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Ms. Fox. I did not hear most of your question, so I am going to have to answer what I did hear. You were asking about the potential of the Institute?

Senator GORTON. Yes.

Ms. Fox. And it has great potential. We had nothing 5 years ago, we did not know anything about hair cell regeneration in the inner ear, and today we have discovered that there are juvenile birds and adult birds, and fish and amphibia that can regrow hair cells after they are destroyed. And this-we have incredible researchers working on this.

Senator GORTON. Do you think that there is human potential for the same thing?

Ms. Fox. Yes; absolutely. As soon as we find out how these animals regrow them, then we will do some studies with mammals. Senator GORTON. To what extent do you feel that there is a sufficient degree of support for that kind of research now, or what could we do to create it?

Ms. Fox. Well, there is tremendous support. In fact, in your State, sir, you have a very fine researcher, Dr. Ed Rubel of the University of Washington, who is one of our, I would say, one of four or five researchers in this country who are doing incredible work. And he runs a marvelous lab. And if you have time, you must visit there because he feels that with financial support from the Congress, within 5 to 7 years, we would see hair cells growing in the human being, which would cure-it is absolutely a cure for most deafness.

Senator GORTON. That support is not available now, but if it were available, this could

Ms. Fox. The support is available. They are supporting. And I am saying with more support. They are supporting this, and it is a very fine study.

Senator GORTON. Do you have any estimate as to what degree of support would be required for what period of time?

Ms. Fox. Yes; I would say $1 million a year for 5 years.

Senator GORTON. All right. And tell me once again what you think that might accomplish.

Ms. Fox. That would accomplish a cure for many types of deafness. And the deafness would come from-such as my deafness is caused by the mumps. I am deaf in my left ear. And I caught the mumps when I was teaching school 32 years ago. It would cure deafness from loud noises. People have lost their hearing from working in construction jobs, et cetera.

Senator GORTON. What percentage, or what share of the deafness problems in the country do you think might be impacted by this kind of research?


Ms. Fox. Well, we have 2 million deaf, and 28 million hearing impaired. And I would think, personally, that over 50 percent would be helped by this. But that is just a rough guess, and it could be more, much more.

Thank you very much.

Senator GORTON. Thank you, Mr. Chairman.

Senator HARKIN. Thank you very much, Geraldine. Thank you, Rachel. Thank you very much Caitland. Thank you all for being here.

[The statement follows:]


As Chairperson of The National Institute on Deafness and Other Communication Disorders, I want to express my sincere appreciation to you, Chairman Harkin, and members of the Subcommittee and your staffs. This is the fifth year that I have appeared before you, and, as always, I am grateful for your kindness and generosity in supporting the NIDCD.

Thanks to your faith in us and your nuturing of this Institute, this year, we are expecting an explosion of grant applications--562--, more than any other Institute at NIH. The interest and excitement of the researchers in this field has never waned but grown enormously.

The Professional Judgement Budget for FY'92 of our Director is $201 million, and this figure would allow us to have a success rate of funding 42% of all approved grants. Attached to my testimony is a copy of the budget and the justification for it.

To quote our Director, Dr. James B. Snow Jr., "We are in the midst of an accelerating period of discovery."

I would like to summarize Dr. Snow's assesment of NIDCD's scientific highlights in the communication disorders fields.


++ At present, there is some outstanding work being done in the field of hair cell regeneration in the inner ear. When these hair cells die or are destroyed for one reason or another (viruses, environmental factors, etc), people can't hear. Hair cells are known to regenerate in certain animals (fish, amphibia, and juvenile and adult birds) but not in man. If researchers could discover how some animals are able to re-grow hair cells after they are destroyed, perhaps we could stimulate hair cell growth in human beings.

Work towards this goal holds the possibility of a true cure for many types of deafness.

++ Research in the field of genetics continues to progress towards helping people with hereditary deafness by the discovery of genes which cause deafness from certain diseases. The location of the genes that cause deafness have been discovered in Usher's Syndrome, Type 2 (thought to be the cause of 10% of all cases of congenital deafness), Neurofibromatosis 1 and 2, Albinism, and one form of Alport's Syndrome (a kidney disease).

++ Not everyone's hearing is affected by acute sounds. Evidence indicates that heat shock proteins formed in the inner ear may protect hair cells from being destroyed.

++ In October, 1990, the FDA released a vaccine to protect infants (beginning at 2 months of age) from the most common type of meningitis. As you know, Caitlin Parton, who is testifying with us, lost her hearing from a bout with meningitis.

++ Researchers are investigating a chemical depletion in the brains of elderly people as a cause of hearing loss.

++ A new speech processor, developed with NIDCD support, shows great promise in producing important gains in speech understanding for patients fitted with multichannel cochlear implants.

++ Recent studies indicate that congenital cytomegalovirus (CMV), a wellestablished cause of disorders of the auditory, visual and central nervous systems (which once acquired lasts a lifetime), may play a previously unsuspected role in the development of Menier's disease.


++ Currently, NIDCD is supporting research on the micromechanical properties of inner ear sensory cells that may explain how they detect forces acting upon them during movement of the head, and transform this information into nerve signals.


++ Research is focusing on the development of objective criteria that could be adapted for clinical use which identify, describle and measure the degree of vocal dysfunction.

++ Research indicates that a new therapy (photodynamic therapy with dihematoporphyrin) is effectively treating patients with papillomavirus infection of the larynx and upper respiratory tract, a life-threatening disease that affects both children and adults and can result in respiratory obstruction.


++ Investigators are studying sex differences in the onset and development of stuttering in children.


++ Recent findings suggest that the loss of ability to use or understand language (aphasia) experienced by stroke patients may be prevented by the immediate administration of Type I gangliosides.


++ As one grows older, the ability to differentiate tastes may decline. However, recent studies indicate that the taste of one substance may be enhanced by another. This finding may help reverse or prevent nutritional deficits that are based upon taste disorders.

++ By comparing patients who developed Parkinson's disease from injecting street drugs with those who developed it from other causes, researchers are closer to understanding the progression of the disease. Patients who used the street drug MPTP do not have smell deficits while patients who contracted Parkinson's disease from other causes suffer smell deficits. Researchers are now studing the possibility that some forms of Parkinson's disease are caused by enviromental agents entering the brain through the olfactory nerve.

While advancements have been made in these fields this year, there is still a great deal of work to be done. Discoveries and solutions do not evolve overnight, but our

researchers are committed and dedicated to the 48 million Americans who suffer from communication disorders and desperately depend on the Institute for answers. The NIDCD has an obligation to them to find the preventions, causes, and cures for all communication disorders. But, we can not do this without a major commitment of resources on the part of the Congress. Through your past generosity you have affirmed the value of the mission of the Institute, and I am urging you to continue to join us in our fight against these debilitating disorders. I am confident that together we will ultimately attain our ambitious goal of relinquishing future generations from the suffering and trauma caused by deafness and other communication disorders. Thank you for allowing me to share this information and my thoughts with you. National Institute on Deafness & Other Communication Disorders Professional Judgement Budget

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