Dr. Mark D'Esposito

Well, if you give acetylcholine and it kind of boosts memory, well, that can indirectly help your executive function.

Or if you give a drug that improves your focus, then that can indirectly help, you know, working memory.

So...

What I'm really pushing for is not just a single, you know, it's going to be one drug.

It's going to be a cocktail.

And we have to not only figure out what the cocktail is, but also figure out who we're giving it to.

What's...

you know, link it to the person's own makeup of their own neurochemistry.

When we get to a point where we'll know, we can map out sort of everyone's dopamine, norepinephrine, serotonin levels, and then we'll make real progress in helping them.

Because right now, I sort of say with my students, what we're doing is just like cutting open the skull and just sort of pouring it onto the brain.

We're not actually doing it, but it seems that way.

The precision is not there yet.

No, and it's even more complicated than it seems because the dopaminergic system is complicated because it's not only just the prefrontal cortex, as we talked about, it's also the basal ganglia.

And so not only do we have to measure dopamine just generally levels, we have to measure the balance of the dopamine in the striatum and the...

and the prefrontal cortex.

There's a model of dopamine function and its relation to executive function that has to do with sort of the balance between these two systems.

That dopamine in the prefrontal cortex is promoting sort of stability, it's keeping information in mind, it's keeping these representations stable.

Whereas the dopamine in the basal ganglia, what it's doing is allowing you to update and refresh the information that you're holding in mind, this sort of stability versus flexibility.

So if you have too much dopamine in the frontal cortex, it can lead to a very rigid state where you don't let anything in.

And if you have too much dopamine in the striatum and you get too flexible, then you can get very distractible.