“I really love maps. I’m not good at art, but as a kid, I would draw medieval maps and those kinds of things.” Now an adult, Nico U. Dosenbach, MD, PhD, still draws maps, but of the human brain.
Dosenbach is a professor of neurology at Washington University School of Medicine in St. Louis, in the Section of Neonatal Neurology, with additional appointments in radiology, pediatrics, biomedical engineering, psychological & brain sciences and occupational therapy. He was elected to the American Society for Clinical Investigation in 2023. “[Dosenbach] has made groundbreaking contributions in the fields of advanced functional neuroimaging and mapping of the brain’s global networks, combining technical innovation with cutting-edge brain network science to drive transformative advancement,” said Jin-Moo Lee, MD, PhD, head of the Department of Neurology and the Andrew B. & Gretchen P. Jones Professor of Neurology.”
Born and bred in the small town of Gültlingen (population ~1,000), at the foot of the Black Forest Mountain range in southwest Germany, Dosenbach came to the U.S. to study biochemistry at Columbia University. After completing his undergraduate studies in 2000, Dosenbach earned his MD/PhD at WashU Medicine, followed by a neurology residency at Barnes Jewish Hospital and a pediatric neurology fellowship at St. Louis Children’s Hospital. After being appointed assistant professor in 2015, Dosenbach was promoted to full professor 2024. Dosenbach is a bit of a celebrity, as far as academic scientists go. In addition to a host of invited lectures for professional organizations like the American Academy of Neurology, the Organization for Human Brain Mapping, and the DBS Think Tank, and interviews with numerous neuroscience podcasts, Dosenbach’s work is frequently featured in popular media outlets, most recently when The New York Times article on a study about psilocybin that he collaborated on went “viral.” Dosenbach is also an inventor, holding several Small Business Innovation Research (SBIR) grants and four patents, and serving as co-founder and director of Turing Medical Inc.
But more than anything else, Dosenbach is a collaborator. In his capacity as PI of his own lab as well an active member of several interdisciplinary efforts on campus, including the Institute of Clinical and Translational Sciences, the Hope Center for Neurological Disorders and the Neuroimaging Labs Research Center, Dosenbach finds a constant source of inspiration in talking and working with others, including those in different fields. “You have to sharpen your ideas,” said Dosenbach. “They’re not that good until somebody has challenged them. So, I think I’m very fortunate that WashU has a really good culture. And it’s super lucky, I think, for me and the folks I’m working with. It’s like we found each other.”
Luck has played a big role in Dosenbach’s career, from the WashU Medicine admissions coordinator who rebooked his flight for his medical school interview after he missed his first two flights, to the teachers who indulged him in his childhood.
“I think I realized that the most powerful weapon, even in elementary school, was knowing stuff about science,” said Dosenbach. “If I think about it, I must have been probably the most annoying child on the planet. But I got lucky, because apparently there’s a whole job description where that’s the whole point, called science. I feel like that’s how science is. It’s like you’re here and there’s the counter side and you’re trying to prove each other wrong and win, and as a cumulative exercise, you get closer to the truth.”
Dosenbach is in search of not just any truth, but the truth about the brain, which just so happens to have the potential to revolutionize the field of neurology. “The brain is the most complex thing in the universe,” he said. “Everybody’s got a brain. I think what people do with their brains or what people’s brains make them do is one of the most powerful forces on the planet because of collective human behavior.”
A pediatric neurologist by training, Dosenbach finds children’s brains particularly fascinating because of the astounding plasticity and resilience they show after strokes or traumatic brain injuries early in life. But the bulk of his more recent work is focused on refining functional brain mapping technologies to develop new and improved brain therapies.
Dosenbach’s work in large-scale brain mapping is in many ways a continuation of the work started by Marcus E. Raichle, MD, the Alan A. and Edith L. Wolff Distinguished Professor of Medicine at WashU Medicine and professor of radiology, of neurology, of neurobiology and of biomedical engineering. Raichle played a significant role in advancing not only the field’s understanding of the default mode network, but also the young Dosenbach’s passion for functional mapping of brain networks. Much of what Dosenbach does, from his earlier work on the cerebellum to identifying the somato-cognitive action network and revising the field’s understanding of the brainstem’s red nucleus, is built on the foundation of improving the signal-to-noise ratio in functional brain mapping technologies such as fMRI to create accurate maps of individuals’ brains, or “individuomes” as Dosenbach calls them.
In alignment with the mission of the Human Connectome Project (HCP), which is devoted to “mapping the human brain, aiming to connect its structure to function and behavior,” Dosenbach and other scientists are pioneering the field of precision mapping, ultimately with the goal of creating highly personalized treatment plans using neuromodulation techniques that target specific regions of an individual’s brain.
“It’s kind of silly in the sense that you don’t treat groups of people,” Dosenbach said. “You don’t show up in groups of 50 at the neurologist’s office and all get the medicine for your average problem. But that’s how we used to do imaging research because we had to, because the signal-to-noise ratio was bad. The methods weren’t as good. So now that we can do better functional imaging, we can make personalized maps. Every brain is unique.”
Precision medicine has increasingly been at the forefront of medical research and practice in recent years. While it is more frequently associated with cancer and rare diseases, Dosenbach sees precision medicine as the future of neurology: “If two people are limping and for one, it’s because they have a broken bone, for another one, it’s because their muscles are sore because they worked out too hard yesterday. If you see them, they are both limping. But it matters why. One is just like, well, don’t work out so hard tomorrow, and the other one is, like, you need your bone fixed and you need a cast. And the brain of course is that to the 10th degree because it’s much more complicated and we know much less about how it works, how it breaks and how it puts itself back together. It’s an exciting time for neurology, for sure, and for neuroscience.”
Dosenbach’s innovative work has already started impacting individuals who have not been able to find successful treatment otherwise. Patients suffering from conditions such as chronic pain or depression have experienced temporary but significant relief from the symptoms that had been plaguing them — for decades in some cases.
“We have one patient who had otherwise treatment-resistant depression for 30 years, multiple suicide attempts, disability, repeated hospitalization,” shares Dosenbach. “He tried all the medicines there are for depression and then had electroconvulsive therapy, which eventually gives you cognitive problems, so you have to stop.”
Using the mapping techniques developed by Dosenbach’s lab, surgeons at the University of Minnesota placed electrodes on the surface of the patient’s brain, with immediate effects on the patient’s mood that have helped him regain his sense of normalcy.
It’s still “early days,” Dosenbach demurred. “You need to do big samples and prove all your stats and stuff. But I felt warm and fuzzy on the inside when I heard that these people were super happy. Our research helped someone.”
The quest to help patients by developing more effective neuromodulatory treatments is something Dosenbach takes very seriously. And he is relentless in pursuing this quest, in terms of both research and clinical translation. What was just a glimmer in Dosenbach’s eye back in 2017 when his lab published the article “Precision functional mapping of individual human brains” in Neuron is now closer to reality. The new Allied Labs for Imaging Guided Neurotherapies (ALIGN) Center at WashU Medicine, led by Dosenbach, will focus on the use of personalized neuroimaging to identify targets for intervention in treating a variety of neuropsychological diseases. But this is just the beginning.
“I think right now there’s hopefully a golden age coming,” Dosenbach said, “which is that the imaging technology has gotten a lot better, the computational abilities you need to sort of process all this data and turn it into usable information has gotten much better. Then you’ve also got both non-invasive and invasive hardware like electrodes or stimulators or TMS or focused ultrasound that has also gotten better in parallel. And now you can try to bring them all together and take a patient, map out the functional circuits of their brain and then treat their brain very specifically.” And the possibilities this opens up? “I think it’s going to be near endless, as far as I can think into the future.”
