For three days this week, Roanoke, Virginia, is the capital of the precision neuroscience world. The first-ever scientific meeting to explore an ultra-personal approach to brain health — the Virginia-Nordic Precision Neuroscience Conference — opened Wednesday morning at the Virginia Tech Carilion Research Institute.
“The promise, hope, and opportunity for precision neuroscience is great — with the potential for realizing the brain and mind’s full potential, preventing disorders, and restoring brain health after injury or degenerative disease,” said Virginia Tech President Tim Sands, who welcomed about 200 scientists on behalf of Virginia Tech and Carilion Clinic. “It is also the responsibility of the scientific and medical communities to help define the real possibilities, differentiate hype from reality, and help focus the scientific enterprise and resource allocation on areas where the promise can be realized.”
More than 1,000 disorders of the brain and nervous system result in more hospitalizations than any other disease group, including heart disease and cancer, according to the Society for Neuroscience.
“By understanding an individual’s genetics, behavior, education, habits, life experiences such as physical and psychological trauma — all the things that make people who they are — the neuroscientific community may be able to develop individually tailored plans for people to optimize education, health care, diet, exercise, and environments where they are likely to thrive cognitively, socially, and physically,” said Michael J. Friedlander, Virginia Tech’s vice president for health sciences and technology and the founding executive director of the Virginia Tech Carilion Research Institute.
The collaboration grew from an idea developed by Friedlander and Tor S. Haugstad, a neurologist and neuroscience chair at Sunnaas National Rehabilitation Hospital in Oslo, Norway, worked to develop as the Norway/U.S. Neuroscience Collaboration, initially called NUNC. The effort has grown to include multiple universities in Norway and several other Nordic countries, as well as universities and foundations throughout Virginia.
People respond to brain injuries differently, which is one of the motivations for further development of the precision neuroscience field.
“We may get two people in our department with very similar brain injuries, and one may be rendered with a low level of consciousness while the other can recover and return home to his family and work life,” said Haugstad, who also chairs the traumatic brain rehabilitation program at Sunnaas National Rehabilitation Hospital. “We need to discover at cellular and molecular levels why people respond so differently and tailor treatment and rehabilitation to the specific person.”
The meeting, which will continue through Friday, is the first to bring the top minds of precision neuroscience from across the globe together in a think-tank setting to explore the challenges and promise of bringing personalized medicine to brain health and brain disorders.
“One individual’s experience with Alzheimer’s disease, Parkinson’s disease, a traumatic brain injury, or various other neurological or psychiatric disorders will not be exactly like anyone else’s,” Friedlander said.
“From a business and health care point of view, clinical trials may fail because they target generic diseases that manifest very differently in different people," Friedlander said. "If a drug or treatment doesn’t work in 75 percent of the people, it is considered a failure — but it worked in 25 percent. Should we forget about the 25 percent of people it helped and scrap potentially lifesaving therapies that may have cost hundreds of millions of dollars during a decade of development?”
By targeting groups of patients based on their predicted manifestations of a particular brain disorder, the success rate for finding new treatments will improve and the investment risk can be lessened, according to Friedlander.
“Essentially the pharmaceutical industry and investors de-risk their investments by having more precise, targeted therapies and tests that are more likely to be successful,” Friedlander said. “The treatment may be effective for 10 percent of people with a particular brain disease, but we can learn a lot about why those 10 percent may have benefitted based on their genetic composition and expression patterns and their life experiences. Then, we get back to work on a treatment for the next 10 percent, and the next 10 percent. It may not be one size fits all.”
Researchers will discuss innovations ranging from a Nobel prize-winning imaging system that visualizes the action of molecules within the brain, to the work of physician-scientists who are on the frontlines of health-care delivery for brain injury, neurodegenerative diseases of aging, and brain developmental disorders.
In many ways, the conference has special meaning for the partner cities in Virginia and in Europe, Haugstad said.
“Roanoke is a city with a history of rail that, through innovation and spirit, is reinventing itself, and it is leading the way in precision neuroscience,” Haugstad said. “In Norway, a country that depends on oil revenue, the cities are changing much like cities in Virginia, by finding new ways to live and move forward. Together, we are very good partners.”
The Roanoke sessions involve brain researchers, physicians, and physician-scientists from Norway, Sweden, Denmark, and Finland as well as from Virginia Tech, Carilion Clinic, and throughout Virginia, including the University of Virginia, Virginia Commonwealth University, and the Howard Hughes Medical Institute Janelia campus in Ashburn. Thought leaders from the National Institutes of Health, health care and pharmaceutical industries, and colleagues from California, Pennsylvania, and North Carolina leaders are involved.