The Judith Hoyer Lecture: Genes, pixels, patterns, and prevention

Abstract

It is a singular honor to deliver this year’s Judith Hoyer Lecture, a special occasion that heralds the opening of the Annual Meeting of the American Epilepsy Society. By its very creation, this lecture has quickly come to symbolize a vital partnership between the US Congress, the National Institute of Neurological Diseases and Stroke (NINDS), the Epilepsy Foundation, Citizens United for Research in Epilepsy, and the American Epilepsy Society to generate and deliver a national investment in scientific research that will lead to a meaningful improvement in the lives of people affected by epilepsy. Although the partnership is longstanding, the Hoyer Lecture now represents a perfect moment in each year to summarize our progress and reflect on the distance remaining to be traveled. The road may be long, but at least we have a firm idea of where to go and ways to get there. We need the ability to discover the precise molecular basis for seizures in any individual with epilepsy, to pinpoint the actual brain networks affected, and to selectively reverse or even prevent the hyperexcitability in these cells while leaving others undisturbed. We also need to identify individuals at risk for epilepsy, and develop treatments that could prevent its appearance. These goals promise countless obstacles, some plainly visible from today’s vantage point, and others well hidden—pitfalls and misinterpretations that will stymie even the surest scientist. Nevertheless, as we examine the clearly defined biological targets we have identified so far, and the increasing accuracy of the tools at our disposal, one fact is obvious: we now have unparalleled opportunities to take precise aim at the root causes of lifelong seizure disorders. Speaking for those in the audience today who are involved in both clinical and basic research, I believe there is an overwhelming sense that neuroscience is poised