NEUROLOGICAL INFORMATION NETWORK

The Institute has developed a National Neurological Information Network to facilitate the prompt exchange of information within the medical and scientific Community through the establishment of information centers in universities having outstanding library facilities. These are the Information Center for Hearing, Speech, and Disorders of Human Communication at Johns Hopkins University; the Brain Information Service at the University of California at Los Angeles; and the Vision Information Center at Harvard University. This latter center will be financed in 1970 from the National Eye Institute.

The Network is directed by the Office of Program Analysis, NINDS, and operates in close collaboration with the National Library of Medicine. It is engaged in a review of scientific reports, indexing for the Library's MEDLARS system, publication of bibliographies, special reviews, symposia, and a review of articles on topics of special interest.

This Network now has a steady output of special service bulletins in a variety of areas such as Parkinson's disease, sleep physiology, electroencephalographic literature, enzyme chemistry of the brain, and communications disorders. Some of the special reviews which have been produced are now the standard works on the subject. The Vision Information Data Bank is computerized and will serve anyone who wants to print a terminal and pay line costs and search it. over twenty such users throughout the country and the number is steadily increasing.

Summary

There are

The increase of $115,000 includes program increases of $60,000 to support research on viruses and their possible role in neurological disorders, $2,000 for annualization of the 1970 pay increase, $27,000 for within grade pay increases, $2,000 for increased cost in 1971 of using the Federal Telecommunications System and $24,000 for payments to the National Institutes of Health Management Fund for centrally furnished services.

This activity supports the training programs for professional, technical, administrative, and clerical personnel, including job-related training at both government and non-government facilities.

The primary objective of the program is to train scientists in particular skills which are needed to carry on various Institute research projects. Long term training is provided by the establishment of agreements and contracts with appropriate schools or institutions.

The Institute, through its Direct Training Activity, supports "Outside the Service Training" of selected staff, generally from one to three years. The purpose is generally to provide advanced clinical and research training for career staff.

Program Plans for 1970 and 1971

During 1970 and 1971, the Institute will support two trainees from the NIH Management Intern Program. However, no positions are shown for these as they are controlled and allocated from the Office of the Associate Director for Administration, NIH.

The Institute supports doctors from the PHS hospitals of the Federal Health Programs Service, Health Services and Mental Health Administration, for advanced training in neurology and otolaryngology. They are selected on a basis of research competence and NINDS arranges for their training in programs noted for excellent research and clinical environment. On their return to their Institutions, they will spend a portion of their time in research. Funding support is furnished from "Other Expenses". The funds are transferred to the Federal Health Programs Service's Reimbursable Account for the salaries and expenses of the trainees involved.

The decrease of $2,000 is for payment to the National Institutes of Health Management Fund for centrally furnished services.

The Extramural Programs administers the Institute's grant and award programs in support of medical research and training in the neurological and communicative disorders. Research grants, program project grants, research center grants, training grants, fellowships, and traineeships, are programmed, examined, processed and administered by the professional, administrative and clerical staff of the Institute's Extramural Program. Advise on technical merit and program significance are provided by organized and ad hoc bodies of non-governmental authorities in the health and science fields, including the National Advisory Council of Neurological Diseases and Stroke, training review committees, clinical center-program project review committees and study sections of the Division of Research Grants, National Institutes of Health.

Program Plans for 1970 and 1971

The program planning, management and review processes continue to impose greater demands on Institute data as a basis for program planning and evaluation. Extramural advisory groups or task forces expert in critical fields of Institute responsibility have been organized to provide essential data and advise on needed program development. In addition, the development of the Extramural Program Data Analysis and Reports Section has provided a base for data storage and retrieval and program analyses.

The decrease of $2,000 includes increases of $1,000 for annualization of the 1970 pay increase, $17,000 for within grade pay increases, $1,000 for the increased cost in 1971 for using the Federal Telecommunications System, and a decrease of $21,000 in the payment to the National Institutes of Health Management Fund for centrally furnished services.

This activity supports professional and administrative direction of the Institute's activities. The Office of the Director provides for the centralized supervision, coordination and review of these programs, as well as for the direction of the administrative functions of finance, personnel, supply, travel, space utilization and management analysis.

Summary

The total increase requested includes $3,000 for within grade pay increases and $14,000 for payments to the National Institutes of Health Management Fund for centrally furnished services.

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PROGRESS REPORT

Senator MAGNUSON. The next institute is the National Institute of Neurological Diseases and Stroke. Dr. MacNichol is the Director of this institute.

We will be glad to hear from you.

For the purpose of the record, the 1970 appropriation was $102.9 million. After the so-called 2-percent reduction, it was $96.3 million, and this vear the budget request was $97 million. The House made it $100.8 million and you are talking about $99.8 million, which is approximately $3.5 million over what you spent last year.

Dr. MACNICHOL. Yes, sir; I believe that is correct. Now, with your permission, I should like to read a very brief progress report.

In epilepsy, clinical tests of several anticonvulsants are underway: Zarontin for petit-mal attacks in children at Virginia College of Medicine and Marquette University School of Medicine.

Albutoin for grand-mal at New Castle State Hospital, Indiana. Sulthiame for partial seizures at the University of Washington, under the direction of Dr. Arthur Ward, who by coincidence seems to be sitting on your left.

Senator MAGNUSON. He is here visiting the bank. [Laughter.]

Dr. MACNICHOL. We are now organizing to conduct clinical trials quickly and efficiently on promising new anticonvulsant drugs as they appear. To aid in the control of blood levels of the drugs, we have started a small laboratory of clinical pharmacology.

HEAD INJURY

A study has been completed on the mechanical properties of the materials of the head in three institutions under contract. We now have the numbers to use in studies of the mechanics of head injury and the design of protective devices.

There are other contract studies on the mechanics of head-neck junction injuries, and of the mechanical properties of cerebral blood vessels.

A study in our Surgical Neurology Branch on monkeys has shown that rotation of the head is more important than linear motion in producing head injury. There are indications that a stiff collar such as is used in the treatment of neck injury would offer considerable protections.

PARKINSONISM

The breakthrough in using L-dopa in Parkinsonism has generated a great deal of new interest in the mechanisms underlying this disease and related ones, such as Huntington's chorea. Several of our grantees are following up leads generated in the L-dopa studies, and a promising new anti-Parkinson drug is undergoing preliminary tests at Johns Hopkins.

Senator MAGNUSON. We had a long discussion last year about L-dopa. A year has gone by. Has it lived up to expectations?

Dr. MACNICHOL. Yes, sir; it has. In fact, the Food and Drug Administration decided to release it for general use with certain restriction.

SENSORY PROSTHESIS

Our program to determine whether or not it is possible to substitute for t and hearing by direct stimulation of the brain is

well underway. Five contracts have been activated, and one of the contractors has already gotten data on the effects of stimulating the visual part of the brain during five successful surgical operations.

PERINATAL

The collaborative perinatal study, started 10 years ago, is now yielding some very interesting results, particularly in regard to maternal nutrition and its effects upon the offspring. These are expected to have wide implications regarding obstetrical practice and the effects of malnutrition due to poverty.

COMMUNICATION

A subcommittee of our council has completed a comprehensive report on research in disorders of human communication, and has made strong recommendations in favor of larger programs in research and training in this important area. However, at present we must continue research and training at levels commensurate with the availability of funds.

STROKE

The Federation of Societies for Experimental Biology held a workshop on the development of new methods to evaluate the cerebral circulation, with particular emphasis on the development of rapid and safe methods for diagnosing incipient strokes, so that corrective measures could be taken before damage is done.

The federation also interviewed a number of experts who could not be present at the workshop, and a comprehensive report has been finished.

I am circulating copies of this report to a large number of leaders in applied physics and engineering to stimulate interest in working on stroke instrumentation.

The National Heart and Lung Institute is cooperating in this endeavor and is already funding projects generated in the course of the workshop.

We have also received several grant applications resulting from this workshop, which will shortly be considered by the National Heart and Lung Institute, the National Institute of Neurological Diseases and Stroke, and the Joint Council Subcommittee on Cerebrovascular Disease set up by the two institutes.

VIRUS DISEASES OF THE CENTRAL NERVOUS SYSTEM

Perhaps the most exciting work is going on in the field of slowacting virus infection of the nervous system.

A number of degenerative diseases of the central nervous system have been shown by Institute scientists to be due to infection with transmissible agents, but with very long incubation periods. The New Guinea disease, kuru, and the much more prevalent Jacob-Creutzfeld disease in the United States have been transmitted from man to chimpanzee. Kuru has been transmitted from chimpanzee to spider monkey, and just recently possibly to the Capuchin monkey.

This last passage took over 4 years, showing that virus infection can produce greatly delayed effects. As yet, the infectious agent has not been positively identified. However, a very similar disease Subaccute Sclerosing Pan Encephalitis SSPE-which attacks children, has been positively identified as being caused by an incomplete measles virus which somehow gets across the blood-brain barrier.