The International Brain Initiative: collaboration in progress

Abstract

On Oct 12, 2021, a virtual workshop—The International Brain Initiative: shaping the future of globally coordinated neuroscience—was hosted by the European Parliament's Panel for the Future of Science and Technology. The workshop was a showcase for the past 4 years of the International Brain Initiative (IBI), launched in December, 2017. The IBI has ambitious plans to tackle brain diseases, but neurologists remain skeptical about the relevance of such initiatives for changing clinical practice. 2013 saw the launch of several large research initiatives with far-reaching aims to investigate the complexity of the brain and, eventually, to develop treatments for and technologies to assess neurological diseases. Notable programmes at that time included the European Human Brain Project, the US Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative, and Japan's Brain Mapping by Integrated Neurotechnologies for Disease Studies (Brain/MINDS). After realising the enormity and complexity of their individual goals, these separate research initiatives joined forces to create the IBI in 2017. Intended as a forum to promote global communication, seven initiatives now fall under the IBI umbrella, comprising not only the European, Japanese, and US projects but also the Australian Brain Alliance, the Canadian Brain Research Strategy, the China Brain Project, and the Korea Brain Initiative. The overarching message from the virtual workshop was the value of collaboration, which has seemingly flourished since inception of the IBI 4 years ago—speakers at the workshop highlighted how research done by one initiative can reduce redundancy when results are shared within the IBI. However, many speakers also highlighted important unmet needs, such as a platform to store and disseminate the sheer volume of data produced by these brain initiatives, education of individual researchers and the lay public about work being done, tackling cultural differences between countries, and addressing ethical regulation in brain research. These are key shortfalls that need addressing; so far, the IBI has established working groups in data governance, neuroethics, education, and public outreach. However, for progress in clinics to happen, results are needed in these areas—and quickly. In addition to global challenges of collaboration, some of the brain initiatives have faced their own internal difficulties. For example, controversy about management of the Human Brain Project led to inception of two independent advisory boards, to provide critical advice about leadership. On Oct 6, 2021, BRAIN Initiative researchers published the BRAIN Initiative Cell Census Network—an atlas of the mammalian primary motor cortex. This achievement was heralded by speakers at the virtual workshop. The findings are primarily from rodents, and work in human tissue is only just beginning to gather pace. Moreover, research underway by brain initiatives in Japan and China is solely in non-human primates. These projects are many years away from producing results pertinent to clinical practice. Advances that are closer to the clinic were highlighted at the annual summit of the Human Brain Project, held virtually on Oct 14–15, 2021. At this event, two innovation awards were presented—one for The Virtual Brain, the other for the Perturbational Complexity Index. Within The Virtual Brain project, technology called the Virtual Epileptic Patient (VEP) has been developed that is intended to identify the epileptogenic zone of a patient, thereby improving surgical prognosis in people with pharmacologically resistant epilepsy. The VEP technology is being tested in the EPINOV (Improving EPilepsy surgery management and progNOsis using Virtual brain technology) clinical trial (NCT03643016), with results anticipated in 2023. The Perturbational Complexity Index measures EEG responses to transcranial magnetic stimulation and is sensitive to signs of consciousness. It is a means to identify patients who have a good chance of recovery from brain injury, helping clinicians make appropriate treatment choices. Advances in brain science are vital for tackling the burden of neurological disease. Globally, neurological disorders are the leading cause of disability and the second leading cause of death. The work of the IBI could be key to keeping this goal on track, but with working groups and many projects in progress, much still needs to be achieved. Furthermore, the total budget for the US BRAIN Initiative is roughly US$5 billion (2013–25), and around €1 billion will be spent in Europe on the Human Brain Project (2013–23). Such funding seems generous, by comparison with the scarcity in many neglected areas of neurological research. Clinically relevant results from the IBI cannot come soon enough for neurologists seeing patients daily.