I’ve spent the past 2 days participating in a workshop at the National Institutes of Health titled “Harnessing Neuroplasticity for Human Applications”. You would probably have enjoyed – and learned from — listening in on these discussions. The participants at this meeting (including many top American gurus and practitioners in neuroplasticity) outlined the state or current research and application, identified gaps in our understanding and impediments for making progress, tried to list obvious therapeutic targets, and considered how more powerful and effective multiplidisciplinary teams could be organized to develop new tools to help neglected medical populations. Different panels reported to the larger group on issues of 1) child health, disease & brain injury; 2) addiction and psychotic illness; 3) brain injury or stroke; and 4) normal and pathological aging.
Meetings like this are both highly encouraging, and substantially discouraging. On the encouraging side, the progress and wisdom of the leaders in this scientific field are rapidly growing — and a growing number of top-level scientists and clinicians are now focussed on the development of this science and the delivery of its fruits out into society. It was also encouraging to see that, slowly but surely, NIH officials are beginning to understand that a medical revolution for neurological and psychiatric medicine — and human health — is now underway.
On the discouraging side, this field is still highly undisciplined, approaching plasticity issues in a myriad of piecemeal ways, still arguing about the fact or power of plasticity in adult brains, still suffering from limited communication between scientists and clinicians in different disciplines (real reading, for scientists, must be at an all-time low), and currently delivering very little of real practical use from the laboratory out to the ‘real world’ of clinical medicine. One problem is a lack of standardized, generally-agreed-upon measures of performance improvement and outcome success in malady and malady. Another problem is the persistent limitation of perspective by which plasticity is defined by scientists in terms of an isolated process(es) in an isolated brain location(s), by a lack of understanding of fundamental science in one neuroplasticity camp, by a lack of understanding of clinical science by the other, or by the reliance in studies of a simple behavior assuming that correcting it equates with overcoming a dysfunction of injury. Plasticity changes complex brain SYSTEMS. Alas, not very many scientists or clinicians yet operate with the grandeur of it all firmly in mind.
Still, I’m hopeful. The NIH is finally beginning to get is act together, in this field. Increasingly, it’s supporting a much more effective multidisciplinary team approach, which is required to accelerate the development of practical aids that can help people in need. It would appear to be interested in supporting more multiple-site outcomes trials for new therapies that promise to benefit the autistics and schizophrenics and depressives and MCIs and TBIs and the thousand-and-one other classes of citizens who could benefit from this science. The Europeans are a little ahead of us, in getting their act together in this field, but we Americans can more than compete, if the admininstrative forces in our Washington health institutions and our great commercial resources can really get this going.
For all you folks out there who want to give Uncle Sam a prod, to assure that they come through, let your Congressperson and Senator know that neuroplasticity research and treatments are important for you and your family, and let the Directors of the Child Health (Dr. Duane Alexander), Aging (Dr. Richard Hodes), Mental Health (Dr. Thomas Insel), Drug Abuse & Addiction (Dr. Nora Volkow) and Neurology (Dr. Story Landis) Institutes of the National Institutes of Health know that this is one of the most hopeful initiatives that has come down the pike in many a moon!