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Michael Johnston, MD

Profile written by Robert S Rust, MD, MA

Michael Johnston

Michael Johnston received his bachelor’s degree in Liberal Arts and Biology from Franklin and Marshall College and his medical degree from the University of Pittsburgh School of Medicine. Numerous awards for his performance in medial school included the Brinton Prize for highest standing in the graduating class and the Senior Prizes in Medicine, Pediatrics, and Ob/Gyn. Dr. Johnston trained in Pediatrics and Neurology at The Johns Hopkins Hospital. A two-year stint as Major in the Medical Corps (Meritorious Service Medal at Discharge), separated these training experiences. During this interval he received additional training in neurochemistry and worked as a part-time emergency physician in Alexandria.

Two years of NINCDS Fellowship training in pharmacology followed under the direction of Dr. J.T. Coyle. During this time Dr. Johnston published his first basic science paper, in Science, employing a mitotic poison to produce targeted neuronal ablation during early brain development. In this and in an ensuing series of eighteen major papers from the same research group the role that Dr. Johnston played can be inferred from the fact that he was the first author of 10 of 18 papers. Nine of these papers have been cited >29 times, 7 >50 times, 2 >380 times. They characterize the neuroanatomic and neurochemical adaptations that accompany developmental disturbance and revealed highly important information not only about the governance of neocortical development, its connections to deep brain structures, and the function of neocortical noradrenergic, GABAergic, and cholinergic neurotransmitter systems. The approach and the conclusions of these studies were to proven highly influential not only methodologically, but in conceptualization of neurologic disease. The immediate applications to the understanding of vulnerabilities during early brain development due to genetic or environmental causes have proven enormously important in the study of developmental interdependence of brain systems, synaptic plasticity and neurotransmitter physiology.

The methods and resulting discoveries provided a foundation for the study of particular vulnerable stages in development, the manner in which various environmental influences may exploit those vulnerabilities to produce injury. They have provided the foundation for meticulous understanding of the time course and stages of devolutionary processes within the nervous system throughout the course of central nervous system function. This understanding permits opportunities for intervention to slow or arrest the course of injury to be identified and tested. As has often been the case in the history of neuroscience, experimental demonstration that particular patterns of neuroanatomic and neurochemical dysfunction result from particular causes has provided clues to the causes of similar patterns in genetically determined neurologic diseases and those for which the cause is as yet unknown. Such advances provide opportunities for the identification of causes that may be prevented or treatments that may be administered. These papers have played a highly influential role in countless subsequent studies in many laboratories not only concerning forms of neurologic disease, but also of neurogenesis, synaptic plasticity, learning, memory, and perhaps most other forms of central nervous system function.

In 1980, after a year as Chief Resident in Pediatric Neurology at Hopkins, Dr. Johnston joined the clinical faculty at the University of Michigan, Ann Arbor, with additional appointment as Research Scientist in the Center for Human Growth and Development. He was supported by a TIDA (PHS-NINCDS)  and Sidney Farber (UCPRF) Awards He rose in seven years to the rank of Professor of Pediatrics and Neurology. In 1988 he returned to the Johns Hopkins Hospital as Professor of Neurology and Pediatrics. He was also appointed Medical Director and Director of the Neuroscience Laboratory at the Kennedy Krieger Children’s Hospital and Research Institute. His own extensive research was supported by a Javits Neuroscience Investigator Award (NINDS-NIH).

Dr. Johnston’s ensuing contributions to science have more than fulfilled his early promise. Indeed, his career has been one of unceasing productivity. Approximately 80% of the 269 original papers and reviews that Dr. Johnston has published to date are major contributions to basic neuroscience. Of the total, 102 (38%) have been cited more than twenty times, 46(17%) have been cited more than fifty times, while 16 are those rare “citation classics” that have been cited more than 100 times. All of his papers are written with clarity and great insight, clearly setting a line of research on a firm foundation and suggesting promising directions for further work. The pace of work is astonishing, undoubtedly reflecting not only his sense of direction, but also his capacity to recruit and direct trainees. But to this must be added the astonishing capacity he has shown to enfranchise such individuals as colleagues, maintaining relationships over productive span of many years. With his first Career Award advisee at the University of Michigan, Faye Silverstein, he has published more than forty well-known papers and highly cited papers, particularly those related to excitatoxic mechanisms and treatment of hypoxic-ischemic injury of the newborn. However, in keeping with the flexibility and richness of the research approach, others concern heritable neurological conditions such as Lesch-Nyhan, CSF neurotansmitters, methotrexate encephalopathy, striatal and hippocampal injuries, and other subjects.

With his first Michigan Ph.D. candidate, John McDonald, Dr. Johnson has also written more than forty papers, including his most highly cited paper (Brain Res Rev 15:41-70—cited 1059 times) a paper that provides a fine example not only of the clarity and elegance found in all papers from the Johnston group, but also the capacity to synthesize information of great importance and leave the reader inspired to carry on such important work. Other subjects of these papers include the inevitable series of excellent papers on the complexities of neurodevelopment and of HIE and its treatment, but also the mechanisms of non-ketotic hyperglycinemia. There are extraordinarily large number of collaborators in the Johnston papers, exemplifying not only his capacity to attract individuals he can train, but his capacity to work with others, the pertinence of his approach to a great breadth of subjects, and his vision and leadership. It also speaks to his phenomenal internal energy, despite a characteristically calm and deliberate exterior. Wherever he has looked at disease, Dr. Johnston has enlightened us as to what is going on and, if possible, where and when we might be able to treat it. Beyond what has already been mentioned, he has contributed to the basic science of intoxication due to bilirubin, lead, anticancer treatments, dexamethasone, and neuropsychiatric drugs. He has characterized mechanisms of extrapyramidal cerebral palsy, Wernicke encephalopathy, lissencephaly, epilepsies, Alzheimer disease, Rett syndrome, autism, and X-linked mental retardation. He has published fourteen papers on the neurological aspects of cardiothoracic surgery. This list is not exhaustive.

Dr. Johnston is apparently an inexhaustible source for new ideas. In the past few years he has laid out fresh conceptions concerning cognitive function. His recent interest in the possibility of sex-related vulnerability to experimental models of cerebral palsy, apparently overlooked by previous researchers, has quickly blossomed into a new line of research. His quiet compassion for individuals with cerebral palsies and developmental disabilities has been reflected in his concern not only for prevention and treatment, but for rehabilitation— in which he received a secondary appointment at Hopkins in 2006. He has provided thoughtful perspective and leadership concerning the scientific and ethical aspects of cell-based interventions for early brain injury. It is important to note that Dr. Johnston’s work has not only informed understanding of dementias experienced in mid or late life, it has done so as well for psychiatric conditions such as schizophrenia, fueling the growing consensus that such conditions are in no substantial way other than primary neurologic diseases. As early as his seventh paper, Dr. Johnston specifically elucidated the instructive parallels between the functional cortical hyperadrenergia produced by foetal developmental abrogation and those of schizophrenia.

Throughout his career Dr. Johnston has been active in all of the pertinent professional societies and a highly active participant and organizer of their research and educational efforts. He has served as Chair of both the CNS Scientific Selection and Research Committees and as a member of the Legislative Affairs and Strategic Planning Committees and Subcommittee for Neurology of Childhood in the Decade of the Brain. He served as Councillor from the East on the CNS Executive Committee. He was a member of the Scientific Program Committee of the ANA and the Research Task Force of ICNA. His service on NIH Study sections and has included, for the past 17 years, yeoman service as member and Ad Hoc Reviewer for Program Projects for the NIH-NINDS, NICDH, NIA, and NIMH, including membership on the NIH-NINDS Training and Career Investigator Study Section. For the ACGME he served on the Subspecialty Committee for Pediatric Critical Care and Committee on Renewal of Certification (ABP) and Director for Neurology of the ABPN. He was a member and Chair of the Neurology RRC and Chair of the Committees on Maintenance of Certification in Child Neurology and Neurodevelopmental Disabilities. As a person whose leadership is always by example, Dr. Johnston became recertified in Child Neurology in 2003. His certificate in Pediatric Critical Care bears the #0005. In 2007 he became President, American Board of Psychiatry and Neurology. He is a reviewer for seven major journals, and serves on the Editorial Board or as Editor-in Chief for nine.

Dr. Johnston has received the John Stobo Pritchard Award (ICNA) and the Weinstein Goldenson Medical Science Award (UCBREF) the Award for Best Basic Science Poster at the World Congress on Rett Syndrome. More than 180 invited lectures have been given to the broad swath of national and international professional societies for which Dr. Johnston’s work has been pertinent, including numerous named lectureships and visiting professorships throughout North America, and fifteen countries on four other continents. He has served as doctoral advisor for four and postdoctoral/career award advisor for twenty-one individuals whose ensuing careers have magnified his impact. He has provided in addition an extraordinary amount of informal guidance to individuals who have taken advantage of his visiting professorships and other opportunities seeking guidance in the development of their careers in neuroscience and medicine.