Because of this Institutes carefully laid program planning and development activities, there have evolved many strong training centers, particularly in the clinical research disciplines of neurology, pediatric neurology, ophthalmology, and otolaryngology. These centers now have highly developed facilities and a full complement of able faculty and supporting staff. They are able to acommodate an increased number of scientist-physicians for training as teacher-investigators in the neurological and sensory fields. An additional investment in training stipends would capitalize on these facilities. In addition, this Institute could launch approximately 25 new training programs designed to prepare candidates for careers in research and teaching and the community service aspects of neurology, ophthalmology, and otolaryngology. For example, in neurology, additional training sites can be developed as focal points for training in cerebrovascular disease; in opthalmology, adequately prepared physicians are being turned away because of a lack of available training environments; pediatric neurologists continue to be a critical area of national shortage in programs aimed at the brain-injured child. In the preclinical sciences such as auditory physics, speech pathology, and sensory physiology, additional training programs at the postmasters and postdoctoral levels can be initiated to provide the essential science base for continuing development. DIRECT OPERATIONS, $1,235,000 The professional judgment budget for direct operations exceeds the President's budget by $1,235,000. Following is a detail of various programs which the Institute could expand or initiate in addition to those in the Presidents budget. A. Intramural research, $150,000 Laboratory of perinatal physiology.-With its acquisition of Deseches Island and with possible acquisition of other sites for experimental primate enclosures, the Laboratory of Perinatal Physiology, in Puerto Rico, could utilize eight additional positions and $150,000 to expand the studies, chiefly with primates, on problems of growth and development of the nervous system. B. Collaborative studies, $1,035,000 Perinatal research.-Five positions and $400,000 could be used to support the collaborative project on cerebral palsy, mental retardations, and other neurological disorders of infancy and childhood. Increased data processing associated with this project could absorb most of the increase. However, some of the funds would be used to study, under contract, the interactions of virus infections with chromosomol aberrations observed in abortions. Another would concern the supplying of data on women before and during pregnancy to permit assessment of variations in fetal growth and development by studying a cohort of pregnant women with precise data of onset of pregnancy. Epidemiology.-An amount of $40,000 would support three positions in studies in epidemiology. These added positions are required to further emphasize epidemiological vision and research including simple glaucoma, chronic vascular changes of the retina, and diabetic retinopathy. Chronic disorders of the central nervous system.-Expansion is planned for the Institute's investigations of slow, latent, and temperate virus infections for the study of chronic progressive degenerative diseases of the nervous system. These studies are designed to determine the transmissibility and establishment of an infectious etiology for these chronic diseases. Such diseases under study are “kuru," amyotrophic lateral sclerosis, parkinsonism-dementia, multiple sclerosis, subacute sclerosing leucoencephalopathy, progressive supranuclear jay, and Schilders disease. Recent exciting developments require the expansion of these investigations. These developments are the observation that experiDental animals (chimpanzees) inoculated with frozen brain materials from a "ru" patient have developed progressive incapacitating cerebellar signs with ataxia and tremors. The procurement of chimpanzees and other species of pribates and pathological studies for diagnosis of the neuropathological lesions will be intensified. The housing facilities for the experimental animals, supported by contracts, will necessarily be enlarged. An amount of $200,000 and five positious could be utilized to support the expanded scope of these investigations. Sperial Projects Branch.—The Special Projects Branch could utilize five new positions and $75,000 to augment and expand collaborative research in epilepsy. Institute-supported scientists have made considerable progress in the basic disiplines associated with epilepsy. However, a need exists for the development of a stronger research program in the general area of clinical investigation. Adequate data are not available for a classification of epilepsy, life histories of patients, genetics, epidemiology, response to medication, and the disease patterns of various forms of epilepsy. Studies have been conducted to determine the feasibility of field investigation units to examine these clinical issues. Participea's agreed on the appropriateness of such units and a protocol for their initiation has been developed. Model field investigation units will implement the Information centers.-Toward the fulfillment of the Institute's information nter program $320,000 could be applied for the establishment of two full centers on speech and hearing and vision and disorders of the eye. The 1967 President's budget includes fund support for two operating centers, he in clinical neurological problems and one in basic neurological sciences. . Review and approval and program analysis, $50,000 Two additional positions and $20,000 are needed for the review and approval of increased grants programs, particularly in stroke and vision. Three positions and $30,000 could be utilized in support of program analysis and vientific information exchange activities. |