Not quite one-third of the way through his 70-minute discussion on the future of neurology, one of the country’s foremost researchers in the study of brain disease unleashed a bold and optimistic prediction.

“I believe,” said Gerald Fischbach, director of the National Institute of Neuro- logical Disorders and Stroke (NINDS) at the National Insti-tutes of Health (NIH), “that we should be able to arrest and perhaps stop Parkinson’s disease within this decade.”

Fischbach spoke to a crowd of several hundred listeners in WHSCAB auditorium, Jan. 10, as part of the Future Makers Lecture Series. His discussion, “The Changing Face of Neuroscience,” was the first such presentation of 2001.

“There is no one better to address the current research initiatives in neuroscience and the challenges ahead,” said Michael Johns, executive vice president for health affairs, during his introduction.
Recent advances in brain disease research over the past two or three years—even just the past year, Fischbach said—have made the eradication of Parkinson’s a possibility. He was quick to credit the work of several Emory neurologists, such as Mahlon Delong, Roy Bakay and Jerry Vitek, adding that much of the data in his presentation was collected by them.

“This center is without question the leading center for the study of Parkinson’s disease and related movement disorders,” Fischbach said of Emory and its neurologists.

Fischbach listed several reasons for his optimism, not only about finding a cure for Parkinson’s but in defeating more than a dozen other brain-related diseases.

Increased public support and funding, analysis of synapses and circuits within the brain, new insights from molecular genetics, analysis of cell death programs, advances in stem cell therapy, and a receptiveness to fresh ideas from new research-ers were all presented as initiatives that could lead to cures not only for Parkinson’s but also Alzheimer’s disease, Huntington’s disease and other neurological disorders.

Fischbach also listed several of what he called “secondary chronic neurodegenerative disorders,” such as multiple sclerosis, stroke, epilepsy and even AIDS, as targets of brain disease research.

“When you add all these together and realize the burden of disease they represent, they far exceed cancer today, and they far exceed heart disease today,” Fischbach said. “So these are major, major issues.

“There’s no question that disorders of the brain will become the leading public health matter in this current century—in fact, they probably already are.”

Fischbach went on to discuss several of the breakthroughs in neuroscience, such as how research on houseflies led to important discoveries about cell death and loss of motion—a main component of Parkinson’s. He also express the importance of increased funding. NINDS’ budget, for instance, increased $120–$150 million each of the past three years, which was crucial to recent research.

Fischbach said research in brain disease never stagnates, noting that more than 40 percent of the funding distributed by NINDS in fiscal year 1999 went to primary investigators who had never received it before.

Despite all of these advances, Fischbach understood the limitations of his science. “I don’t think we will ever understand consciousness; we won’t understand intelligence; we won’t understand some of the more profound aspects of memory, love and emotion,” he said. “But we can have insights into the brain. Fortunately, we don’t have to understand its basic workings to understand pathological processes and what goes wrong.”

Fischbach, actually, is about to move on from his position as NINDS director. He has accepted a position as dean of the faculty of medicine and vice president for health and biomedical sciences at Columbia University. He has led NINDS since July 1998.