IPathway specific mechanisms of anesthesia in the cortex

Prior to receiving an IARS Mentored Research Award in 2013 while a visiting scientist at Matt Banks’ Lab at University of Wisconsin in Madison, Aeyal Raz, MD, PhD, was considering giving up on his research path in anesthesiology. The IMRA recognition significantly altered his path and launched him on an extremely successful journey as a researcher, ultimately landing him today as the Chair of the Anesthesia Department at the Rambam Medical Center in Israel and with his own lab. That initial award, and his first grant, for his research project on “Pathway Specific Mechanism of Anesthesia in the Cortex” allowed him to investigate a topic that had fascinated him since training, the effects of anesthesia on feed forward and feedback pathways in the brain. Through this study, Dr. Raz was able to demonstrate that anesthetics differentially affect different thalamocortical pathways. He did not stop at this initial conclusion but continues to investigate the fundamental mechanisms of anesthesia and consciousness. Below he discusses his research path, his career trajectory and his hopes for a multidisciplinary approach to studying neuroscience and the fundamental mechanisms of anesthesia and consciousness.

1. What is your current position? How long have you been in this position? What was your role when you were first funded by IARS?

When I was first funded, I was a young lecturer (the Israeli tenure system has 4 levels, this is the most junior one). I was a visiting scientist at Matt Banks’s lab in the University of Wisconsin in Madison. Currently, I’m a senior lecturer (I expect to be promoted soon). I’m the Chair of the Anesthesia Department of Rambam Medical Center (since 2020) as well as the Chair of the Department of Anesthesiology and Intensive Care at the Technion’s Rappaport School of Medicine (since 2022).

2. What drew you to anesthesiology and to your particular area of research? Has your research subject area evolved since the award?

After completing my PhD thesis in neuroscience, I decided to go for a residency in Anesthesiology. I enjoy the combination of clinical physiology and pharmacology. The rapid decision making and management of critical situations appealed to me and seemed to be a field that I can excel in.

In my opinion, the most exciting field of research and the holy grail of neuroscience research is how the brain creates and supports the experience we call consciousness. Anesthesiology gives us a great tool to switch this phenomenon on and off in a controlled manner, and thus to study it effectively.

We have made a lot of progress during the last decade. A number of theories were developed, and our studies are able to support some theories and negate others.

3. What was the goal of your initial research project? Was it met?

We set up to study the effects of anesthesia on feed forward and feedback pathways in the brain. We were able to demonstrate that anesthetics differentially affect different thalamocortical pathways. As often occurs in research, we completed much of the original goals, but as time passed and information was gathered, our research diverged in different directions and it is still ongoing.

4. How did your findings impact patient care?

My research deals with the fundamental mechanisms of anesthesia and consciousness. It has a great scientific interest and importance to our clinical understanding. However, it will be a long time before such research has a clinical impact (if at all).

5. How did your findings impact the field of anesthesiology?

We are starting to understand the effects of anesthesia on the brain’s network. This is critical to identify situations such as awareness without recall, and to identify loss and recovery of consciousness.

6. How did the award affect your research/professional trajectory?

The IMRA had a major impact on my career trajectory. This was my first significant grant, which was a significant breakthrough in my career. Once I had my own research funds, I was able to continue my research, and get a tenure-track position in Madison. Later, based on this, I was able to get a dual clinical-research position at Rambam. I am currently the Chair of my department, and my lab is active and supported by competitive grants. Much of this is related to the early success of receiving the IMRA award.

7. How do you feel about having received the IARS Mentored Research Award?

Receiving the IMRA was a pivotal point in my career. At that time, it was very difficult for me to keep up doing research, and I was on the verge of giving up and going back to Israel as a clinician, giving up my research ideas. Once I got the grant, I was able to continue my research and bring it to the next level. Later, after going back to Israel, the fact that I already had a history of obtaining a significant grant, and publishing in high-quality journals, allowed me to get a position with protected research time and my own lab. This allowed me to arrive at where I stand today.

8. What would you like to convey to our donors, the people who made this award possible?

First, I would like to thank the donors for the opportunity, and their support. I would like to convey the notion that this is indeed a major contribution and may be a career-changing event for early-career physicians who try to combine research and clinical work. I can honestly say that without this award my career would have been very different (and most likely I would not have been a clinician-scientist).

9. What is something that someone would be surprised to learn about you?

I enjoy wildlife photography as a hobby, and I am a diving physician as well as an anesthesiologist (I am currently on a liveaboard diving safari in Sinai Peninsula).

10. What is your vision for the future of anesthesia research?

Anesthesiology should become one of the clinical fields of neuroscience. Currently, neuroscientists are considering neurology, neurosurgery and psychiatry as their clinical fields. I believe that anesthesiology should join the clinical fields of neuroscience. This will bring research funding, leading scientists, and research interest to our field.