 – 2,500,000 – 19,000,000 – 25,000,000 Anxiety disorder due to a general medical condition Yes Panic disorder Yes Phobia Yes Separation anxiety disorder Yes Obsessive-compulsive disorder Yes Posttraumatic stress disorder Yes Generalized anxiety disorder Yes Adjustment disorder with anxiety Yes Anxiety disorder not otherwise specified No No No No No No No No Anxiety Electroconvulsive therapy Most neurological and psychiatric disorders are neither preventable nor curable. Staphylococcus Streptococcus Penicillin Alexander Flemming A Brief History of Antibiotics Pasteur Bacteria Flemming Penicillin 1877 1st Penicillin Treatment 1928 1942 Death due to TB and pneumonia plummets 1960’s Present A Brief History of Antibiotics and Vaccines Pasteur Bacteria Flemming Penicillin 1877 1st Penicillin Treatment 1928 1942 1960’s 1796 1952 Jenner Cowpox Salk Polio U.S. life expectancy: 47 years in 1900 Death due to TB and pneumonia plummets 1977 Smallpox eradicated Present 1998 1 polio in U.S. 1 diphtheria 34 tetanus 89 measles 77 years today Easy and Hard Problems of Infectious Disease Staphylococcus vs. HIV / AIDS Revolution 2.0 DNA X-ray diffraction pattern - 1952 Protein DNA 40,000 genes What’s it all good for? Phenylketonuria and Mental Retardation HEREDITY: Defective gene for Phenylalanine hydroxylase ENVIRONMENT: Eating proteins rich in the amino acid phenylalanine High blood levels of phenylalanine Abnormal brain development Mental retardation Universal Newborn Testing for PKU If positive, change diet Easy and Hard Problems of Molecular Medicine Phenylketonuria HEREDITY: Defective gene for Phenylalanine hydroxylase ENVIRONMENT: Eating proteins rich in the amino acid phenylalanine High blood levels of phenylalanine Abnormal brain development Mental retardation vs. Cancer 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? Easy Problem in Clinical Neuroscience Possibly Constraint-induced Rehabilitation Easy Problems in Clinical Neuroscience Relatively Pediatric Amblyopia Easy Problems in Clinical Neuroscience Relatively Pediatric Amblyopia Occlusion Easy Problems in Clinical Neuroscience Relatively Pediatric Amblyopia Weakening Easy Problems in Clinical Neuroscience Relatively Pediatric Amblyopia No Recovery Easy Problems in Clinical Neuroscience Relatively Pediatric Amblyopia Reverse Patch Easy Problems in Clinical Neuroscience Relatively Pediatric Amblyopia Restoration Solvable Problems in Clinical Neuroscience Deafness Hearing Loss 22 million Americans suffer irreversible hearing loss. 1 million are deaf. Engineering Solutions to Neuroscience Problems 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 Parkinson’s Basal Ganglia Disease Circuit X 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 Other tools Transcranial Magnetic Stimulation What are the hallmarks of curable disorders? Single Cause or Feedback Insult Disuse Neural Weakening Dysfunction Stroke Disuse Neural Weakening Motor Dysfunction MCI Neural Isolation Weakening Cognitive Dysfunction Autism Neural Isolation Weakening Language Dysfunction Today most neurological and psychiatric disorders are neither preventable nor curable. How will the world look when they are? The coming Brain Revolution will significantly alter: Medicine Economy - Lifespan - Quality of Life - Improved efficiency - New designs Philosophy - Greater understanding Education Justice System - Level the field - Culpability - Treatment - Improved efficiency Thanks to: Reprogramming the Human Brain Symposium April 12 -13, 2007