The following was recently added to the NINDS web site -  the Director's
statement on  the NINDS FY 2001 budget request.  I've starred all the
sections related to PD research, which seems to figure significantly in
the overall 2001 NINDS budget proposal and research goals.
If you don't have time to read the entire statement,  this excerpt sums
it up:

 "As requested by the Appropriations Committees, NINDS is working on the
first phase of an effort to develop a comprehensive research agenda for
Parkinson's disease. We were joined in this effort by NIH Institutes and
Centers with significant programs in Parkinson's disease, by patient
advocacy groups, and by distinguished intramural and extramural
scientists. We are confident that the proposed research agenda will
advance the fight against Parkinson's disease and point the way for
similar progress in other neurodegenerative disorders."

[National Institute of Neurological Disorders and Stroke, NIH]
DEPARTMENT OF HEALTH & HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
Statement by
Gerald D. Fischbach, M.D.
Director, National Institute of Neurological Disorders and Stroke
to the House Subcommittee on Labor-HHS-Education Appropriations
on Fiscal Year 2001 President's Budget Request
for the National Institute of Neurological Disorders and Stroke
Tuesday, February 29, 2000
· Director's Statement
· Uses of FY 2000 Increase
· A Healthy Brain for Life
· Halting the Process of Neurodegeneration
· Repairing the Injured Nervous System
· Reducing Health Disparities
· Working Together to Fight Brain Disease

Mr. Chairman and Committee Members:
I am pleased to present the President's non-AIDS budget request for the
NINDS for Fiscal Year 2001, a sum of $1,050,412,000, which reflects an
increase of $54,327,000 over the comparable Fiscal Year 2000
appropriation. Including the estimated allocation for AIDS, total support
requested for NINDS is $1,084,828,000, an increase of $55,085,000 over
the Fiscal Year 2000 appropriation. Funds for the NINDS efforts in AIDS
research are included within the Office of AIDS Research budget request.

I became Director of NINDS eighteen months ago with great enthusiasm
about neuroscience research and the likelihood of significant advances in
treating neurological disorders that were considered intractable only a
few years ago. My enthusiasm has grown with time because new discoveries,
generous public support and a widening sphere of collaborations within
the NIH and with outside organizations have brought our mission of
reducing the burden of neurological diseases into clearer focus.

We are now in the second year of a strategic planning process that has
galvanized our research and patient communities as well as our own staff.
Last year's planning document, "Neuroscience at the New Millennium,"
identified major targets of opportunity and laid out a strategy for
approaching disease problems and for strengthening the capacity of the
research community to continue the stunning advances of recent years. The
momentum generated by this process, that engaged efforts of more than 100
distinguished extramural and intramural scientists, professional
societies, and many patient advocates, resulted in many new initiatives.
The Strategic Plan is based on the cross-cutting topics of
neurodegeneration, neural repair, neurodevelopment, neurogenetics,
synapses and circuits, cognition and behavior, and the neural
environment. Our Plan is now in its second phase. Because the planning
panels were so successful, we reorganized the extramural program staff
into working clusters that track the major planning topics. This
flexible, non-hierarchical structure has led to productive interactions
among our program directors, senior staff, and external advisors in
advancing our research agenda and in responding to the initiatives of
investigators and to concerns of the lay members of the planning
community.

USES OF FY 2000 INCREASE
The FY 2000 appropriation will allow NINDS to maintain and build on
critical initiatives begun in FY 1999 and to take advantage of new,
extraordinary opportunities, including support of 200 more project grants
and 50 more scientists in training and career development.  *** I am
pleased to report that in FY 1999 we were able to fund eight new Morris
K. Udall Centers of Excellence in Parkinson's Disease, instead of the
five we had planned. Together with the three Centers funded in late 1998,
we now have a national network of eleven Centers that includes a wide
spectrum of basic and clinical research.  Annual meetings of the Centers,
along with ongoing informal interactions, will increase opportunities for
collaboration and maximize this significant investment. Each Center has a
training component, so new investigators will be introduced to
Parkinson's disease and related disorders each year.

***Another new initiative this year seeks to explore the promising new
technology of deep brain stimulation in Parkinson's disease and other
neurological disorders. Studies of electrode design, patterns of
stimulation, and clinical trials will determine if DBS can halt the
progress of neurodegeneration as well as reverse disabling symptoms.
Another solicitation is concerned with the safety of the blood supply. We
seek a rapid and sensitive test for the infectious agent (prion)
responsible for the new variant Creutzfeldt-Jakob Disease. The public
must be confident in the safety of the blood supply.
During the current year we will expand our efforts to apply sophisticated
technology to map the location and timing of gene expression in the
brain. This is an essential step in determining the function of normal
and mutant, disease-causing genes. We will expand our successful neural
prosthesis program, and we will develop innovative, high throughput
screens for potential therapeutic agents. We intend to promote new
approaches to spinal cord injury, and we plan a broad approach to analyze
the efficacy of neural stem cells in repairing focal and generalized
lesions. Building on one of our most successful innovations in FY 1999,
we plan to expand our support for a full range of infrastructure needed
for modern neuroscience research. Finally, we plan to increase our
investment in training physician-scientists who are most likely to engage
in translational research and patient oriented research. Looking to the
future, I would like to tell you about just a few of our major
initiatives and priorities for FY 2001.

A HEALTHY BRAIN FOR LIFE
We are concerned with neurological disorders over the entire lifespan. It
is important to focus on developmental and degenerative disorders of
children that can produce a lifetime of disability. Our efforts range
from a new, exploratory grants program looking for new insights into
common disorders such as autism and epilepsy, rare disorders such as
Rett's Disease, Batten's Disease, and lipid storage diseases. We have
emphasized gene discovery in epilepsy because it seems that even the most
common forms such as febrile convulsions have a heritable component. At
the same time we seek to promote better treatments, and even a cure, for
the large number of people with "intractable" epilepsy. Many of these
individuals are children, whose lives are disrupted by inadequately
controlled seizures. Later this spring we will sponsor a White
House-initiated conference, "Curing Epilepsy: Focus on the Future."

***HALTING THE PROCESS OF NEURODEGENERATION
As requested by the Appropriations Committees, NINDS is working on the
first phase of an effort to develop a comprehensive research agenda for
Parkinson's disease. We were joined in this effort by NIH Institutes and
Centers with significant programs in Parkinson's disease, by patient
advocacy groups, and by distinguished intramural and extramural
scientists. We are confident that the proposed research agenda will
advance the fight against Parkinson's disease and point the way for
similar progress in other neurodegenerative disorders.
Neurodegeneration is more widespread than previously thought. In addition
to classical adult neurodegenerative disorders such as Alzheimer's,
Parkinson's, Huntington's and Lou Gehrig's diseases, neurodegenerative
processes are at work in a number of serious disorders of childhood.
Neurodegeneration also complicates conditions as disparate as stroke,
spinal cord injury, epilepsy, multiple sclerosis, and depression. A cell
death program, named apoptosis, appears to be a "final common pathway" in
the process of neurodegeneration.  Encouraging evidence indicates that
inhibition of this pathway may be a useful therapeutic strategy,
regardless of the initial causes of the degeneration.
We must not lose sight of our goal of cognitive and emotional health
throughout life. The study of disease is teaching us that decline in
cognitive and emotional health is not an inevitable consequence of aging.
For many, perhaps most of us, a healthy brain is as realistic a goal as
is a healthy heart. But we cannot achieve our goal without a much better
understanding of disease, particularly the risk factors and early changes
that point to possible preventive or corrective measures. *** A new
patient registry for Parkinson's disease, to be followed by a larger
population-based study, will point the way to further study of
neurodegenerative diseases at every stage of life. Through collaboration
with other Institutes, we will expand these studies to include cognitive
and emotional disorders and to define and promote cognitive and emotional
health across the life span.

REPAIRING THE INJURED NERVOUS SYSTEM
Modern neuroscience is rewriting the textbooks that tell us that nerve
cells cannot recover from deadly injury. Research on a number of fronts
has produced tantalizing evidence that manipulating the cells'
environment by adding factors that promote growth or interrupting
processes that disrupt it+will eventually redefine the future for those
who have lost function due to injury. A recent initiative is seeking
additional research on interneuronal circuits to restore lost function.
As in so many other areas of neuroscience, the ability to manipulate and
implant stem cells from a variety of sources is particularly promising
for both acute and chronic injury. Complementing these efforts are
advances in our ability to design neural prostheses+ devices that connect
with the patient's own nerves and muscles to restore or augment function.

REDUCING HEALTH DISPARITIES
As we rejoice in the progress of modern medicine, we must not neglect
those who, by virtue of biology or circumstance, bear a disproportionate
share of the burden of disease.  NINDS enthusiastically shares the
commitment of NIH to reducing health disparities, and we will continue
our leadership in this area. Stroke is a major health problem for the
entire population but one that disproportionately affects minority
citizens, particularly African-Americans. We support a broad program
directed at the impact of stroke on minority populations, ranging from
epidemiological and descriptive studies of disease patterns to specific
therapies and educational approaches. The neurological complications of
diabetes, another common disorder that particularly affects minority
groups, is a major focus of interest.
Progress against health disparities also depends on building a diverse
scientific workforce a strategy that makes sense in general but is
particularly important in working with minority populations. NINDS has a
long history of leadership on this front. More recently, with support
from the Office of Research on Minority Health, we initiated the first
prototype of a Specialized Neuroscience Research Program (SNRP) at the
Morehouse School of Medicine in Atlanta.  A unique feature of the program
is the establishment of collaborations and professional networks between
investigators at minority institutions and those from more research
intensive institutions and community-based organizations. Based on
excellent results from the pilot program at Morehouse, and recognizing
the work still to be done, the NINDS, in collaboration with NCRR, is now
supporting additional SNRPs. This year we will expand the program to
include a focus on HIV/AIDS, a particular problem in the nervous system,
where the virus can cause dementia and neuropathy even when other
manifestations of disease are well controlled.

WORKING TOGETHER TO FIGHT BRAIN DISEASE
Neuroscience is recognized as one of a few great unifying themes in
modern science. Nowhere is this more evident than at NIH, where almost
every Institute and Center is involved to some extent in brain research.
Here we have a unique opportunity to break down what is increasingly
recognized as an artificial barrier between mind and brain, between
neurology and psychiatry. Our goal is to develop a model for
collaborative neuroscience with an emphasis on translational research.
The National Neuroscience Research Center, for which start-up funds are
requested in the Buildings and Facilities budget, will provide an
environment that will promote modern neuroscience in the form of
collaboration, communication, and shared resources. It will build on the
impressive progress already made by intramural science leaders and on the
example being set by the National Vaccine Research Program.
The emphasis on collaboration will, in my view, stand out as the
distinguishing feature of NIH in our time. NINDS is actively working with
one or more Institutes and Centers on diseases including autism, Duchenne
and facioscapulohumeral dystrophy, and neurofibromatosis. ***Our efforts
against neurodegenerative disease include collaborations with the
National Institute of Aging on clinical trials for Alzheimer's disease
and with the National Institute of Environmental Health Sciences on
Parkinson's disease, as well as plans for an innovative public-private
partnership to foster future research. Our collaboration with the
National Cancer Institute to map the genes involved in a deadly form of
brain tumor has blossomed into the formation of a joint Progress Review
Group for brain tumor research, building on a planning technique that has
been highly successful for research on other forms of cancer. In stroke,
we have joined forces with the National Heart, Lung, and Blood Institute
and with Suburban Hospital in Bethesda to improve rapid diagnosis and
treatment of both stroke and heart disease. We continue to work with the
Brain Attack Coalition to raise public and professional awareness of
stroke as a preventable and treatable disease.
The NIH budget request includes the performance information required by
the Government Performance and Results Act (GPRA) of 1993.  Prominent in
the performance data is NIH's first performance report which compares our
FY 1999 results to the goals in our FY 1999 performance plan. As our
performance measures mature and performance trends emerge, the GPRA data
will serve as indicators to support the identification of strategies and
objectives to continuously improve programs across the NIH and the
Department. For NINDS, this effort will be augmented by our strategic
planning process, which provides an ongoing forum for assessing progress
and setting priorities, and by our strong commitment to efficient and
effective management of our resources.
Mr. Chairman, this concludes my prepared statement. I would be happy to
answer questions you or the other Members may have.
Last Updated: February 29, 2000.
National Institute of Neurological Disorders and
Stroke National Institutes of Health
Bethesda, MD 20892
SEE:
http://www.nih.gov
Click on NINDS