NINDS Advisory Council Meeting Minutes, February 12-13, 1998

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blue bullet image I. CALL TO ORDER AND OPENING REMARKS blue bullet image VII. SCIENTIFIC PRESENTATION: "Brain Tumor Genome Anatomy Project"
blue bullet image II. COUNCIL PROCEDURES AND RELATED MATTERS blue bullet image VIII. OVERVIEW, DIVISION OF INTRAMURAL RESEARCH
blue bullet image III. REPORT OF THE ACTING DIRECTOR, NINDS blue bullet image IX. SCIENTIFIC PRESENTATION: "Plasticity of the Human Brain"
blue bullet image IV. REPORT OF THE DIRECTOR, DIVISION OF EXTRAMURAL ACTIVITIES blue bullet image X. REVIEW OF THE DIVISION OF INTRAMURAL RESEARCH BOARD OF SCIENTIFIC COUNSELORS' REVIEWS
blue bullet image V. POLICY DISCUSSIONS blue bullet image XI. COUNCIL CONSIDERATION OF PENDING APPLICATIONS
blue bullet image VI. CANCER AS A GENETIC DISEASE blue bullet image XII. ADJOURNMENT

DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
NATIONAL INSTITUTES OF HEALTH
NATIONAL ADVISORY NEUROLOGICAL DISORDERS AND STROKE COUNCIL
Summary of Meeting 1
February 12-13, 1998

The National Advisory Neurological Disorders and Stroke Council was convened for its 141st meeting on February 12, 1998, in Building 31, Conference Room 6, National Institutes of Health, Bethesda, Maryland. Dr. Audrey S. Penn, Acting Director of the National Institute of Neurological Disorders and Stroke (NINDS), served as Acting Chairperson.

In accordance with Public Law 92-463, the meeting was:

Open: February 12, 1998 - 8:40 a.m. to 3:30 p.m.

for the review and discussion of program development, needs, and policy; and

Closed: February 12, 1998 - 3:30 p.m. to 4:55 p.m.

      February 13, 1998 - 8:30 a.m. to 11:15 a.m.

      for the review of the Board of Scientific Counselors' Report and discussion and consideration of individual grant applications.

      Council members present were:

      Mr. Robert V. Abendroth
      Ms. Alicia M. Conill
      Dr. Mahlon DeLong
      Dr. Martha Bridge Denckla
      Dr. Darryl DeVivo
      Dr. Gerald D. Fischbach
      Ms. Martha E. Keys
      Dr. Lynn Landmesser
      Ms. Sue Levi-Pearl
      Dr. John Mazziotta
      Dr. George Ojemann
      Dr. Jerome Posner
      Mr. Arthur D. Ullian

      Council members absent were:

      Dr. Dennis W. Choi
      Dr. Masakazu Konishi
      Dr. Roberto Heros
      Mr. Henry Morris, Jr.
      Dr. Carla Shatz

      Council Roster (Attachment 1)

      Ex officio members present:

      Dr. John Booss, Department of Veterans Affairs
      Dr. Andrew Dutka, Department of Defense

      1For the record, it is noted that members absent themselves from the meeting when the Council is discussing applications (a) from their respective institutions or (b) in which a real or apparent conflict of interest might occur.

      Special guests present for portions of the meeting included:

      Dr. Richard Klausner, Director, National Cancer Institute

      Members of the public present for portions of the meeting included:

      Mr. David McCoy, Executive Court Reporters, Inc.
      Mr. Nielsen Hobbs, The Blue Sheet
      Ms. Melinda Kelley, Paralyzed Veterans of America
      Ms. Pam Moore, Capital Publications
      Ms. Laurel Stone, Epilepsy Foundation

      NINDS employees present for portions of the meeting included:

          Dr. Audrey S. Penn
          Dr. Constance Atwell
          Ms. Brenda Kibler
          Dr. Judy Small
          Mr. Edward Donohue
          Dr. Cheryl Kitt
          Ms. Mary Graham
          Dr. F. J. Brinley
          Dr. Al Kerza
          Dr. Giovanna Spinella
          Dr. Michael Walker
          Dr. William Heetderks
          Dr. Paul Nichols
          Ms. Margaret Jacobs
          Ms. Marian Emr
          Dr. Katherine Woodbury
          Dr. Philip Sheridan
          Mr. Jim Stoneman
          Ms. Kathleen Howe
          Dr. Joseph Drage
          Dr. F. Terry Hambrecht
          Dr. Robert Baughman
          Dr. Eugene Oliver
          Dr. Sally Broman
          Mr. Phillip Wiethorn
          Dr. Deborah Hirtz
          Dr. Charlotte McCutchen
          Ms. Mary Miers
          Dr. Mary Ellen Cheung
          Dr. Claudia Blair
          Mr. Robert Zalutsky
          Ms. Scott Sigley
          Ms. Patricia Jennings
          Ms. Susan Free
          Ms. Suzanne Strickland
          Mr. Gahan Briethaupt
              Dr. John Marler
              Dr. Paul Sheehy
              Ms. Karen Reese
              Dr. Lillian Pubols
              Ms. Shannon Garnett
              Ms. Margo Warren
              Mr. Levon Parker
              Dr. Emanuel Stadlan
              Ms. Stephanie Clipper
              Ms. Christine Steyer
              Mr. Larry Salas
              Ms. Nena Wells
              Ms. Paula Walker
              Dr. Gabrielle Leblanc
              Ms. Marcia Vital
              Mr. John Jones
              Dr. Tom Jacobs
              Ms. Natalie Larsen
              Ms. Maureen Volz
              Ms. Ruth Linn
              Mr. Andy Baldus
              Mr. Luis Arvelo
              Mr. Henry Moore
              Dr. Walter Bell
              Ms. Patricia Driscoll
              Ms. Jennifer Gorman
              Mr. Mark Salo
              Ms. Pat Turner
              Ms. Janice Solomon
              Ms. Shirley Broderick
              Ms. Clarise Lassiter
              Ms. Carol Smith
              Dr. Mark Hallett
              Ms. Dianna Jessee
              Ms. Marilyn Morgan
              Ms. Nancy Hart

              Other Federal employees present for portions of the meeting included:

              Ms. Janet Healy, OD
              Ms. Margaret Huyck, OD
              Dr. John Ferguson, OD
              Dr. David Simpson, CSR
              Dr. Herman Teitelbaum, CSR
              Dr. Joe Marwah, CSR
              Dr. Brent Stanfield, CSR
              Dr. Larry Stanford, CSR
              Dr. Kathleen Michels, CSR

              I. CALL TO ORDER AND OPENING REMARKS

              D r. Audrey S. Penn

              Dr. Audrey S. Penn, Acting Director, NINDS, welcomed the Council members, guests, and staff to the 141st Council meeting. With Dr. Zach Hall's departure in December 1997 as Director, NINDS, Dr. Penn indicated that she is the Acting Director, Dr. Constance Atwell, the Acting Deputy Director, and Mr. Edward Donohue, the Acting Director, Division of Extramural Activities. She noted that Dr. Story Landis continues as the Director, Division of Intramural Research, and Mr. John Jones continues as the Acting Executive Officer following Mr. Richard Sherbert's retirement last year. With regard to personnel appointments within NINDS, Dr. Robert Baughman is now Director, Division of Fundamental Neuroscience and Developmental Disorders and Dr. Alan Willard will begin in March as a Scientific Review Administrator in the Scientific Review Branch. Next, Dr. Penn introduced four new Council members: Mr. Robert Abendroth, Dr. Martha Bridge Denckla, Dr. John Mazziotta, and Dr. Jerome Posner. She also introduced Dr. James McNamara and Dr. Richard Johnston as special visitors to the Council.

              II. COUNCIL PROCEDURES AND RELATED MATTERS

              D r. Constance W. Atwell

              A. Council Procedures

              Government in the Sunshine Act and Federal Advisory Committee Act:

              These Acts require the DHHS to open to public observation as many advisory committee meetings as possible, including the meetings of the National Advisory Councils. The Council meeting, therefore, was open to public observation except when grant applications were being reviewed, at the times previously specified in these minutes. Notice of the date and place of the Council meeting was published in the Federal Register thirty days prior to the meeting.

              Conflict of Interest:

              The regulations concerning conflict of interest were reviewed, and Council members were reminded that materials furnished for review purposes and discussion during the closed portions of the meeting are considered privileged information. All Council members present signed a statement certifying that they did not participate in the discussion of, or vote on, an application from any organization, institution, or any part of a university system, except for those which have multi-campus institution waivers or are specifically designated as separate organizations under 18 U.S.C. 208(a), of which they are an employee, consultant, officer, director or trustee, or in which they have a financial interest.

              B. Consideration of Minutes of Previous Meeting

              The minutes of the Council meeting of September 11-12, 1997, were considered and accepted as written.

              C. Consideration of Dates for Future Council Meetings

              May 28-29, 1998 (Thursday and Friday)
              September 17-18, 1998 (Thursday and Friday)
              February 11-12, 1999 (Thursday and Friday)
              May 20-21, 1999 (Thursday and Friday)

              III. REPORT OF THE ACTING DIRECTOR, NINDS

              D r. Audrey S. Penn

              Dr. Penn began her report with a summary of the President's budget showing a comparison of the FY 99 budget to that of FY 98 and FY 97. In the President's budget the NINDS received an 8.1 percent increase, with an 8.4 percent increase over FY 98 for NIH. The Hearings on the budget will occur in March and April. With science and NIH moving forward in the new millennium, it is expected the NIH will see regular increases. Dr. Penn showed several slides in her discussion of the budget.

              Dr. Penn then discussed the NIH Director's use of his authority to transfer up to one percent of funds among institutes to support areas of special research interest. The monies are pooled and each Institute competes for a share based on the quality of the projects proposed. There are also NIH areas of special emphasis that determine how the budgetary increase for the year is divided among Institutes. For the last several years these areas of special emphasis have included: the biology of brain disorders, which for NINDS is mainly neurodegeneration; genetics of medicine; therapeutics/drug development; and infrastructure. About 12 institutes participate in the biology of brain disease area of emphasis. Next, using slides, Dr. Penn reviewed the categories within each area of special emphasis and briefly discussed NINDS special initiatives and workshops held by NINDS. Copies of the slides used in Dr. Penn's discussion of the budget and areas of special emphasis are attached as Appendix 1.

              IV. REPORT OF THE DIRECTOR, DIVISION OF EXTRAMURAL ACTIVITIES

              D r. Constance W. Atwell

              Dr. Atwell began her report by noting that five Council members were unable to attend this Council meeting: Dr. Dennis Choi, Dr. Roberto Heros, Dr. Mark Konishi, Mr. Henry Morris, and Dr. Carla Shatz. Council was informed that Darlene Michalski, former Committee Management Assistant, had passed away following her retirement last year. Dr. Atwell introduced Ms. Janice Solomon, Committee Management Assistant, and Dr. Claudia Blair, who is on detail to NINDS from the Office of the Director, NIH. Council had previously requested and was provided with an extramural staff photo directory. Dr. Atwell thanked Janice Solomon and the staff of the Office of Scientific and Health Reports, specifically Shannon Garnett, for their work in producing this directory.

              A. Policy Issues

              Dr. Atwell reminded Council that First Independent Research and Transition (R29) award applications will no longer be accepted as of June 1998. She briefly discussed the reasons leading to the decision to phase out the R29 mechanism. Council was provided with the December 19, 1997, NIH Guide announcement on this topic. Because of the restructuring of the neuroscience study sections effective June 1998, amended applications being reviewed in June may be submitted again as third amended applications if that becomes necessary. This is an exception to the rule of limiting the number of amendments to two (the original application plus two revisions).

              New neuroscience review study sections within the Center for Scientific Review are recruiting Scientific Review Administrators. Staff from various Institutes are helping with the first round of reviews. Drs. Mary Ellen Cheung and Gabrielle Leblanc from NINDS are helping with these reviews for the Center for Scientific Review.

              Dr. Atwell noted that at the Planning Subcommittee meeting held the previous day, the suggestion was made that NINDS closely monitor the review process regarding applications in terms of meeting the goals of the NINDS. A subcommittee composed of Council members, and possibly non-Council members, will be formed and chaired by Dr. Mahlon DeLong. The Center for Scientific Review is establishing its own evaluation procedure for it, which would be more general, but this effort is aimed at specifically making sure that the goals of the NINDS are being adequately met by the new review procedure. This would be an ongoing process.

              B. Rebuttal Process

              Council was provided with the November 21, 1997, NIH Guide announcement regarding the appeals of initial scientific peer review. Dr. Atwell briefly discussed the changes in this process and noted that Council received far fewer appeal letters this round due to the new process.

              C. Program Announcements

              Dr. Atwell reviewed the list of Program Announcements and Request for Applications that Council had received copies of prior to the meeting.

              D. Reports Book

              Dr. Atwell called Council's attention to the Reports Book. This book consists of lists of all funding actions since the previous Council meeting. It also contains the list of interim actions taken by staff since the last Council meeting. These interim actions are administrative in nature and are authorized by the Council General Recommendations.

              E. Council General Recommendations

              Each January/February, the Council considers the general guidelines for administrative actions that may be taken by Program staff without prior approval by Council. There were several changes in these recommendations. The changes to last year's Council General Recommendations included:

              • Report interim actions once a year by category of the total amount obligated using Council-delegated authorities. The report would identify funds for administrative supplements, minority supplements, and disability supplements;
              • Change wording for clarification purposes for several authorities were recommended; and
              • Delegate the authority to staff to reinstate years of support that may have been recommended for deletion by the initial review group.

              With regard to the delegation of authority to staff for restoration of years, a few Council members expressed concern that there be senior staff level review for restorations as well as reductions of years on applications. Council was reminded that each Division Director is responsible for maintaining its average four years over the course of a fiscal year, not necessarily in one round at a time. Following discussion, Council concurred with these recommendations. A copy of the amended Council General Recommendations is attached as Appendix 2.

              V.

              POLICY DISCUSSIONS
              Dr. Audrey S. Penn

              P Series Grants

              Council discussed the impact of the current cap of $750,000 direct costs on P01 and P50 grants. With an average 10 percent reduction from recommended budget levels as part of the Institute's cost management plan, the effective cap on these mechanisms is $675,000. Several Council members expressed concern that this level of funding is insufficient to sustain three or four subprojects plus associated cores. There was also considerable discussion of the benefits of multidisciplinary and collaborative research done under the aegis of program projects or center grants, especially for clinical research. Council requested additional information on the average cost of program projects at other institutes and the effect of reducing or eliminating the average 10 percent reduction on P series grants.

              Clinical Research Training

              Dr. Penn described the NINDS' proposals to enhance clinical research training, especially patient-oriented research. Plans include selected funding of institutional training grants (T32), increasing the number of Clinical Investigator Development Awards (K08) devoted to patient-oriented research, increasing the salary on K08s to $65,000, and awarding supplements to clinical trials for the purpose of training young investigators in clinical trials methodology and design.

              Dr. DeVivo summarized the discussion of this issue at the Council Planning Subcommittee. Impediments to patient-oriented research training include: (1) escalating debt from medical school; (2) perception that clinical investigation does not receive appropriate recognition in the academic personnel system (e.g., tenure consideration); (3) history of ad hoc clinical research training (do what your mentor does); (4) changes in health care delivery (e.g., managed care) that make it difficult to enroll patients in research in academic institutions. He proposed several solutions for Council consideration: (1) increase in salaries; (2) increase the priority of clinical research for funding; (3) change the perception that the K08 is a mechanism to support clinicians to go into basic science laboratories rather than clinical research; (4) link certification in specialty training to the mission of academic institutions (i.e., research).

              Council discussion led to a consensus that the proposed changes to the NINDS clinical research training and career development programs constitute a good first step but that more extensive changes will be needed to address adequately the problems of clinicians who want to conduct patient-oriented research. A subcommittee of Council, chaired by Dr. DeVivo, will consider the issue and recommend further changes that may be necessary.

              Ten Percent Average Reduction in Competing Awards

              Administrative cuts that average 10 percent of the recommended level of funding for competing grants have been a feature of the NINDS cost management plan for several years. Council members discussed the advisability of reducing or eliminating these cuts in the future, with the recognition that fewer grants would then be awarded. Future Council discussions of this issue will take into account the likely impact of full or slightly reduced funding of grants on applicants' success rate in achieving funding at all, and other models such as a sliding scale of reductions related to quality ranking of the applications.

              Copies of the slides used during this discussion are attached as Appendix 3.

              VI. CANCER AS A GENETIC DISEASE

              D r. Richard Klausner

              Dr. Klausner, Director, National Cancer Institute, began by describing a new planning process linked to the legislative mandate that the Director, NCI, produce a so-called bypass budget. A group of advisors met to first establish a set of criteria of what is meant by an extraordinary investment opportunity. What criteria are useful to produce a plan that not only sounds good but is useful, i.e., something an Institute can actually use to enhance discovery? Through a fairly long process a set of criteria were identified, as well as four areas of extraordinary opportunity for discovery and investment. These needed to be achievable, real goals that can be described in terms of milestones that would affect progress against all cancers, not just a particular cancer, and for which the consequences of not investing can also be defined. The four areas are cancer genetics, pre-clinical models of cancer, detection and imaging technology, and molecular detection. Once these four areas were well defined and a plan and goals laid out, a group of advisors was brought together to form a "Think Tank." An Internet site was set up for each of these four areas to facilitate ongoing interaction within each group.

              Dr. Klausner quoted Peyton Rose in his Nobel Prize lecture some 30 years ago, "Tumors destroy man in a unique and appalling way as flesh of his own flesh which has somehow been rendered proliferative, rampant, predatory, and ungovernable. Yet despite more than 70 years of experimental study they remain the least understood. What can be the reason for these happenings?"

              Dr. Klausner noted that we now know that all cancers are genetic diseases. Only unusually are they inherited diseases, but all are genetic diseases with a characteristic molecular phenotype of genomic and genetic instability. Cancer arises in all cases because of the accumulation of genetic changes over years to perhaps decades. He noted that as far as we know, no single genetic change is sufficient to develop cancer, but a set of genetic changes is needed. To study these changes we want to be able to read and interpret all of the genetic changes in a single cell in real time. In order to address this area, an infrastructure was designed that NCI could fund to help provide to the community resources and information. The result was the Cancer Genome Anatomy Project (CGAP). The goal was simple and modest: to complete the discovery of all expressed genes in normal cells and at stages from being normal all the way through being malignant. Dr. Klausner described the website and databases that have been designed and set up for implementing this project. Polymorphisms will be sought for selected interesting genes that are known to be involved in cancer because of predisposition syndromes or differential expression or metabolic pathway. The data will be put in a public database so that it is completely, freely and widely available for researchers.

              VII. SCIENTIFIC PRESENTATION: "Brain Tumor Genome Anatomy Project"

              D r. Thomas Jacobs

              Dr. Jacobs, Health Scientist Administrator, Division of Stroke, Trauma and Neurodegenerative Disorders, reported that last summer, the NCI announced the implementation of the Cancer Genome Anatomy Project (CGAP). The NCI welcomed the NINDS's initiative to add brain tumors to CGAP and provided a background for developing specific NINDS-related projects that could use a similar infrastructure. The Brain Tumor Genome Anatomy Project (BTGAP) would use the CGAP infrastructure and focus initially on gene discovery using biopsy samples followed by gene expression specific staging using laser capture microdissected tumor cells. A BTGAP Working Group, chaired by Dr. Jerome Posner, included Dr. Robert Martuza, Dr. David Louis and Dr. Mark Noble provided the scientific and clinical expertise to evaluate the BTGAP concept. Other members included Dr. Robert Strausberg, the NCI's program director for CGAP, Drs. Audrey Penn, Michael Walker, Judy Small and Tom Jacobs represent the NINDS staff. The first meeting was held on December 11, 1997, to evaluate the initiative to add brain tumor to CGAP, assess an NINDS collaboration in CGAP and set priorities for brain tumor genomic research.

              One of the major challenges we face in treating brain tumors is identification of the type which may be very difficult due to the large number of types and the lack of specific markers for them. Treatment of brain tumors is dependent on the tumor grade which is based on histopathological classification and it is well recognized in the brain tumor field that better markers and more accurate criteria for diagnosis are needed. Gliomas make up approximately 50 percent of all brain tumors and are by far the most malignant. Gliomas are considered by many to be a genetic disease because mutations lead to progressive worsening of disease. They are also considered multi-lineage tumors where the genetic alterations that occur could depend on whether the tumor develops in a cell from an astrocyte or oligodendrocyte line. For example, the most aggressive gliomas are those that develop from an astrocytic lineage. Also, recent data suggests that oligodendrogliomas are responsive to chemotherapy whereas, astrocytomas are not. Recent studies on Glioblastoma Multiforme (GBM) suggest that there are genetic subsets of this tumor. Primary GBM which has epidermal growth factor receptor (EGFR) amplification as its main genetic alteration, arises de-novo, occurs more often in older adults and is highly malignant. In secondary GBM, p53 mutations are more prevalent, and this tumor is seen more often in younger adults. These two major genetic changes and their relationship to age illustrates the benefit of having a profile of differentially expressed genes. A comprehensive profile of genes expressed in gliomas may help us to better characterize the clinical course of the disease and hopefully intervene.

              The overall goals of the BTGAP would seek to determine the complete profile of expressed genes in normal, pre-malignant and malignant brain cells, contribute to an accurate diagnosis and develop specialized treatment of brain tumors. The BTGAP working group expressed unanimous enthusiasm for the NINDS-BTGAP initiative. They also agreed that investigating the genetics of GBM is the highest priority. Concurrently, studying the anaplastic oligodendroglioma is also a high priority. Developing lineage-specific, mutation-specific and gene expression-based analysis of adult and pediatric gliomas should be emphasized as the BTGAP progresses. The NINDS's BTGAP initiative is a creative approach to the challenging task of diagnosis and staging of gliomas which are critical to developing more effective treatments for these devastating brain tumors.

              VIII.

              OVERVIEW, DIVISION OF INTRAMURAL RESEARCH
              Dr. Story Landis

              Dr. Landis, Director, Division of Intramural Research, reported that approximately 10 percent of the NINDS budget supports the basic and clinical research programs conducted in the NINDS Intramural Program. The research in the Intramural Program varies from very basic studies such as examining structure, function and relationships to define the pore of the potassium channel, to very clinical studies including enzyme replacement therapy development in storage diseases. The Basic Neuroscience Program, headed by Dr. Harold Gainer, is composed primarily of bench research. The Clinical Neuroscience Program, headed by Dr. Mark Hallett, includes physicians and physician scientists and also Ph.D.s who are doing preclinical research, translational research, and clinical studies including clinical trials.

              The intramural program is comprised of approximately 100,000 square feet and has 760 people. Of this total, 65 are either tenure-track or tenured-independent investigators. Decisions about how resources will be allocated are based on the Board of Scientific Counselors' (BSC) reviews. The BSC is composed of nine regular members. A number of ad hoc members are identified specifically for each review. Based on a site visit, presentation of past research and aims for future progress, the BSC makes its recommendations for an increase or decrease in that particular laboratory's allocation.

              Dr. Landis then discussed special advances in the Intramural Program this year. Under the joint NINDS-Human Genome Initiative, the Niemann-Pick C gene was cloned, and the protein encoded by this gene is likely to have an important role in cholesterol metabolism. Another important advance was a series of studies that showed that by creating an immunotoxin -- diphtheria toxin coupled to a transporter -- there was a significant regression in a number of brain tumors. Another study defined a number of factors that influence neural stem cells to become either neurons, glial astrocytes or oligodendrocytes.

              Next, Dr. Landis briefly reported on the recent appointments of Dr. Marla Feller, who is studying the role of activity in synapse formation in the developing nervous system, and Dr. Roland Martin, who will join the Neuroimmunology Branch. An individual has been selected for the position of Chief, Neurogenetics Branch, but negotiations are still underway. Dr. Nick Bryan, Associate Director for Radiologic Imaging Sciences with the Clinical Center, has a joint appointment in NINDS and will have his research program based in NINDS. A search for the Neuroimaging Branch Chief is still underway.

              Revitalization efforts within the Division of Intramural Research are well underway. Dr. Landis reported that at present she is working with a steady state budget and is looking critically at existing programs and, where appropriate, is reallocating resources for new initiatives.

              Next, Dr. Landis discussed the NINDS Clinical Research Advisory Group (CRAG) report. Council had been provided with a copy of this report. She explained that senior staff had convened a committee of extramural scientists to evaluate the Intramural Program and its clinical aspects and to provide advice on how to better maximize the resources in order to make the most important contributions possible in neurology. Members of the committee included Drs. Dennis Choi, Francisco Gonzalez-Scarano, Mark Hallett, Guy McKhann, Mahlon DeLong, George Ojemann, Edward Oldfield, Timothy Pedley, Joseph Volpe, and Anne Young. The committee was given an overview of the activity in the clinical branches and were asked how the NINDS Intramural Program might revitalize or reorganize.

              The CRAG report made recommendations in several areas: (1) recruitment of tenure-track and tenured scientists; (2) allocation of resources to independent scientists; (3) mentoring of post-doctoral fellows for post-NIH careers; and (4) communication among staff in the various laboratories and branches. Dr. Landis described changes in the NIH tenure-track recruitment process, allocation of dedicated space and operating budgets directly to independent scientists rather than through the lab and branch chiefs, and new accountability for post-NIH employment as a condition for ability to sponsor future fellows. A CRAG proposal for a matrix organizational structure that would have each scientist assigned to both a disciplinary-based group (e.g., cell biology, genetics) and a mission or disease-based group (e.g., epilepsy, neurodegenerative disease) is under consideration but will not be enacted yet. Dr. Landis hopes that a scientific retreat of the intramural staff (the first in seven years) will facilitate communication without the need for a major restructuring at this time. Communication among the various NIH institutes that conduct brain research is improving through a common seminar series and involvement in staff searches. Dr. Landis herself is chairing the searches for scientific directors of NIMH and NIDCD. Pooling of resources in areas of shared interest such as cognitive neuroscience could also facilitate communication as well as maximize use of resources. The CRAG also recommended enhancement of communication between the intramural and extramural communities through a reciprocal sabbatical program. Impediments to a suggested NINDS intramural program brain bank were also discussed.

              IX. SCIENTIFIC PRESENTATION: "Plasticity of the Human Brain"

              D r. Mark Hallett

              Dr. Landis introduced Dr. Mark Hallett, Clinical Director, Division of Intramural Research, NINDS. Dr. Hallett reported that the connections of the human brain are so complex and the developmental processes that create them are so complicated, that they have often been thought to be fixed. It is now clear that the brain remains plastic throughout life and that plasticity is responsible for learning, adaptation to changes in the peripheral nervous system, recovery of function after damage to the central nervous system, and, possibly in some circumstances, the production of pathological conditions.

              Most of the work of the Human Motor Control Section, Medical Neurology Branch, has focused on the human motor system. The motor cortex can be mapped and its physiology assessed with non-invasive tools such as transcranial magnetic stimulation (TMS), functional neuroimaging (PET and fMRI), and EEG. In peripheral injury such as amputation, motor representation areas targeting muscles ipsilateral and proximal to the stump enlarge. Such changes can occur quickly since motor evoked potentials (MEPs) from TMS in muscles proximal to an anesthetized forearm using blood pressure cuff increase in amplitude in minutes after onset of anesthesia. Some changes require years to occur, such as the topography of biceps MEPs in patients who had intercostal nerves anastomosed to the musculocutaneous nerve after brachial plexus avulsion. In early brain injury including patients with hemispherectomy, some recovery of function seems due to enhancement of ipsilateral pathways. Stroke in adult life may cause some reorganization in the lesioned hemisphere, but ipsilateral pathways seem less useful. Patterns of use and motor learning can influence brain organization. In Braille readers, the representation of the first dorsal interosseus muscle in the reading hand is larger than that in the nonreading hand, while disuse will reduce muscle representations. In motor learning, such as learning a finger sequence, the representation of muscles involved with the learning increases in size. Occupational cramps, an example of focal dystonia, could be due to a disorder of motor learning as documented by changes in topography of finger representations in the sensory cortex. The capability of the brain for plastic change should be able to be exploited in new physical therapy methods for neurologic rehabilitation. In some situations plasticity can even occur across sensory modalities; when patients blinded early in life read Braille, they activate and use their occipital cortex to process the somatosensory information.

              X. REVIEW OF THE DIVISION OF INTRAMURAL RESEARCH BOARD OF SCIENTIFIC COUNSELORS' REVIEWS

              D r. Story Landis

              During the closed session of the meeting, Dr. Landis briefed Council members on the findings and recommendations of the Board of Scientific Counselors with regard to review of two laboratories of the Division of Intramural Research.

              XI. COUNCIL CONSIDERATION OF PENDING APPLICATIONS

              This portion of the meeting, involving specific grant review, was closed to the public. The Council gave special attention to applications from foreign institutions, and to applications with potential problems involving human and/or animal subjects, as well as inadequate gender and/or minority representation.

              A. Research Training and Career Development Programs

              The Council reviewed a total of 61 training and research career development grant applications; of this total, 60 applications had primary assignment to NINDS, and 49 of the 60 (81.7 percent) were recommended for support in the amount of $7.2 million first-year direct costs. It is anticipated that, of the training and research career development grants competing at this Council, NINDS will be able to pay first-year direct costs of approximately $2.8 million.

              In addition, Council concurred with staff's recommendation to fund one predoctoral training grant in response to the Jointly Sponsored NIH Predoctoral Training Program in the Neurosciences. Council was reminded that 11 predoctoral training grants were approved for funding at its September 1997 meeting.

              B. Research Grant Awards

              The Council reviewed a total of 831 research grant applications; of this total, 592 applications had primary assignment to NINDS, and 398 of them (67.2 percent) were recommended for support in the amount of $82.9 million first-year direct costs. It is anticipated that, of the research grants competing at this Council, NINDS will be able to pay first-year direct costs of approximately $25.7 million.

              Senator Jacob Javits Neuroscience Investigator Awards

              The Senator Jacob Javits Neuroscience Investigator Awards are made to distinguished investigators who have a record of scientific excellence and productivity, who are actively pursuing an area of research of strategic importance, and who can be expected to continue to be highly productive for a seven-year period. Candidates are nominated at each Council meeting during the fiscal year, and from these nominations the awardees are selected at the June Council. At this meeting, the Council nominated two investigators as potential recipients of this award.

              C. Special Program Actions

              The Council reviewed a total of 100 Small Business Innovation Research (SBIR) and Small Technology Transfer Award (STTR) grant applications; of this total, 59 applications had primary assignment to NINDS, and 33 of them (55.9 percent) were recommended for support in the amount of $3.4 million first-year direct costs. It is anticipated that, of the SBIR and STTR applications competing at this Council, NINDS will be able to pay first-year direct costs of approximately $2.5 million.

              The Council reviewed a total of 23 Academic Research Enhancement Awards (AREA) grant applications; of this total, 17 applications had primary assignment to NINDS, and 16 of them (94.1) were recommended for support in the amount of $1.1 million first-year direct costs. It is anticipated that, of the AREA grants competing at this Council, NINDS will be able to pay first-year direct costs of approximately $0.7 million.

              XII. ADJOURNMENT

              Prior to adjournment, Council applauded Drs. Penn and Atwell for their leadership in their acting capacities. The meeting was adjourned at 11:15 a.m. on Friday, February 13, 1998.

              We certify that, to the best of our knowledge, the foregoing minutes and attachments are accurate and complete.

              We certify that, to the best of our knowledge, the foregoing minutes and attachments are accurate and complete.

              5/14/98
              /s/
              Constance W. Atwell, Ph.D.
              Executive Secretary
              National Advisory Neurological Disorders
              and Stroke Council
              .
              Director, Division of Extramural Activities
              National Institute of Neurological Disorders and Stroke
              5/14/98
              /s/
              Audrey S. Penn, M.D.
              Acting Chairperson
              National Advisory Neurological Disorders
              and Stroke Council
              Acting Director
              National Institute of Neurological Disorders and Stroke
              These minutes will be formally considered by the Council at its next meeting. Corrections or notations will be incorporated in the minutes of that meeting.

              A complete, printed copy of the Council minutes, including attachments, may be obtained by contacting:
              Mrs. Ruth Linn
              Committee Management Specialist
              National Institute of Neurological Disorders and Stroke
              Neuroscience Center, Suite 3309
              6001 Executive Boulevard, MSC 9531
              Rockville, MD 20852-9531
              (301) 496-9248
              (301) 402-4370 FAX
              ruth_linn@nih.gov

              Last updated June 19, 2008