The Possibility of a Pill to Repair the Brain: It's Not Magic Powder. The Key to the "Brain-Healing Pill" is "Pairing"

The headline from The New York Times (NYT) on September 4 was, "A Pill to Heal the Brain Could Revolutionize Neuroscience." This article provides an overview of the forefront of research aimed at enhancing recovery through "oral treatment" for neurodegenerative diseases, stroke, and traumatic brain injury (TBI). In other words, it challenges the medical student axiom that "the brain does not regenerate." The article was also featured in UCLA's news roundup, highlighting the discovery that the brain can sprout axons in remote areas after injury (sprouting). UCLA

What's "new": The idea of reopening the "window" of plasticity with drugs

The key concept is neuroplasticity. After an injury, the brain often opens a window of plasticity, which, when combined with learning and training, accelerates functional recovery—efforts are underway to intentionally reopen this window with molecular targeted drugs. The UCLA team focused on the role of parvalbumin-interneurons responsible for gamma oscillations and reported that a compound called DDL-920 enhanced motor recovery in a mouse stroke model. Pharmacological priming as an "accelerator" for regenerative medicine and rehabilitation is beginning to appear on the list of candidates for clinical application. UCLA BSCRCUCLA Health

Clinical trials for TBI: A strategy of multi-arm platforms using already approved drugs

In the field of traumatic brain injury (TBI), a multi-arm, multi-stage (MAMS) adaptive platform trial is underway, designed to compare the repurposing of already approved drugs such as statins, ARBs, and tetracyclines in parallel. The UCSF program is at the stage of verifying whether drugs like atorvastatin, candesartan, and minocycline can improve outcomes through anti-inflammatory, vascular protective, and microglial modulation, while setting up a clinical system to quickly identify "effective candidates." San Francisco Chronicleclinicaltrials.ucsf.edu

Existing evidence base: Amantadine and the "speed of recovery"

There has long been evidence that amantadine can enhance the speed of recovery of higher functions such as thinking and attention in TBI. While not a panacea, it has a wide safety margin, and the possibility that early administration can help "kickstart" functional recovery has been reproduced. The evaluation of new compounds and repurposed drugs builds upon such existing knowledge. Brain Injury Association of America

An "alternative route" with psychedelics: Reports on ibogaine research

Meanwhile, psychedelics such as ibogaine have the potential to promote synapse formation and network rewiring, with reported symptom improvements in veterans with TBI and PTSD. Although not yet sufficiently tested in randomized controlled trials (RCTs), the unique profile of "long-term effects with few doses" holds appeal as a "plasticity modulator." Stanford MedicinearXiv

"Magic powder" does not exist: Drugs must be paired with rehabilitation

As emphasized in the NYT article, drugs alone do not create the ability to "do" actions. Simply enhancing plasticity does not determine "which circuits to strengthen," so it is only when paired with rehabilitation tasks and learning tasks that the effects are maximized. This is the design philosophy of "drugs × training" common to motor learning, language training, and cognitive rehabilitation, and can be considered the implementation theory that most influences the clinical field. UCLA

Reactions on social media: Expectations, caution, and a practical perspective—A three-way battle

The NYT headline quickly spread on social media. **Voices of "revolutionary" expectations, caution to curb hype and focus on RCTs, and a practical perspective of "pairing with rehabilitation for realistic solutions"** are in a three-way standoff.