Ep 02 | Part 1 - Peering into the ENIGMA of Alzheimer’s | Prof. Paul Thompson

追加: 2026-06-06

[00:00:22]Hello all. Uh we're joined at the second edition of the Center for Brain and Mind podcast with uh Dr. Paul Thompson. Uh welcome Paul.

[00:00:31]>> Thank you.

[00:00:31]>> Um just to introduce Paul briefly. Uh, Professor Paul Thompson is a professor of neurology at the imaging genetics center at the University of Southern California. Uh, Paul has a bachelor's degree in Greek and Latin languages as well as mathematics from Oxford University, a master's in mathematics from Oxford and then a PhD from neur in neuroscience uh from the University of California, Los Angeles. uh he specializes in the field of human brain imaging and has uh interest in mathematical and computational algorithms that look at neuroiming data.

[00:01:08]He currently leads the enhancing neuroiming genetics through metaanalysis or the enigma project which is a global data collection and sharing effort designed to understand how brain structure changes during the trajectory of brain atrophy, mental illness, Alzheimer's disease and so on and therefore underlying uh understanding the underlying genetic landscape. So welcome Paul.

[00:01:32]>> Thank you. Appreciate it.

[00:01:34]>> Pleasure to have you here. How have you enjoyed Bangalore and Monot for the last two days in our neuroscience conference?

[00:01:41]Uh if you can tell us a little bit about that.

[00:01:43]>> Well, it's it's brilliant to be here and uh it's been a real pleasure. So just thinking about Manotava which I was not familiar with before coming here. I mean that is a really eye-opening event. I mean in many ways it was um the first time I'd seen I think you put it this way. was a celebration of mental health and understanding all of the factors that go into having a a balanced life.

[00:02:08]You know, if people want to improve their mental health, what should they do? And then more on the medical side, if they have, you know, maybe in their family, you know, people with uh mental health conditions, what are the things that uh are on the horizon to be helpful? Where can they get help now?

[00:02:22]So, I I think that was truly unique. I mean, you did an amazing job, the organizers did an amazing job. Um, and I was just a spectator. I just enjoyed it.

[00:02:32]And, uh, what was it? Something like 6,000 people were were there. And, uh, it seemed like a very engaging, uh, place to sort of discuss a lot of these different issues.

[00:02:43]>> Amazing. Thank you. Just as I was reading your bio, I read you have a bachelor's degree in Greek and Latin and then you moved to neuroscience at the end.

[00:02:52]>> Yes.

[00:02:52]>> Tell us your trajectory through that.

[00:02:54]>> No, I I I mean, I'll tell you, it's a little bit of a funny story. So I grew up in in England. Um and I don't know if in India this is taught here. It it might be a little bit different. I mean there's different classical uh cultures that are of interest.

[00:03:11]But I went to Oxford thinking that I would become a linguist and and and you know some of the languages that were taught uh in in Britain at the time were Latin and Asian Greek. I was very interested in um ancient history and the the all the Greek tragedy authors and Herodotus and Thusidities and all the um and this is a bit old-fashioned I think nowadays in England there's not a lot of students who who do this there's some luckily there's still some >> and it was a wonderful time and I I I met great people I mean a lot of these people um what one professor she she was very very famous Barbara Le Barbara Levik um she had a radio program and she would talk about um all the Roman emperors and all of classical Greek culture uh on the radio. Um and she was very eccentric.

[00:04:05]She liked to have uh tutorials on a punt boat on the river so the students would sit with her. So that was like a a a period in my life that was very different than now. But moving to neuroscience and I know this is the topic of this this podcast.

[00:04:21]I became very interested in um neuroscience after seeing a presentation by um I think it was someone at a drug company who was talking about how treatments work for neurological illnesses such as stroke. And I I had never thought of anything like this before. They were saying this is how we develop drugs. This is how the brain works. But they said in the end we don't know a lot about the major mental illnesses. We don't know a lot about even dementia. I mean, dementia, we know what the symptoms are, but we don't know entirely what is going on in the brain.

[00:04:56]If only we knew a little bit more about that. And so I said, you know, is is is there any room for someone who hasn't done this before? And I don't know, maybe people are listening who are considering a career in in in this area.

[00:05:07]And they said, "Well, neuroscience is a very unusual field because it isn't like genetics where you learn genetics and and and I mean, you would work in a lab doing genetics and it isn't really like psychology because there's more uh to do with the anatomy and systems of the brain that you'll learn about. Um, and and and yet again, you you know, it isn't physiology and there's a little bit of a mix of these things. So they said, you know, if you're willing to learn a little bit of each of these things, um there's probably room for somebody who doesn't have a background in in any of those things. And uh so yeah, um it was a good decision. So I think >> many think so the scientific community that's very kind.

[00:05:54]I was just wondering uh we're talking a lot about neuroscychiatric diseases and neurodeenerative diseases today and could you give us a brief overview of what the mental health disease burden is in the world and why it's so relevant and important to talk about it.

[00:06:10]>> That's a great question. So there's a there was a talk this morning uh by Dr. Bju Viswanath who was at Nims and he I didn't know this. He said one in seven people in India has a mental health condition and I think that is um about the same globally. It'll vary a little bit from from country to country. And these are often problems you you don't see. And so they they they you know, if someone has a physical disability, it it's often clear and and other people would help them or there might be a concern about them. But, you know, a lot of people are studying are struggling with um depression or they they might have a um an eating disorder or they might have um you know, any number of traumas in their life that have caused them to be either uh anxious or socially withdrawn or they they um may have difficulty um you know with stressful situations and things like this and these can be profoundly disabling. So I mean to think of some of the neurological conditions that we know about you know many people will have a relative with um dementia and dementia is a very interesting condition because it isn't common in younger people but as people get into their 70s and if if they if they survive till their 80s there can be profound changes in memory there can be um a great deal of anxiety and It can be disturbing to families to to really work out what can be done. And more recently, neuroscientists have studied this and they said, well, there are parts of the brain that are important for memory and we understand what's going on uh to some degree now. And there are some treatments for dementia. Some of them um I mean they they're not entirely effective, but they're effective for some people that can limit the loss of cells in the brain. If the person is anxious, if they're they're having um um motor disabilities as well, there are some treatments that can help them with their uh mobility. Um and in addition to drug treatments, there's um you know, psychiatric help, social help, social work, and things like that. So, I think one of the reasons this isn't discussed is it's a little bit of a taboo. I mean, we don't we don't always like to admit that there's something going wrong. I mean we want to make you know other people think that everything is just fine. But certainly in the case of uh dementia you know many of the disorders uh of old age that there are uh some solutions ways to get help. And then you know you mentioned also you know psychiatry and mental health. There's a huge amount of work going on in neuroscience to understand you what are the best treatments for things like uh uh depression uh anxiety and even more disabling conditions um addiction is is is a big issue. So certainly in the United States where where I I live at the moment, it's a very very prevalent condition where people are either um you know drinking too much alcohol or they're addicted to painkillers and the it it it's something that the brain very naturally does. I mean there's a reward system in the brain that we you know if you figure out a way to be rewarded I mean that becomes a behavior that people fixate on and it's it can be very unhealthy. it can be very disabling. So there are centers here uh at NCBS, the centers also in Bangalore at Nimanss where um I mean you know this the researchers are world leaders in this I mean they're not just experts in the clinical treatment of the disorders but they're you know pioneering new new new treatments. Um, I mean, one aspect of the meeting today that was fascinating, I didn't know about this at all, is that there's a type of brain cell that helps rescue you if you have a brain injury.

[00:10:11]And so there there's um many people that will have um a brain injury from a a concussion or a head injury. And the brain brain is remarkable in the sense that it can recover. So um if the injury isn't too serious, the brain will start to repair itself. And one of the one of the researchers today and it's fascinating that they can do that um is designing a type of genetic modification to a type of brain cell. It's called an astroite that is a helper cell. So I many people may not know that this type of brain cell exists. It's it's a type of cell in your brain that rushes to help when you have an injury just like a bruise or any anything like that. And these are cells that the geneticists can reprogram to be more effective in repairing uh damage to the brain. It might be a brain injury.

[00:11:02]Um you know people might have a stroke.

[00:11:06]It's a condition of the brain that is fairly common where the blood flow to the brain is interrupted. Um and not the entire brain is affected. It's often just a small part. But it's important for someone uh with signs of stroke to get treatment. you know, go to the hospital, get some uh medication. But even in the research field, you know, there there seems to be new avenues there for having, you know, novel and new therapies that could help people with that condition.

[00:11:34]>> So, it is really debilitating mental health uh problems with your mental health and we don't often recognize it and which is why there's I guess a need for us to talk about it even at a podcast.

[00:11:47]>> There certainly is. I mean I mean what what are the things that I mean you mentioned the prevalence of these conditions about a third of people during their life will suffer from for from major depression. Now what do we mean by major depression? Now me many of us are unhappy about something but we bounce back from it and we get on with something else and and you know it's very natural to have sad thoughts or maybe someone has had a setback but major depression is a type of uh sadness that doesn't go away and if untreated someone wouldn't be able to go to work.

[00:12:26]it's difficult for them get to get out of bed. But there are really good treatments for depression and many of them, you know, if a if a trained psychiatrist can speak to the person and understand what's going on, there could be many many causes of depression. There are some treatments that involve uh medications that uh people can take and their mood is is drastically improved.

[00:12:50]Um there are experimental treatments that are very interesting that um you know neuroscientists have come up with with ways of stimulating the pathways of the brain that in a depressed person are not working properly. So in a depressed person very often their reward system um is is not active or at least it's not active in the situations where a healthy person would would have activity. And there's a treatment that's known as as transcranial magnetic stimulation. And when I first heard of this, I thought, well, I I don't think I would like that.

[00:13:22]I I think that seems like it it it's a bit high-tech. But what it is, it's very very small amounts um of electric current, a tiny tiny amount that just changes the balance in your brain. And it's been found as a very very interesting topic even people who had uh suicidal thoughts. So people who were so depressed that they thought I don't think there's any way out of this. I I I thinking of of taking my own life. This type of treatment in combination with expert help as well has been shown to at least in the clinical trials where it's been used, it's been shown to reduce the incidence of suicide in people who are depressed and then in other people who are depressed, it's been shown to remit their symptoms. So I think you know thinking about these things collectively and talking about them is the first step and you know folks who are affected by this you should know that there are many many options um they don't have to take the options I mean there's nobody forcing people but even just learning about these looking at the internet finding a professional they can talk to about these things is is is an option and they do work the the these therapies do work. So you know you can think of something like dementia which is phenomenally difficult to treat because it's a progressive organic disorder of the brain but depression is a disorder of the brain's function and even talking to somebody your brain function is reactivated. It doesn't require a medication and so um even though these are very prevalent conditions there's certainly a way uh to to make them better in many many cases.

[00:15:02]>> There are ways out of it.

[00:15:04]>> Yes. Yes. Yes. uh for the benefit of the audience I was wondering if you could describe your project Enigma in sort of a a way to understand mental health.

[00:15:15]>> Sure. So many people who have been to a hospital uh might have had a brain scan and so I know when I was younger I had an X-ray. If you break a bone you you you might have an X-ray to see if the uh the the bone is is is broken right through or or is recovering. Now the brain is a little bit different. If you have an X-ray, you won't see it because the bra brain is made of uh it's made of brain tissue. So, the commonest way of looking at the brain if you go to a hospital is with MRI. It's it's magnetic resonance imaging. And you can look if you're a radiologist at the MRI and say this person looks very healthy. Um if they'd had a operation to the brain, you could see if the brain's recovering. But it's not often used in psychiatry. And so you could say well you how how how would MRI be interesting there? So one of the ways that we decided to use MRI and brain imaging in general is to try and understand how all the different brain diseases affect the brain. Is is is there a particular diagnostic test we could use uh that would be based on what what is happening in the brain? And and just to be very concrete about this, I mean someone might say um you know there's a disorder like Parkinson's disease and I'll tell you a little bit about that. So Parkinson's disease is a neurodeenerative disease where rather than people losing their memory, they lose their um ability to be mobile and so it's difficult to stand up. You might see a person with Parkinson's has a slight tremor or in some cases they're very rigid.

[00:16:53]And so Parkinson's disease is a very interesting disease. My my father-in-law had Parkinson's disease. There are treatments that can reactivate the part of the brain that controls motion. And there's um a medicine called L-dopa which affects the the dopamine neural pathways of the brain. And when some patients take that medication, their their motion, their rigidity is alleviated. They can they can suddenly move more. their tremor is is is reduced and in many many cases this this has been very effective in restoring some of the mobility to to patients with this.

[00:17:31]So, one of the things that Enigma does is we we'd like all of the diseases to have some solution a little bit like Parkinson's like maybe um if there's another brain disorder, what is wrong with the brain? Can we identify it? Can we direct that person to either the best treatment today or figure out a new treatment by testing different medications and looking at the the brain scans? So just to be very brief, Enigma is a large scientific project. The goal is to study I think now over 30 brain diseases. Some of the brain diseases everyone will be familiar with.

[00:18:08]Alzheimer's disease, maybe Parkinson's, which we just talked about, maybe stroke, which is a vascular disease of the brain. These diseases are comparatively well understood. And in fact, if you or I had a brain scan, a doctor could tell us whether or not we have those diseases. But the vast majority of brain conditions, we don't know how to diagnose them. One one of them that's very interesting is um autism. So autism is a developmental disorder um that affects maybe about one one in 80 children. Um and it's a very interesting disorder. So children with autism, they it's it's not like a degenerative disease. they have problems with uh communication and social uh function. Um at at one end of the autism spectrum, people can have children who are profoundly disabled. They don't want to interact with other people at all, but then at the other end of the the spectrum, the person might be just have have slightly unusual behavior. And uh sometimes it's not a problem if it's not interfering with their with their life.

[00:19:16]So neuroscientists have wondered what it is about the brain that is different in autism. So one of the things Enigma is doing and other neuroscientists are doing is they're collecting very large numbers of brain scans of children with autism and and and then typically developing children who you know don't have any uh developmental condition. And these differences are subtle. I mean I I suppose one thing that is in a sense encouraging is I mean if you were if you were I to look at these brain scans we'd say well I don't really know this this child whether they have autism or attention deficit disorder or OCD which is an obsessivecompulsive disorder.

[00:19:58]These are all conditions that affect uh children adolescence. you or I looking at the brain scans and we've looked at a lot of brains. It would be difficult to tell but computers can aggregate the information. They can measure the structure of the brain its connections and if there's something about the brain connections um that is subtly different the computer will be able to figure that out. And um one of the interesting findings I I I know in your own work you've studied the amygdala and the connections. So the amygdala is very interesting. It's a it's a very small nucleus of the brain and that the brain looks like a very large wrinkled object, but it it it has units and they're a little bit like cities in a country. And this particular city, the amygdala, it it it is very active when someone is stressed. It it it is active when someone is anxious. Um sometimes helpfully. If someone's being attacked, it will rouse them to to to to fight back. But it can also be an area where if it's damaged, a person can have extreme anxiety, social um uh issues, and in mental health conditions like PTSD or post-traumatic stress disorder, this part of the brain, the amygdala, t tends to be altered in its function.

[00:21:19]Now, it's still there. The amygdala is still there. It hasn't lost its cells.

[00:21:24]So there's a lot of interest in whether efforts to alter the brain's connectivity, the way parts of the brain speak to each other. There's a lot of interest in whether those efforts can put the brain back on track. And people, I mean, you know this, people that have post-traumatic stress, people who've served in the military or people who've had a traumatic experience, a lot of them do recover and they can recover either through medical means or some some newer means using stimulation. And it's a very interesting area for neuroscientists to sort of puzzle out what are the main contributors to illness and maybe how they can be restored in patients.

[00:22:05]>> Interesting. And because you mentioned big data sets, I was just wondering what you think currently, I mean AI and LLMs and deep learning have you know overtaken the news >> and um do you see all those algorithms playing a role in neuroscientific data, neuroiming data in the future?

[00:22:26]>> What what a great question. So so a AI is is profoundly transforming a lot of areas of life and my daughter's a university student. she's actually studying similar things to what we're talking about and she said you know a lot of the students use AI to write things to summarize things so we think of AI in its commonist use as a chatbot where it'll reply to a question but a different use of AI and and maybe not everyone thinks about this is analyzing images and so one of the early uses of AI and you'll see this if you go to the airport so you go to the airport a security system will scan you. It'll look at your face and somehow there's a database that tells whether um it's you or whether you are matching the passport. Those AI methods fall into an area known as computer vision. And computer vision is a set of mathematical approaches that detect patterns in images. And if it's an authentication system, it's using features that are typical of that individual. But in a medical context, computer vision can identify disease. And so, just as we said, it's difficult to tell if someone has Alzheimer's or Parkinson's from the scan, it it's something a computer is very, very good at. And so thinking of what would be the ingredients in a in a diagnostic system. Number one, if there's a lot of scans of people with these different conditions, a computer can identify all of the major signs that are characteristic of a certain disease.

[00:24:02]So if for example Alzheimer's disease shows shrinkage in the memory system of the brain the hippocampus even if it's too subtle for us to see with our own vision it it has statistics on this from other scans and it can say you know that's just fine it's just an older person that's natural or it isn't it's it's something that's more abnormal. So I think this is one of the areas that I'm certainly excited about and the students are excited about because the use of AI to automate tasks that are very difficult for humans can extend into medical diagnosis and you can use this for biomedical discovery as well. So, in a clinic, a radiologist might have a um an AI assistant, and the AI assistant might say, "We flagged a stroke in this scan."

[00:24:55]Now, the radiologist isn't going to just believe what the AI says. I mean, they've had training to do it, so we don't have to worry that the AI is going to be diagnosing us, but it could be very helpful. They they could say, "Well, I had a lot of scans to read today and I'm very relieved that it's found this one because this person needs urgent help. We're going to deal with it immediately."

[00:25:16]That is already happening in radiology where AI is helping. But only in a small number of brain conditions, stroke, Alzheimer's, where there's a a strong signal in the brain. If we could design an AI system to diagnose the other disorders, which I think is quite possible, it might use different features of the brain. So, you know, you you you know this as a neuroscientist, there's a very broad range of techniques to look at the way that the brain systems speak to each other. So, one of them that's very strange is called resting state functional MRI. So you can sit in the scanner and do nothing and your brain is very active and the electrical activity of different parts of the brain is synchronized and this was only discovered comparatively recently that there are attention networks and salience networks and there's something called the default mode network which is active when we're not doing anything. When we're speaking it's not active when we're at rest it's active. Now in patients with psychiatric conditions the temporal relationship between these networks is disturbed and there are a lot of theories about this. So let's take someone with um schizophrenia which is a a disorder where people might hallucinate. They might uh hear things that aren't there. There are sometimes perceptual disturbances.

[00:26:44]Schizophrenia has puzzled neuroscientists because there isn't anything obvious in the person's visual field that would explain what they are experiencing.

[00:26:55]But one of the things neuroscientists have found using functional MRI is this network of the brain that's called the salience network. It's very active when we're noticing something. So if we notice a person we recognize or we notice a a clock um the salience network will become very active and they notice that when a person with schizophrenia is experiencing an everyday situation they're focusing on things that a regular person wouldn't focus on like there'll be a sound in the distance that they focus on. And this slightly unusual way of attending to the experiences of everyday life is evident in the image.

[00:27:37]And so it's a signature that people that are interested in schizophrenia can identify and they can say well maybe with the help of AI we could learn what it is that's more characteristic for this condition and is less characteristic in in healthy people. And although these techniques don't exist today I mean they're not available yet.

[00:27:59]It's within reason that within a couple of years there could be a system that would detect this. Now you you don't want to just detect it. You want to see what would fix it. So if a treatment then is given to that patient, maybe a a so-called antiscychotic drug which can actually eliminate these hallucinations, the drug companies find it easier to have a drug approved if there's a physical indication of the drug working.

[00:28:24]And the the these things are often called biomarkers. And so if someone um in a neuroscientific lab has a a physical test of of an illness, if a drug makes a quantitative difference to the measure of disease, it's very much easier for a drug company to say, look, there's an empirical um experiment that has shown that this is effective. So a lot of the neuroscientists that are using brain imaging are interested in, you know, what are the functional signs of a of a disease? What are the best ones? Can we make them into a diagnostic test? And then can a drug company use them? If they are useful in flagging a diagnosis, can any of their treatment shift those back into normality? And so it's a very broad landscape of activity.

[00:29:10]>> It is. And while we're talking about the beneficial uses of AI, um I'd like to bring up two things and ask you your thoughts on it. One is how is international collaboration then important? Whether it is important? I figure you think it is because enigma is across multiple countries across the world. And the second is do you anticipate some ethical considerations, some regulatory considerations and what might those be and where are we?

[00:29:38]>> Yes. Yeah. Those are really interesting questions. So to take the first one on international cooperation. So it's it's always been the case that science has been international and and we're very lucky. I mean I I I think a lot of scientists who are reading the latest developments in their field will hear of breakthroughs from all over the world.

[00:29:59]And there's no monopoly on science. I mean a person um so long as they're lucky to have some educational support and training in the field of their interest, you know, they're capable of making a breakthrough in in any of these areas. But usually it's not a very talented individual working alone, at least not in the medical field. It's more common now to work in in in groups of people with complimentary skills. And so what you'll see looking at medical research studies more commonly is, you know, a group of maybe geneticists, neuroscientists, people that are interested in pharmarmacology, maybe people interested in neurology and psychiatry are working together. But we don't always have experts in all of those things in one university. And so it's very very common that let's say we were looking at um data from patients with a certain condition like Alzheimer's. It could be that the brain scans that are collected some of them might be collected in Bangalore here here in India. Some of them might be collected in Europe, others in the US, Australia and overseas. Now there's two or three reasons why this is good. So one of them is a simple reason. It's just faster. So if if if if people are all collecting data in parallel, the critical mass of data needed to answer a question, it might not be that you need thousands of data points, but for questions where you need thousands of data points is more efficient. The second one is is expertise. So as we said, nobody has a monopoly on good ideas. And very often um and this has no correlation with seniority or anything like this. Very often there might be a junior trainee who has a very good idea and they might say well I don't really believe that or I don't think so having a culture where people feel open to be critical there.

[00:31:55]There's an acceptance that people from any different uh you know area of expertise can can comment and even new people who know nothing about these fields can join in easily. that environment for dialogue and new ideas is it's very energizing and you know people who are lucky to go to a conference or who went to Monatava and they hear about um public health developments it starts a thought process in their own mind you know how could they contribute or how could they apply what they've learned to a problem in their own life or to help uh other people and so very often science is not a solitary activity it's a flow of ideas among large groups of people. And I I think we've sort of spoken of two different things. The the collection of data which is good to do internationally and then the fact that the expertise is also international. But there's one last thing which is a little bit different and that is if medical tests are developed in certain parts of the world, it's very important to know if those medical tests would work in other parts of the world. And in genetics, it's very interesting. There's certain genes that in Europeans they put you at very high risk of Alzheimer's disease. In certain parts of the world like Japan or China, the same genes increase the risk by a tremendous amount. And then in people of an African ancestry, those same genes might have lesser effect, but there might be other genes that are important. So I think the international medical community is well aware of this. And there's a lot of interest in trying to understand not just does a drug work once, but are there other contexts where it either works better or worse or if we're not aware of a side effect, there can be a group that's brought in to do that. That was sort of a long answer to the your very >> thing I wanted to ask was the ethics and regulatory guidelines. Do you think >> they stop you from you know pursuing your international collaborations or are they >> Well, they maybe two two points here. So, e ethics is very important in medical research in general is particularly important in AI, but in medical research in general, um maybe not everyone knows this. So, if you're in a research study, they might take a blood sample or with your consent, they might take a brain scan and other people who are qualified to discover things in that data um are allowed to look at it. Now, you could say, well, I I don't want my brain scan used for things I don't approve of. Can I make sure? And, you know, I've worked on this for a long time now. I I I can pretty much guarantee that if you are in a research study, the researchers will respect um you know, the things you want your brain scan used for. And we every day in our email we we sometimes get an an email that says these participants have withdrawn their data from from the study and this is very healthy. You know someone can change their mind they might not want to be in it. So there is an ethical um oversight of all medical research all over the world where um scientists with an interest in fairness, ethics, the people get to um uh and there's a flip side to this. So the fact that people do participate in research is tremendously informative. I mean without um people contributing their blood samples, maybe other medical samples, there isn't enough information to to to test this. So this is a it's almost like an ethical agreement. Now AI has slightly different concerns and I I'll articulate a couple of of the concerns that are specific to AI. So, let's say you and I say, "Well, it sounds like a good idea to train an AI program to detect any number of diseases. Can we use the brain scans that were collected uh in the local hospital?"

[00:36:04]Now, one person might say, "Well, that that's a tremendously good idea." But an ethical person would say, well, no, you you when those people went to the hospital, there was no mention that this was going to be used for research. So, I mean, just to reassure people that this isn't isn't done. If someone wants to get medical data to train an AI system, it's actually fairly difficult. And that's good news. I'm happy I'm happy that the data that other people have contributed isn't going into an AI. But there's a very regulated process that would allow someone who is interested in this to make their medical record data available. And that might be their brain MRI scan, which is something that we analyze. It might be their health records that might contain um you know information on their medical history and treatment. And there are AI systems that with people's consent read medical records and they notice patterns. They they notice that maybe people that took this drug surprisingly recovered from some condition that the drug wasn't intended to treat. And there are many many examples. There are examples where a drug that was designed for cardiovascular health, heart health, ended up being helpful for dementia. And people were not taking this drug. it was a drug to lower blood pressure. But then by an AI system looking at medical records, it it it it's something called drug repositioning. It would notice that a drug just by looking at all of the aggregated evidence was beneficial for vascular disease, dementia, maybe uh even obesity, weight uh issues. And that's a tremendously exciting area, but I think it's one where if there are ethical safeguards, all of the people that are contributing either as scientists or as patients or or or even as legal people, legal people are very important to this. They make sure that um you know the data security um is appropriate to the uh confidential nature of these studies. Um and I I agree with you whenever there's a new technology AI is one of them. One of them was the internet. I mean internet I guess was invented 40 50 years ago that you know engendered some concerns. I mean, are medical records going to be available on the internet? And when that concern was raised, all hospitals uh introduced something known as a firewall where whatever the internet is used in the hospital is not connected to everybody else. I mean, there's a security system for it. So, the these are interesting times.

[00:38:50]>> It is. Yeah.