UTSW's John Warner, M.D., hosts a neurolgy special that untagles the mysteries of the brain, featuring William Dauer, M.D., and Nader Pouratian, M.D., Ph.D.
here at Ut Southwestern. We're making significant progress in untangling the mysteries of the brain from Alzheimer's disease, depression, epilepsy and more. Our research is translating into better treatment, joining me today to share specific examples and what we can expect. Next is Dr William Dauer, director of you to South Western's. Peter O'Donnell Jr Brain Institute and Dr Nader Pratt in chair of neurological surgery. I look forward to our conversation Dr Dauer this last decade has produced a number of advances and learning about how the brain works and technologies and therapies to improve brain health and treat brain disease. Tell us some things. The O'Donnell Brain Institute is prioritizing and working on first and foremost genetics has been a very important growth area. Um We've identified genetic causes of things ranging from pediatric brain diseases to Parkinson's to Alzheimer's and many others. Another major advance is in the immune system actually. So we're learning much more about the interaction of the immune system with the brain. And then lastly, I would focus on right important technology for recording thousands of nerve cell activity at a time and that's leading to new ideas about how to modulate brain activity as a new type of therapy separate than what we would typically think of as a drug, but using electricity and other things for brain therapy. Dr prodi and your research focuses on brain mapping, tell us what that is and what role it might play in the future of neurosurgery, brain mapping is, the science of understanding how the brain is laid out both in terms of structure, meaning, you know, what parts of the brain are, where you know how thick some parts of the brain are or where the tracks are. Um as well as mapping functions. So understanding what functions that we value as human beings are located in different parts of the brain by understanding brain function and structure. We can hopefully develop and innovate new techniques to treat diseases that we otherwise haven't had therapies for. So, you know, brain mapping techniques have given rise to some clinical trials that were starting in depression and chronic pain to try and help people who may have limited options with traditional treatment. Dr Dauer tell us what a neuro degenerative brain disease is in the normal case. Your nerve cells should live for your for your entire life. But in neurodegenerative diseases and there are several of them specific types of brain cells begin to die away or to degenerate. There are three major diseases in this category are Alzheimer's disease, Parkinson's disease and something called Lou Gehrig's disease or ALs we're really trying to identify both root causes, how to stop these diseases at their before they come or slow their progress or in patients who already have them had the best modify their brain function to reduce their symptoms. Dr pride and I can't think of a specialty that depends more on imaging than the treatment of brain disease. Tell us where those imaging techniques are going and what's different from what we were doing five or 10 years ago and what's happening today. We're now able to use advanced imaging to look at how different parts of the brain are connected. What we call these white matter tracks, because we know the brain doesn't work in isolation. The different parts of the brain are connected to one another and seeing those white matter tracks helps us protect them as well as you know, possibly target them with our treatments. We're also able to use advanced imaging not only to look at the structure but function so we can use things like functional M. R. I. To look at what parts of the brain are active during specific tasks. Again to try and protect those areas or to target them as the case may be for the different interventions that we have. Dr Dauer CRISPR technology is a genetic editing technology that's recently awarded one of the Nobel prizes. Tell us what that technique is and how it's being applied to brain disease. Our D. N. A. Is composed of what are called bases or like letters of an alphabet um strung altogether, that tells the cells how to work. There are actually three billion of these letters in your D. N. A. What we can do with crisper Is go in through those three billion letters and change a single letter. Many diseases. We're learning about our genetic diseases that are caused by abnormalities of one or two of those letters. That gives us the opportunity now to go in and basically revert them back to what they should be or correct them most exciting within the O'donnell Brain Institute. This is being pursued by DR eric Olson to treat Duchenne muscular dystrophy, a really tragic illness that affects the people's muscles and can be fatal in many cases, CRISPR technology is tremendously valuable also in our research laboratories. So it's allowing us to do all types of experiments in cells where we can really do basically D. N. A. Surgery and that's extremely exciting dr friday. And we're devoting a lot of effort at UT Southwestern into understanding and treating epilepsy. Tell us a bit about what your team is doing in that area. Traditionally, the treatment of epilepsy has been limited to medical management. Unfortunately for many people, medical management does work. We have one of the leading centers though, for the surgical management of epilepsy. Some examples include using targeted lasers that we can implant through just a four millimeter hole in the skull to target the areas of the brain where seizures might be coming from. And then using uh that laser to uh a blade or burn that part of the brain and take away the root cause of the seizures are real strength here is, you know, we're understanding the root cause of epilepsy and we have a huge armamentarium of options to have the right treatment for the right patient in the right environment. So it's an exciting time and we continue to innovate and develop even further therapies. Dr tao we've talked on this program about high intensity focused ultrasound or high food. Tell us about the potential that technology has for treating diseases like essential tremor or Parkinson's in those diseases, their particular abnormalities and how electricity moves throughout the brain. And so what high intensity focused ultrasound does it allows us to um essentially damage a very very tiny part of the brain that we can focus and direct in such a way that we can reroute that information for therapy. It can also be used in other ways to sort of open something called the blood brain barrier that sort of um shield that prevents things from going from the blood into the brain. DR Procter and how does neuromodulation or deep brain stimulation treat depression? We often in our world speak about these diseases as network based diseases, meaning that we're disrupting how the brain different parts of the brain talk to other parts of the brain and that's what gives rise to symptoms. We use techniques like transcranial magnetic stimulation or TMS which is run by our psychiatry department through the interventional psychiatry program. We also have tried and true old technique which is electro convulsive therapy. And now we're moving forward to the next step of initiating clinical trials where we will be doing targeted deep brain stimulation for depression again. We're going to target those parts of the brain that can elevate the network function that are that is related to depression and hopefully alleviate those symptoms. Dr Dauer with the approval of the new drug for Alzheimer's out of home. Um there's been a lot of attention on Alzheimer's disease. Tell us what your thoughts are on the drug and what Ut southwestern is doing in terms of prioritizing research on Alzheimer's. Alzheimer's of course is a major area of focus for the O'donnell Brain Institute and the recent FDA approval of Abraham as you said, has brought a lot of attention to this. The classic idea of Alzheimer's disease, based on really decades of research has been um the idea that a protein known as beta amyloid accumulates in an abnormal way sort of clumps in the brain. That has been really viewed as a key driver of the neuro degeneration or the abnormal death of cells that leads to the symptoms of memory loss in Alzheimer's disease. What Adu helmet is is essentially an antibody that gets into the brain binds to amyloid. And the idea is essentially sort of like a vacuum cleaner takes it out of the brain and so prevents it from accumulating and the idea is that should improve symptoms or at least slow the progression of the disease. Over time. Most of the government payers are going to cover that drug but only for patients that are in approved clinical trials. And my feeling is that is a really good decision because we really just don't know yet whether that will be helpful and separate from the amyloid idea is another protein called tau, which also accumulates in the disease and in fact has been more tightly linked to the abnormal symptoms and in the center for Alzheimer's Alzheimer's disease and other neurodegenerative diseases led by DR Diamond. There's a very large, multidisciplinary focus on Tao and antibodies for that as opposed to amyloid as well as other therapies. And we think those hold a lot of promise. Well, these are exciting times in both understanding and treating brain diseases. And I want to thank you both for joining us here today and for these great insights on the progress that we're making UT Southwestern and in the field. Thank you so much for the opportunity. Thank you. Thank you for joining us until next episode. Stay safe and stay healthy.
