National Academies Press: OpenBook

Transforming Human Health: Celebrating 50 Years of Discovery and Progress (2022)

Chapter: Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain

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Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
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Neuroscience and Neurological Diseases:

Unlocking the Mysteries of the Brain

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Illustration of neural networks in the brain (iStock®)

As the nexus among health, behavior, and medicine, the brain is vital in extending human life and enhancing well-being. Intensive study of the cellular and molecular processes that control our thoughts and actions, combined with the use of animal models in neurological research, have produced key insights into how the brain works and the development and treatment of neurological disorders.

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Advanced 3D MRI scan of a human brain (Science Photo Library®)
Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
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1970s

Treatment for Parkinson’s Disease

Although Parkinson’s disease was first described in medical literature in 1817, an effective treatment wasn’t available to most patients until the 1970s. Levodopa works by addressing dopamine deficits in the brain thought to be responsible for symptoms such as tremors and stiffness. In 1986, an effective surgical technique known as deep brain stimulation was introduced. In 1997, scientists discovered that a neuronal protein called alpha-synuclein plays both a genetic and neuropathological role in Parkinson’s disease, opening a path to new therapies.

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Illustration of a deep brain stimulation treatment for Parkinson’s disease: A brain pacemaker sends electrical impulses to specific areas of the brain through an electrode implanted below the scalp. Continuous electrical stimulation blocks the signals that cause the tremors of Parkinson’s disease. (Science Photo Library®)

1971

A “GPS” in the Brain

Humans and other mammals can orient themselves in space and remember the route from one place to another thanks to a positioning system in the brain. Nerve cells known as “place cells,” discovered in 1971, form a mental map of a person’s surroundings, while “grid cells,” not discovered until 2005, act as a coordinate system that enables precise positioning and pathfinding.

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iStock®

1971

Role of the Brain in Hormone Regulation

In 1971, scientists synthesized luteinizing hormone-releasing hormone, a compound produced by the hypothalamus to regulate the pituitary gland’s secretion of certain reproductive hormones. Culminating decades of research to understand the relationship between the nervous and endocrine systems, the achievement led to new treatments for infertility and hormone-sensitive cancers.

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Illustration of the pituitary gland (upper red) and the thyroid gland (bottom red), part of the endocrine system (iStock®)

1973

Discovery of Opioid Receptors in the Brain

Opiates have been used to dull pain for thousands of years, but scientists didn’t understand how drugs like morphine and heroin affected the brain until 1973. This breakthrough led to the discovery of endorphins and other naturally occurring opiate-like molecules, which dramatically advanced understanding and treatment of pain and substance use disorders.

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Illustration of an enkephalin molecule, which is an endorphin and one of the opioid peptides that occurs naturally in the human brain (Science Photo Library®)
Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
×

1980s

Understanding Alzheimer’s Disease

Within the brains of individuals with Alzheimer’s disease, proteins responsible for the formation of plaques were discovered in the 1980s, followed shortly by the identification of genes associated with inherited and idiopathic forms of the disease. Cognex, the first drug to treat the memory loss and dementia associated with Alzheimer’s, reached the market in 1993—a year before President Ronald Reagan announced his own Alzheimer’s diagnosis. By 2010, Alzheimer’s had become the sixth leading cause of death in the United States, and prevention and treatment remain urgent areas of research.

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Illustration of amyloid plaques among neurons: The plaques lead to degeneration of the affected neurons. (iStock®)
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iStock®

1991

Mapping the Olfactory System

The human brain can recognize about 10,000 different odors. In 1991, scientists discovered that about 3 percent of the human genome is dedicated to maintaining this complex sense of smell. About 1,000 genes determine the makeup of highly specialized olfactory receptors located on cells in the nasal cavity, which in turn send signals to the olfactory center of the brain.

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iStock®
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Illustration of olfactory nerves (Science Photo Library®)

1990s

Navigating Neuroplasticity

For many years, scientists believed that brain plasticity—the ability to change and adapt—was limited to early childhood. However, beginning in the 1990s, research began to demonstrate that the brain is capable of remodeling itself at any age, although at a more limited scale and pace. Principles of neuroplasticity have informed treatment for brain injury and a range of neurological disorders. More recently, scientists have learned about processes that inhibit plasticity, including the role of glial cells in “synaptic pruning” and the accumulation of proteins that affect the brain’s receptors.

1993

Diagnosing Huntington’s Disease

In 1993, scientists succeeded in isolating and sequencing HTT, the gene that causes Huntington’s disease—an autosomal-dominant, fatal neurodegenerative disorder. A simple blood test can now determine the presence of HTT, allowing those with the gene to make informed decisions about family planning.

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Illustration of pyramidal neurons of human brain temporal cortex (Science Photo Library®)
Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
×

2019

Gene Therapy for Infants

The most common cause of inherited infant mortality, spinal muscular atrophy usually results from a missing or mutated form of the survival motor neuron 1 gene. Children with this condition suffer from debilitating and often fatal muscle weakness and have problems holding their head up, swallowing, and breathing. In 2019, the U.S. Food and Drug Administration approved a gene replacement therapy involving a one-time intravenous injection that replaces the defective or missing gene with a working copy that increases motor neuron function, decreases the need for respiratory support, and increases the likelihood of survival.

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Light micrograph of dendrites (black) from motor neurons in muscle tissue (pink-purple strands) (Science Photo Library®)
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Woman with spinal muscular atrophy (Science Photo Library®)

2019

Three-Dimensional Mapping of the Brain

In 2019, a map of neural connections in the brain of the microscopic worm C. elegans was published—the first complete “connectome” of a multicellular animal. Partial connectomes of a mouse and fruit fly followed months later, marking a significant step forward in visualization of brain processing. These and future connectomes may yield important insights into brain diseases like Alzheimer’s and schizophrenia.

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Colored 3D diffusion spectral imaging scan of the bundles of white matter nerve fibers in the brain (Science Photo Library®)
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iStock®

To reduce the ravages of neurological diseases, much still needs to be learned about how disease and age alter the structure and function of the brain. New knowledge could inaugurate an era of “neurotherapeutics” in which gene therapies, pharmaceuticals, and brain–computer interfaces can address a wide variety of neurological conditions.

Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
×
Page 6
Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
×
Page 7
Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
×
Page 8
Suggested Citation:"Neuroscience and Neurological Diseases: Unlocking the Mysteries of the Brain." National Academy of Medicine. 2022. Transforming Human Health: Celebrating 50 Years of Discovery and Progress. Washington, DC: The National Academies Press. doi: 10.17226/26722.
×
Page 9
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The past half-century has been an era of astonishing progress for biomedical science, health, and health care in the United States and worldwide. This volume, commissioned to mark the occasion of the 50th anniversary of the founding of the U.S. National Academy of Medicine (NAM; formerly the Institute of Medicine [IOM]), tells the story of that progress across five major fields: biomedical science and technology, diseases and conditions, public health, U.S. health care, and global health. Since the NAM was founded in 1970, the nation and the world have seen multitudes of remarkable "firsts"—including the dawn of targeted gene therapies, the near eradication of polio, revolutionary treatments for cancers and cardiovascular disease, and many more. NAM members were the architects of many of these breakthroughs, alongside countless dedicated scientists, clinicians, educators, and public health leaders worldwide. The milestones chronicled in this volume are a testament to their remarkable work, which has saved and improved innumerable lives.

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