Texas Needs a State Brain Research Institute
Learn more about efforts to establish a Texas brain research institute here.
Brain diseases can cause tremendous pain and suffering for individuals of all ages and their families. The impacts are wide-ranging: Many young parents have lost infants or discovered their child has a debilitating, lifelong brain disorder such as autism, cerebral palsy, or blindness. Countless military veterans have struggled, and continue to struggle, with thoughts of suicide. Professionals in the prime of their life have been struck down by degenerative brain diseases like multiple sclerosis or Lou Gehrig’s disease. Cumulatively, cases like these greatly impact our communities and economy.
We have the opportunity, however, to take advantage of world-leading research to reduce such cases of brain disorders in Texas. For example, what if aging Texans could regain decades of their neural health? What if emerging adults could reduce depression and stress before they became clinically debilitating, or if students living in poverty could be better equipped to close the academic achievement gap and even accelerate their education? With access to better brain health services, veterans, service members, and first responders could build stronger, faster, and more agile neural networks to calmly meet the constantly changing demands of their work. People struggling with Alzheimer’s disease could increase their well-being to find life still worth living. Babies with autism could be diagnosed within their first year, dramatically improving their life trajectory.
Aims like these demand major, focused research commitments. Recent discoveries in neuroscience have radically revised our understanding of the brain’s lifelong ability to change, adapt, and improve its functioning. Now, we should direct concerted resources toward preventive, predictive, and restorative brain research in order to identify strategies, tools, and treatments for improving brain health and wellness among Texans.
This policy brief is a clarion call for a state-funded institute to research, increase our understanding of, and develop novel treatments for enhanced brain health to build a more vibrant Texas. Such an institute could be modeled after the Cancer Prevention and Research Institute of Texas (CPRIT), which has created a critical infrastructure for cancer research and prevention in the state and generated numerous economic benefits for the state and local governments. To date, CPRIT has returned 2 1/2 to 4 times the amount of funds invested.
The goal of a state brain research institute would be to combat debilitating conditions such as autism, Alzheimer’s disease, and ALS — and help all Texans become the architects of their own brains and improve their ability to flourish at any age.
What Is Brain Health?
Brain health is defined by the World Health Organization as the promotion of optimal brain development, cognitive health, and well-being across the life course. It has profound implications for every person across all stages of life; optimizing it can push out the age of disease onset or lessen the disability caused by a brain disease or injury.
The brain drives all that we do, think, create, overcome, solve, and feel. A healthy brain is essential for developing good habits, elevating well-being, enhancing social connection, increasing years of productivity, and expanding creativity — all of which help us to deal with life’s challenges. The brain is our most vital organ, yet most of us do not give our brain a second thought unless it is injured, diseased, or declining. Even for those of us who are otherwise healthy adults, our bodies outlive our brains by 20-plus years.
Improving the health of the human brain has recently become a pivotal goal on the road toward enhancing population health more broadly. But in order for us to achieve breakthroughs in brain health as we have in heart health, for example, the field needs urgent attention from legislators.
The Pandemic Spotlighted a Growing Brain Health Crisis
In 2021, Texas lawmakers filed legislation that would authorize a state brain research institute. House Bill 15 and House Joint Resolution 5 earned a successful House vote, pending a change to the constitution allowing the issuing of bonds. While this approach garnered some support, the legislation ultimately stalled in the Senate.
Meanwhile, there remains a critical need to invest in brain research. The COVID-19 pandemic highlighted a brain health crisis that has been developing for decades, as manifested by increasing mental health challenges, sleep disorders, anxiety, social divisiveness, and brain fog. An estimated 22%-32% of patients who have recovered from COVID-19 experience brain fog and cognitive challenges as part of their experience of long COVID. Other research suggests that one-third of COVID-19 sufferers will experience an episode of a new or existing psychiatric problem (often depression or anxiety) in the year following infection.
It is not just people with severe COVID-19 whose brain health may affected by the virus; studies have found that people across the spectrum of COVID-19 infection, whether hospitalized or not, have experienced challenges with attention, memory, and executive functioning. From a clinical perspective, we know that several factors can lead to post-COVID-19 cognitive problems and mental disorders, including preexisting illnesses, damage from the virus itself, neuroinflammation, and vascular damage. However, further research is needed to understand the mechanisms by which the virus impacts the brain, as well as the extent of its implications for brain health.
Impacts of Brain Health Challenges
COVID-19 is also just one of the latest challenges for an ongoing, multifaceted brain and mental health crisis. Deaths from Alzheimer’s disease were exacerbated by the pandemic, increasing 145% in 2020. By 2050, the health care costs for Alzheimer’s patients alone are expected to reach $750 billion per year. Pandemic-related disruptions in the education system have left millions of children falling behind, negatively affecting their mental health and development. (Prior to the pandemic, U.S. students were already lagging behind their peers in other countries; in 2018, the U.S. ranked 32nd in math literacy and 10th in science literacy among the 35 member countries of the Organization for Economic Cooperation and Development.) Moreover, since 9/11, over 7,000 service members have died in military action, yet over 30,000 active-duty service members and veterans have died by suicide. This suggests that U.S. military members are 4 times more likely to die from suicide than in combat.
In the aftermath of the COVID-19 lockdowns and the labor shortages that ensued, the importance of a brain-healthy workforce that can adjust to change also became more apparent. Our businesses and workplaces have become increasingly knowledge-intensive, and workers face pressure to be creative, curious, adaptable, and motivated enough to keep up with changes in technology, globalization, and emerging work styles. Peak brain performance is also intricately linked to enhanced productivity and economic growth. Globally, an estimated $2.5 trillion is lost each year due to poor brain performance. In a 2020 report, the World Economic Forum ranked “analytical thinking and innovation” and “active learning and learning strategies” — skills which had not appeared on its previous lists — as its top two skills for 2025, while “resilience, stress tolerance, and flexibility,” another skill cluster that did not make the previous list, debuted at No. 5. All of these “soft skills” are quantifiable and rely on good cognitive performance.
By catalyzing a groundswell of innovation, ranging from precision diagnostics and treatments to future-proofed economic policies and innovative investment models that put brain health at the forefront, a newly created Texas brain research institute could both ease the ongoing brain health crisis and boost the state’s economy. With its many resources — including a highly skilled and diverse workforce, easy access to global markets, reasonable regulatory environment, and large and generous philanthropy and investment sector — Texas is uniquely positioned to lead the way for the country and the world.
The following tables outline existing large-scale health funding efforts at the state, national, and global levels that could inform the creation of a state-funded brain research institute in Texas.
Table 1 — Overview of Mental Health Projects Funded by the Texas State Legislature
Darrell K Royal-Texas Alzheimer's Initiative
Since initially funding it with $2 million in 2006, the Texas Legislature has provided over $64 million to the Darrell K Royal-Texas Alzheimer’s Initiative and its grantees. Early appropriations were used to organize a steering committee, establish specific aims, recruit participants, collect and manage data, and launch research on the impact of Alzheimer’s disease on Texas’ Hispanic population. Under the oversight of a national panel of scientists, the organization currently awards direct research funding on a competitive basis to Texas medical schools to support meritorious plans for Alzheimer’s research.
Lone Star Stroke (LSS) Research Consortium
The Lone Star Stroke Research Consortium is a collaboration among leading medical research institutions in Texas to improve the health of Texans affected by stroke and cerebrovascular disease. Its mission is to establish a state-wide network for patient-centered stroke research and therapeutic trials. By linking academic health institutions with proven expertise in stroke research to community stroke centers, LSS works to find better therapies and disease prevention strategies to improve Texans’ cerebrovascular health.
LSS was established through a $4.5 million appropriation by the 83rd Texas Legislature in fiscal year 2015. Its funding and contracts are administered by The University of Texas System. With a robust, geographically diverse network of sites, the consortium has the capability and infrastructure to implement studies quickly throughout the state, making game-changing breakthroughs possible for people who have had or are at risk of developing a stroke.
Texas Child Mental Health Care Consortium
The Texas Child Mental Health Care Consortium was signed into law in mid-2019 to address mental health challenges among Texas children. Comprising the state’s 12 publicly funded medical schools, it has received $118.5 million in state funds to provide universal access to child psychiatry consultation in primary care, urgent access to psychiatric telehealth care and referrals in Texas schools, and expanded workforce training, particularly for the public psychiatry workforce.
The consortium was launched in May 2020, and in less than a year it had engaged 5,000 pediatric primary care providers in its child psychiatry access network and reached nearly 1.7 million Texas students through its telemedicine program. Of the students reached, 12.5% were Black and 34% were Latino — numbers proportionate to the broader child population of Texas.
The Texas Legislature recently designated $113 million in American Rescue Act funds to ramp up the consortium’s programs in response to the ongoing mental health crisis among Texan children, taking advantage of the consortium’s ability to scale its infrastructure up or down as needed.
Table 2 — Large-scale National and Global Brain Health Funding Initiatives
California Institute for Regenerative Medicine
The California Institute for Regenerative Medicine was created in 2004 through the passage of Proposition 7 in California, which allocated a $3 billion bond to support stem cell research in the state. The institute’s primary mission is to accelerate stem cell treatments to help patients with unmet medical needs. Its funds also create tax income for the state. In 2020, California voters passed Proposition 14, which dedicates $1.5 billion for the support of research and the development of treatments for diseases and conditions of the central nervous system, such as Alzheimer’s disease and Parkinson’s disease.
A 2019 economic impact report conducted independently by the University of Southern California’s Schaeffer Center for Health Policy and Economics found that CIRM has had a major impact on the state’s economy, creating tens of thousands of new jobs, generating hundreds of millions of dollars in new taxes, and producing billions of dollars in additional revenue. The report looked at the impacts of CIRM funding on both the state and national economies from the agency’s establishment in 2004 to the end of 2018.
The report found the following estimated impacts:
Furthermore, an additional 2019 report by the Schaeffer Center noted that developing stem cell treatments and cures for some of the most common and deadly diseases could produce multibillion-dollar benefits for California in reduced health care costs, improved quality of life, and increased life expectancy.
Davos Alzheimer's Collaborative
Initiated in Davos, Switzerland, during the World Economic Forum’s 2020 Annual Meeting, the Davos Alzheimer’s Collaborative is a public-private partnership committed to aligning stakeholders with a new vision for the global response to the challenges Alzheimer’s presents to patients, caregivers, and health care infrastructures. Led by the WEF and the Global CEO Initiative on Alzheimer’s Disease, and fueled by a mission of service to the 150 million families and half-billion people whom will be inevitably impacted by the disease by 2050, DAC is a collaborative for the benefit of all people, in all places. It is developing a cohort of 1 million people to provide a comprehensive data resource that is racially and ethnically inclusive and truly global in scope to promote scientific discovery. The program will aggregate current research data and support new data collection from teams of researchers across the globe.
DAC and CIRM recently announced their interest in working together on a shared mission to accelerate the discovery, assessment, and delivery of precise and effective therapeutic interventions for diseases of the brain, including Alzheimer’s disease.
Healthy Brains Global Initiative
The Healthy Brains Global Initiative is developing $10 billion worth of financing mechanisms to fund the increased delivery of brain science breakthroughs and evidence-based interventions. The nonprofit One Mind and the National Academy of Medicine are leading the HBGI in collaboration with the World Bank, the World Health Organization, and the National Institutes of Health, as well as major investment banks, grant-making organizations, and research institutions. CIRM provides a useful predicate for potential outcomes in the high-income settings where HBGI capital may be deployed; as noted, a 2019 report by the Schaeffer Center found that the institute has had a major impact on California’s economy, creating tens of thousands of new jobs and producing billions of dollars in additional tax revenue for the state — additional benefits alongside CIRM’s main goal of improving health and well-being.
Our knowledge and understanding of the brain has never been greater, and breathtaking breakthroughs are on the horizon. Advanced brain imaging is helping us improve our understanding of complex neural processes and disease mechanisms. Neuromodulation offers the ability to improve neurologic function by inhibiting or stimulating distinct sets of neurons. Genetic analyses are becoming cheaper and increasingly driving an era of personalized medicine. Gene editing has arrived. Deep brain stimulation and brain-computer interfaces constitute a new frontier of brain engineering. Collectively, these innovations offer new opportunities to understand and tackle some of the most pressing brain challenges using holistic and durable approaches to the prevention, diagnosis, and treatment of neurologic conditions. There is hope — but we must step up to the plate, invest, lead, and work together.
Today, there is a renewed interest in a comprehensive, cutting-edge, Texas-led approach to integrating brain discoveries, brain metrics, and applied brain science to solve the myriad challenges facing our state. If we are to better understand the science of early learning, combat the mental health crisis, and boost workforce readiness by emphasizing peak brain performance, the time to focus our collective energies and funding on the brain is now.
The potential rewards and sources of economic growth that would stem from a state-funded brain research institute — including increased sales, local, state, and federal tax revenues — are significant. Brain health-focused life sciences companies would be drawn to the state, adding new infrastructure and creating high-quality, well-paying jobs. Cost savings would be realized in the form of reduced health care expenses.
The competition to lead the field of brain health is mounting, with major efforts underway in the U.S. as well as in Europe. But Texas leads the country and much of the world in creating economic growth that fuels quality of life. This is an opportunity to be on the forefront that we cannot afford to lose.
The author would like to acknowledge the following individuals for their review of this paper: Sandra Bond Chapman, Ruth Fitzgibbons, Debbie Hanna, Rita Hortenstine and Andy Keller.
This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s), and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.