The Honorable Gus Bilirakis: Title VI of H.R. 3717 increases funding for the Brain Research through Advancing Innovative Neuro-technologies (BRAIN) Initiative. Will you tell me more about this initiative and would this help in the study of Traumatic Brain Injury (TBI) or Post-Traumatic Stress?
Dr. Michael Welner: The (BRAIN) initiative aims to identify how cells and groups of related cells network within the normal and diseased brain. We already appreciated the nervous system as circuitry. It follows that disease includes alteration of that circuitry. If we better understand the points of abnormality specific to certain conditions or certain symptoms, we have far more specific guidance about where the fix needs to be done.
If we appreciate that problems in this circuitry are like breaks on a railroad track, we are given specific direction about where the repair needs to take place. Further study identifies the nature of the repair, and eliminating consequences of that repair. But pinpointing the features of illnesses along circuitry makes for far more specific treatments.
The implications for a circuitry model of mental illness are clearer for head injury. Head injury can sometimes be seen grossly on imaging scans. But more consistently, damage is reflected in functional, or neuropsychological, testing. Identifying neural circuitry affected in head injury and correlating it with functional deficits enables us to pinpoint approaches to healing the brain as if we were healing a wound or torn ligament.
Posttraumatic stress disorder is not as concrete as a head trauma. The BRAIN Initiative will eventually illuminate the circuitry of this illness. However, that may be just the beginning; for PTSD involves problems of hyperarousal, memory, emotion, and fear. Circuitry that relates to disparate functions within the brain will then have to walk backwards to remedy the upstream disease site.
Compare that approach to medicines that target neurotransmitters that are variably distributed throughout the brain. The gross vs. fine treatment of conditions is likewise reflected in the time it takes for the mind to adjust to these treatments, and their reversibility when medicines are removed.
In short, if we can identify diseases by unique networks and circuitry of neurons, our approaches to treatment can one day be as precise and fine as the resolution.
