I have been immersed in trying to develop a brain stimulation method in the central thalamus to improve cognitive function. I can tell a sequential story of when segments of the work were published, but the research has had an ongoing life of parallel events. The same set of problems has taken me from my initial fascination as an undergraduate researcher through medical school research, my residency—which crystallized my ideas after observing patients—and the stated long-term goal in the first National Institutes of Health (NIH) grant I received, to my work to date.
As an undergraduate, I did historical research at the Montreal Neurological Institute, working with the collected archives of neurosurgeon Wilder Penfield. The institute’s director recognized my interest and said, “Not a lot of people are interested in consciousness any more, but there is one neurologist who is still doing it. His name is Fred Plum, and he’s at Cornell University.” That stuck in my mind. I came to Cornell, and on the first day of medical school at the white coat ceremony, I met Fred Plum (professor emeritus, Neurology and Neuroscience). He has been a mentor ever since.
How do some areas of the central part of the upper brain stem and the thalamus participate in establishing and maintaining consciousness in the brain? It is a compelling question. After my third year of medical school at Cornell, I received a Howard Hughes grant, and I focused on absence seizures and the organizational aspects of consciousness in the brain. How can we learn about the circuit mechanisms underlying this type of seizure? I wanted to obtain a new set of skills—to understand how to do mathematical modeling of electrical signals and to think about what the relationship was to consciousness. I went to work on applied mathematics in the lab of Jonathan Victor, now the Fred Plum Professor of Neurology.
After my internship in Chicago, I returned to Cornell to do my residency, during which I figured out a way to take the model I had been pursuing for seizure problems and turn it into a deep brain stimulation question: how might deep brain stimulation modulate perceptual function?
I began writing grant proposals to fund the research that could be the foundation for setting up models to develop new therapeutics. Fred Plum, however, made another recommendation, saying, “This is great, but I don’t want you to work only in the lab. I have another project I’m trying to get started. I’m working with Rodolfo Llinás downtown at New York University (NYU) with magneoencephalographic technology, and I want to restart a program that we worked on in the mid-’80s. I want you to come and work with me on that, as well.”
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“If we knew a patient was able to talk every now and then, perhaps we could get the patient into that state and hold the brain in that state. But could we get the brain to function in that state? Nicholas Schiff, Neurology and Neuroscience”