Dr. Mark D'Esposito

So probably half the population.

Now this is going to vary.

depend on where you live and where you come from and things, but maybe half the population either has an underactive enzyme or overactive enzyme.

If you have an underactive enzyme then actually more dopamine sits around and you actually have more dopamine than others and if you have an overactive enzyme it's the opposite.

So we've actually shown that if you now

go and genotype people with a simple saliva test and figure out do they have this genetic what we call polymorphism where just one amino acid gets changed and the enzyme becomes either active or underactive.

We can do the same thing as grouping them by their capacity.

Those that have the low dopamine we will make them better and those who have sort of baseline high dopamine will make them worse.

Yeah, I mean, one of the most disappointing things to me in my career has been that pharmaceutical companies have not picked up on this idea that we could improve cognition and very specifically improve counterprocess with very specific neuromodulators.

The discovery that depletion of dopamine and not other transmitters impairs working memory was made in 1979.

When I heard Pat Goldberg talk about this as a resident, I was just amazed that there could be a single transmitter can change a single behavior.

I was seeing very complicated behavioral deficits, and it just seemed impossible to me that there could be such a tight link between a single device.

you know, a single neuromodulator, a single cognitive process, and just opened the door for me that this really could be an incredibly beneficial therapy for anyone with executive function or frontal lobe function.

But unfortunately, there's never been a pharmaceutical company that's tried to develop a drug for improving cognition to this day.

I'm not sure.

I mean, when I realized that I could test these drugs in healthy individuals, that if I gave them in low enough doses, they were safe, and I had so much experience of them in patients that I felt comfortable doing it,

then I started asking pharmaceutical companies, you know, do you want to get involved here?

This should be done, I can't do this by myself, we need to have real trials and real studies of how this will help, you know, and just it was, you know, their eyes would always cross and never got any sort of traction.

It always went back to sort of disease, you know, what disease are you...

curing, you know, what's the market for it?