Dr. Ray Watts: Orchestrating Brain Research, Supporting the Orchestra

Ray L. Watts, MD, changed careers for complex reasons—literally. The Birmingham native graduated from West End High School and enrolled at UAB to study electrical engineering.

"But then I spent a summer working on a research project with some students from biomedical engineering, and that got me interested in biological systems. They're so much more complex than the linear systems I was studying. So that's what led me to medical school, and to biomedical science."

Likewise, when it came time for Watts to choose a specialty, he gravitated to one of the most complex systems of all: "The classes that most fascinated me were neurosciences," he says. "The more you study the brain, you realize that when somebody says, 'I believe in my heart that I'm right,' it's just not accurate. The heart pumps blood. Your values, your personality, your character—all those things are in your neurological circuits.

"I considered neurosurgery and pediatric neurology, but I decided the best fit for my background was adult neurology, electro-physiology."

So it was no surprise that Watts—who came back home in July, 2010 to accept the UAB position of senior vice president for medicine and dean of the School of Medicine—has spent much of his career, including a research fellowship at the National Institutes of Health, focusing on one of the most complex and mysterious malfunctions of those neurological circuits: Parkinson's disease.

"Parkinson's is the number one movement disorder," Watts says, "and it's very much on the increase, mostly because people are living longer. Now that we can treat heart disease and cancer so much better than before, and with the advent of antibiotics and antivirals for infectious diseases, the incidence of Parkinson's and Alzheimer's both go up as we age.

"The average onset of Parkinson's is about 60, but some 10 percent of patients are diagnosed at an age less than 40, as actor Michael J. Fox's case is obviously a prime example. The good news is that the last decade has seen an explosion of Parkinson's knowledge and research, so that we can treat the disease pretty effectively for 10, 15, sometimes up to 20 years."

The biggest breakthrough in those treatments was the discovery of a drug called L-Dopa, which first received wide notice in the hit movie Awakenings, about the work of New York City neurologist Oliver Sacks. The worst side effect of L-Dopa was severe nausea, but researchers have since discovered a drug named Carbidopa that blocks the nausea-causing enzyme.

Even today, the result is often incredible for new Parkinson's patients, Watts says. The downside is that, as years pass, higher quantities of the drugs are required to achieve the same effect: "Somebody who's been taking the medicine for 15 years might need a dose every two to three hours of their waking day just to keep moving."

Environmental factors such as diet also become complicated, he says: "Something as simple as eating a hamburger at a certain time can overwhelm the L-Dopa because when the proteins from the meat are broken down, they can saturate the amino-acid transmitter. Stress is also a big factor. It can increase tremors and other involuntary movements. That's true even of 'good' stress, like watching an exciting football game. Which means that, as the years go on, it becomes harder and harder to keep the patient functioning on a good, even keel."

As a result, the Holy Grail for researchers is to find a drug that not only treats the symptoms of Parkinson's, but also actually slows or halts the disease's progression. Watts says there are some promising treatments on the horizon.

"The goal for our center is to find the root causes of Parkinson's," he says. "We have some outstanding people at UAB, as well as through our partnership with the Southern Research Institute, who are trying to develop disease-modifying therapies from several different angles. The one that's in the lead right now is known as LRRK 2, for Leucine-rich repeat kinase."

Genetics is also playing a large role, according to Watts. "We're searching for biomarkers, because ideally we'd like to find people who are at risk long before they lose the 70 or 80 percent of their dopaminergic cells that make the symptoms appear, and introduce the therapy early enough to ensure the Parkinson's never shows up.

"The reason it's so important to find modifying and curative treatments is that, today, there are some two million people with Parkinson's and some five million with Alzheimer's. But because we're living so much longer, in several decades that number could be 40 or 50 million, becoming some of the most important diseases affecting mankind."

Watts somehow finds time in his crowded schedule to support the Alabama Symphony Orchestra, and currently he's committee chair of the group "Doctors for ASO." His involvement started when a colleague invited him and his wife to an ASO concert. "We loved it, and I came to be more aware of how important the Symphony is to our community, our state, and to UAB in recruiting the best scientists and physicians," he says.

Watts since has discovered another UAB connection, learning that "Doctors for ASO" was originally founded by former university president Dr. Charles (Scotty) McCallum.

"Many people don't realize what a terrific Symphony we have right here," Watts says, "just as people beyond Birmingham and the South don't realize that UAB has one of the greatest medical centers in the world.

"Doctors for ASO is not just for physicians; there are PhD scientists involved, and it's a broad eclectic group who have come together to support this great cultural asset. I invite people who don't consider themselves classical music buffs—as I certainly don't—to attend a concert and get involved. It's a wonderful experience, and you'll be helping preserve this excellence for our community."