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Slash. wondering. Have

1:00

you heard You can listen to your

1:02

favorite news podcasts ad free? Good.

1:04

News: With Amazon Music, you

1:06

have access to the largest

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catalog of ad free top

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membership. To start listening, download

1:15

the Amazon Music app or

1:18

visit amazon.com/news ad free that's

1:20

amazon.com/news ad free and catch

1:22

up on the latest episodes

1:24

without the ads. What

1:34

is New York City without

1:36

skyline monuments to commerce standing

1:38

proudly shoulder to shoulder war

1:40

office space than anything in

1:42

the world. But. Peek inside.

1:45

All this vertical real state

1:47

pin, There's a fundamental question:

1:49

where is everyone? More than

1:51

ninety five million square feet

1:53

of New York office space

1:56

currently unoccupied? The of thirty

1:58

Empire State buildings. think

2:00

this is an existential moment. You know, I

2:02

call it crossing the chasm. What's the chasm

2:04

specifically? This post COVID world of

2:06

higher interest rates, the changing nature of how

2:08

people work and live. We're not going

2:10

back to where we were. It's a different world and

2:12

it's going to be turbulent. Most

2:17

American families know someone who's

2:19

been afflicted with Alzheimer's disease

2:21

or the scourge of addiction.

2:24

Tonight, we will show you research that

2:26

is being done on both and

2:29

introduce you to the pioneering

2:31

neuroscientists who allowed us to follow

2:33

his startling progress. Okay,

2:35

ready, we can start again now. There we

2:37

go. There's always risk, but

2:40

you cannot advance and

2:42

make discoveries without risk. But we need

2:44

to push forward and take the risk

2:46

because people with addiction

2:49

and Alzheimer's is not going away. It's

2:52

here. So why wait 10-20 years?

2:55

Do it now. I'm

2:58

Leslie Stahl. I'm Bill Whitaker.

3:01

I'm Sharon Alfonsi. I'm John Wirthime.

3:03

I'm Cecilia Vega. I'm Nora

3:05

O'Donnell. I'm Scott Pelly. Those

3:08

stories and more tonight on 60 Minutes.

3:16

I'm CBS News correspondent Major Garrett, host

3:19

of the podcast Agent of Betrayal, the

3:21

double life of Robert Hanson. During the

3:23

Cold War FBI agent Robert Hanson traded

3:25

classified secrets to the Kremlin in exchange

3:28

for cash and jewels. In the podcast,

3:30

you'll hear from Hanson's closest friends, family

3:32

members, victims and colleagues for the most

3:34

comprehensive telling of who Robert Hanson really

3:37

was. Binge the entire series now, Agent

3:39

of Betrayal, the double life of Robert

3:41

Hanson is available on the Wondery app,

3:43

Amazon Music or wherever you get your

3:46

podcasts. Don't

3:48

miss true crime anytime you want,

3:50

anywhere you go. With a 48

3:53

hours podcast, real crimes like a

3:56

John Grisham novel come to life

3:58

real lives. He

4:00

played a gun to me and said, this is the day you

4:02

die. And he shot me

4:04

and I know justice. There's

4:06

some questions that have to be asked. It's a

4:08

neat answer. I'm an innocent man and I

4:11

hope the whole world can say that. Catch the

4:13

latest episodes of 48 Hours, wherever

4:15

you get your podcasts. Looking

4:18

for signs the U.S. economy can continue to

4:20

stave off a recession? Avert

4:22

your gaze from commercial real estate. City

4:25

office buildings are in trouble. For

4:28

a century the towers have been propped up

4:30

by two pillars. One, workers filling

4:32

the buildings all week. Two, money flowing

4:34

freely in the form of loans to

4:36

borrow, buy and build. Those

4:38

days are over. As hybrid

4:41

work hardens from trend to new normal,

4:43

office occupancy rates have hit all-time lows.

4:46

Meanwhile, interest rates have spiked to historic

4:48

highs. And now the mortgage comes due.

4:52

$1.5 trillion in commercial real estate loans expire

4:54

in the next two years. It's

4:56

enough to make you rethink the future of cities. We,

4:59

Chris Cross Manhattan, talking to players

5:01

big and small about a sector

5:03

rocked to its foundations. What

5:07

is New York City without its skyline? Monuments

5:10

to commerce standing proudly shoulder

5:12

to shoulder. More office

5:14

space than any city in the world. But

5:16

peak inside all this vertical real

5:19

estate, pen there's a fundamental question.

5:21

Where is everyone? More than

5:23

95 million square feet of

5:26

New York office space currently unoccupied.

5:29

The equivalent of 30 Empire

5:31

State buildings. This building had a lot

5:33

of law firms, had some government tenants.

5:35

Scott Reckler is CEO of RXR, a

5:37

New York real estate company with more

5:39

than $20 billion in holdings. We

5:42

walked through his property at 61 Broadway

5:44

near Wall Street. Every other

5:46

floor, half the building, lies empty. I

5:49

think this is an existential moment. What's

5:51

the cause of the chasm? What's the

5:53

chasm specifically? This post COVID

5:55

world of higher interest rates, the changing nature

5:57

of how people work and live. We're

6:00

not going back to where we were. It's a different world,

6:02

and it's going to be turbulent. It

6:04

already is. The return to office

6:06

has stalled out. Fridays

6:09

are dead. Mondays aren't much busier.

6:12

As tenants shrink their office footprint, office

6:14

landlords are confronting the fact that some

6:16

of their buildings have become obsolete, if

6:19

not worthless. Ever the pragmatist,

6:21

Reckler, decided not to throw good money after

6:23

bad at 61 Broadway and defaulted

6:25

to his bank on a $240 million loan.

6:30

I can see people say, it's a lot of money.

6:32

How did he sleep last night? We invest a lot

6:34

of equity. If it works, we make

6:37

a lot of money. If it doesn't work, the lender

6:40

can take over the building. You've got

6:42

to face reality, right? Reality is coming

6:44

your way. The reality is the price

6:46

of office buildings is tanking, as much

6:48

as 40 percent since the pandemic. Uptown

6:51

at Columbia Business School, Stan Van Neuwerburg,

6:53

a professor of real estate, has modeled

6:56

out the impact of hybrid work on

6:58

pricing and calls it a train wreck

7:00

in slow motion. And this is

7:02

just the beginning. And the reason it's just the beginning

7:04

is because there's a lot of office

7:06

tenants that have not had to make an

7:08

active space decision yet. Do I

7:11

want to renew this space? Do I want to vacate? Maybe

7:13

I sign a new lease for half as much space. This

7:16

is what tenants have been doing for the

7:18

last three years. So when you take all

7:20

of those current and future declines of cash

7:22

flows into account, we end up with about

7:24

a 40 percent reduction in the value of

7:26

these offices. Consider this

7:28

office building near Penn Station, one

7:30

of a handful of sales in the city last fall.

7:33

Built in 1920 and showing its

7:35

age, eight empty floors with a

7:37

99-cent store on the ground level. Cocoa

7:41

butter is 80 percent off. Real

7:43

estate partners Tony Park and Alaud Dror

7:45

told us they'd been eyeing that building

7:47

for years, and pre-pandemic offered the owner

7:50

$80 million. They didn't get very far.

7:52

He doesn't answer. He didn't even answer

7:54

you guys. He didn't answer, yeah. We

7:57

didn't have his attention at all. The

8:00

happen although the now empty in

8:02

September Park and drawer.the building for

8:04

less than half the original office

8:07

in. They have plans to convert

8:09

the place. Did you ever think

8:11

of just. Keep it

8:13

as an office building known as

8:16

our the Last. Anything that is

8:18

not an office. Anything that is

8:20

not an office with Howard Morning.

8:22

So much for the proceeds Hollywood

8:25

has for decades conferred on Manhattan

8:27

office might. Suffice. To say

8:29

they didn't said Mad Men and Succession above

8:31

and ninety nine cent store. Know that Wire

8:33

Okay has gotten very clear. But.

8:36

You might set a glitzy office trauma

8:38

in a place like this one. Vanderbilt

8:40

part of a crop of so called

8:42

proof rebuilding. One. Brazilian sliver

8:44

of this changing real estate market.

8:47

To. The very very top Marks Holidays

8:49

Ceo that so green New York's

8:51

biggest office landlord also to Sixty

8:54

Minutes landlord he took us to

8:56

the top of this new three

8:58

billion dollar skyscraper the have happily

9:00

to Philly from her death of

9:02

resort less from here that chips

9:04

and there's a view but more

9:06

critically the building is connected underground

9:09

two Grand Central Terminal for an

9:11

easy commute. Sufi buildings reflect a

9:13

flight to Quality. Corporate. Tenants

9:15

with deep pockets flocking to amenity

9:17

rich towers. this one includes to

9:20

Michelin star restaurants. All of it's

9:22

designed to motivated for you to

9:24

leave their homes. One Vanderbilt is

9:26

ninety nine percent occupied the hedge

9:28

fund here for consulting firm there,

9:31

but when we talk to him

9:33

in September holiday was obsessing over

9:35

occupancy across all of the So

9:37

Greens properties. Or. Go was ninety

9:39

two percent for this year. Now we've got

9:41

some work to do to get their your

9:43

occupancy rates now or about eighty nine percent

9:46

you said I'd ideally about ninety two would

9:48

be great. I could see people saying yes,

9:50

To. Three points difference. What's the big

9:52

deal? Know and when you have thirty

9:54

million square feet like we do, every

9:56

one percent is a big difference. In

9:59

we pride ourselves. In in keeping

10:01

our occupancy is historically at ninety five

10:03

percent and above you do. except that

10:05

work from home is fundamental shift in

10:08

how we work in that it's here's

10:10

day. It's one of the biggest societal

10:12

problems we're facing right now is work

10:14

from home. I think that it's bad

10:17

for a business, it's bad for cities.

10:19

It's. Bad for people. It's

10:22

also been bad for his stock

10:24

price down fifty percent since the

10:26

pandemic. A culture of smooth talking

10:28

sharp elbows commercial real estate as

10:30

a world built on loans. Big

10:32

one. And the assumption that

10:34

those moon to be refinanced with little

10:36

friction every five to ten years. Not

10:39

any more. The bank will look at that

10:41

billie and say well of I used to

10:43

be willing to lend you eighty million dollars

10:45

against as building, but I don't think that

10:47

building a fourth as much anymore they used

10:49

to be. So maybe today I'm only willing

10:51

to lend you sixty million dollars against that

10:54

same building. Eyes. And now the

10:56

office owner dark I don't try to make

10:58

in a do I come out of pocket

11:00

for that twenty million dollar difference or do

11:02

I walk away The rubber meets the road

11:04

when it comes time to refinance right. And

11:06

to make matters worse, interest rates are now

11:08

much higher. Interest rates have essentially doubled, so

11:10

the cost of that new mortgage even if

11:12

you can got one will be much higher.

11:15

What happens when that cost becomes too high

11:17

for so? in to the terms of sales

11:19

which on the lawn in front of a

11:21

Manhattan courthouse, we saw something you won't see

11:23

on a double decker bus tour. nine. Million

11:25

Six Mortgage foreclosure run an office

11:28

building. Once.

11:31

Going twice here. No one in

11:33

the crowd is willing to outbid

11:35

The bag. Holding alone on the

11:37

building in disobey grip doesn't look

11:39

thrills. It's because he has an

11:41

empty office building bragging down his

11:43

sound seats professor been newer Bird

11:45

has been meeting with Captains of

11:47

Industry in the Federal Reserve on

11:49

this very point. So. Commercial

11:52

Real Estate as a new suit part of

11:54

the book of Business of your typical bank

11:56

and I'm talking mostly about the smaller and

11:58

medium sized may be regional bank. They have

12:00

a lot of exposure, that is their bread

12:02

and butter activities. About thirty percent of all

12:05

their loans are commercial real estate loans and

12:07

here we are seeing weakness in Off is

12:09

that is something like that we have never

12:11

seen before. And banks and me to come

12:13

to grips with us. Or you're comfortable calling

12:15

as a crisis. I think we're at the

12:17

beginning. There's a potential prices here. In.

12:20

December nationwide off a slew delinquency

12:22

rates crowded six percent, almost four

12:24

times what they were a year

12:26

ago for things have been reluctant

12:28

to write down his losses feel

12:30

entered David Harbour on from Maverick

12:32

Real Estate affirms. He and his

12:34

partner found it after the two

12:36

thousand and eight financial crisis. their

12:38

specialty buying distressed debt on the

12:40

cheap ever on, keeps tabs on

12:42

the death on every office building

12:44

in the city, He says New

12:46

York is awash in billions worth of commercial

12:48

real estate loans at risk of not being

12:51

paid. We know that there's

12:53

this build up of bad debt

12:55

in the system, but it's not

12:57

being dealt with just yet. In

12:59

it's in large part because the

13:01

banks have been kicking the can

13:03

down the road as best they

13:05

can trying to push the sauce

13:07

as far as they can. What

13:09

does that mean? It means that

13:11

banks are entering into extensions on

13:13

a lot of their bad loans

13:16

which essentially a change their classification

13:18

from on nonperforming loans alone that's

13:20

in distress to of performing. Loan

13:22

a healthy loan even though they

13:24

haven't received a pay down on

13:26

alone and the collateral value on

13:28

that loan continues to drop Extended

13:31

Pretend that's rights and it works

13:33

really well when interest rates are

13:35

low because the banks can just

13:37

keep the status quo going. but

13:39

once rates are high, it doesn't

13:41

really work anymore. A

13:44

downturn in real estate made worse

13:46

by bad loans, contaminating bags, and

13:48

potentially the entire economy. Echoes.

13:51

Of the global financial crisis of two thousand

13:53

and eight or hard to ignore. But.

13:55

whether the trouble with office buildings ends

13:57

and a simple pricing for action or

14:00

becomes a systemic crisis, likely

14:02

there's pain coming. Not

14:04

just for building owners and banks, but for

14:06

cities themselves. In the

14:09

long run, property taxes on those buildings

14:11

will also fall by 40 percent. And

14:14

these commercial property tax revenues are an

14:16

important component of the budget of local

14:18

governments, which means less money for police

14:21

departments, trash collection, and some

14:23

people are going to decide that the

14:25

quality of life has deteriorated too much and they

14:27

want out. And in fact, that's what

14:29

we've seen. In the last three years, about

14:31

our largest ten cities have lost about two

14:33

million residents. You're losing that tax

14:35

base as well. And now you're losing that tax

14:37

base. And now this cycle continues. And

14:40

we end up in something that we have called an

14:42

urban doom loop. It's awfully quiet

14:44

around here. The urban doom loop

14:46

sounds scary, and it's making the

14:48

rounds, threatening cities beyond New York,

14:51

Dallas, Chicago to say nothing of

14:53

San Francisco. A

14:55

question posed across the country, especially

14:57

given the housing shortage, why

15:00

not convert empty office buildings to

15:02

apartments? Some

15:04

developers are. The elevators here

15:06

were standing about. Tony Park and a

15:08

large roar are turning the former 99

15:11

cent store building into 77 units, renting

15:14

at market price. Developers

15:17

we talk to say they simply can't turn

15:19

a profit converting to affordable housing. Less

15:23

than half of New York office space is zoned

15:25

for conversion. And even then, it's not

15:27

so easy. We

15:31

visited this residential conversion near Wall Street,

15:35

where developers from Van Barton Group were

15:37

making an end run around a city

15:39

rule that says you can't add to

15:41

existing square footage. What is this? They

15:44

call this the void. They call this

15:46

the void, a giant 30-story hole they cut

15:48

through the middle of the building. It's

15:50

one of the tricks of the trade. You

15:52

take the center section of the office floor, the

15:54

part that doesn't get a lot of light and

15:56

air, seal it up, and preserve that square footage

15:58

so you can see it. you can apply

16:01

it somewhere more valuable, say a penthouse.

16:03

Residents may not even know it's here. They'll never know. Maybe

16:06

not, but the void offers a larger

16:08

lesson in urban real estate. Where

16:11

there's space, there's potential. This

16:14

will be the tallest commercial building in

16:16

the Western Hemisphere by floor. For

16:18

Scott Reckler, that means doubling down, even

16:20

in a down market. Near

16:23

Grand Central, he's lined up financing to

16:25

build his own trophy building, part office,

16:27

part hotel. But

16:29

for Professor Van Neuwerburg, the reimagining

16:32

can and should be far more

16:34

ambitious. A sweeping new deal,

16:36

combining public and private money and

16:38

ideas for what to do with

16:40

old office space. It's no longer

16:43

fit for purpose. We got to

16:45

redesign it. You know, more space

16:47

for communities, more space for artists,

16:49

maybe pickleball courts or basketball courts.

16:51

There's lots of different uses for these buildings,

16:53

especially when you combine them at a depressed

16:56

price. If Van Neuwerburg gave us

16:58

the term urban doom loop, he

17:00

also gives off a certain optimism about

17:02

the current point of inflection. For all

17:05

of human history, humankind has been tied

17:07

to work where it

17:09

lives. We were farming the farms and we

17:11

lived on our farms. We were working in

17:13

the factories and living close to the factories.

17:15

We no longer have to live where we

17:18

work. And that's a very transformational

17:20

idea. And I believe society is only at

17:22

the beginning of realizing the full potential of

17:24

that idea. Anyone

17:27

who's had experience with Alzheimer's disease knows

17:29

the agony of watching someone fade away

17:32

as it steals memory. And at the

17:34

end, a person's own identity. Tonight,

17:37

we'll show you an experimental way to

17:39

try and beat back Alzheimer's. It's

17:42

been tested on just a handful of patients,

17:44

but it caught our attention because of

17:46

the doctor involved, Dr. Ali Rezai,

17:49

who 60 Minutes first met 20

17:51

years ago. Dr.

17:53

Rezai is a neuroscience pioneer

17:55

who's developed treatments for Parkinson's

17:57

disease and other brain disorders.

18:00

Over the last year, we followed

18:02

this master of the mind as

18:04

he attempted to delay the progression

18:06

of Alzheimer's disease and its worse

18:09

symptoms using ultrasound. We

18:11

saw a cutting-edge approach to brain surgery

18:13

with no cutting. If

18:15

we can, we should not be doing brain

18:17

surgery. You're a brain surgeon. I am, but

18:20

I should be out of a job because

18:22

brain surgery, it's cutting the skin, opening the

18:24

skull. It can be barbaric. You're going to

18:26

go right in there. It

18:29

looked like a scene from a sci-fi movie. Okay.

18:32

Make it a little bit more comfortable. A

18:34

halo-wrapped patient pushed into a tube. We're ready

18:36

to go. As a team of doctors manipulate

18:38

his brain from the other side of the

18:40

glass. Gain high, modulate power in three

18:42

minutes. Okay, we're ready to go. Dr.

18:44

Ali Rezai allowed us to

18:46

witness his revolutionary attempt to

18:49

use ultrasound to slow down

18:51

the cognitive decline in three

18:53

patients diagnosed with Alzheimer's disease.

18:55

It's never been done before. There's

18:58

no miracle cures here. It's advancing

19:00

medicine with calculated risks and pushing

19:02

the frontiers. So we're targeting these

19:04

areas. Dr. Rezai and his team

19:06

are focused on these red patches

19:08

in the patient's brain scans. The

19:11

red indicates the densest beta-amyloid

19:13

protein. That gummy protein is

19:15

believed to play a major

19:17

role in Alzheimer's by disrupting

19:19

communication between brain cells.

19:22

In people with Alzheimer's, it accumulates

19:25

much faster. And over

19:27

time, these protein aggregates,

19:29

we call them plaques, like

19:32

plaques into arteries. They keep on

19:34

accumulating and impacting function. There

19:37

are two FDA-approved drugs on the market

19:39

that can help break up that brain

19:41

plaque. Atakanumab was approved

19:43

in 2021, followed by Lacanumab last year. Both

19:48

are given intravenously, but they work

19:51

slowly. Typically,

19:53

you go into the clinic and

19:56

you get an IV, and you have

19:58

the antibody infusion over one to two hours. and

20:01

you have to do it once a month or twice

20:03

a month for 18 months and longer.

20:05

And during those 12 to 18 months

20:07

the brain is continuing to progress. Alzheimer's

20:10

not going away. It

20:12

takes so long because the drugs have

20:14

a hard time getting through something called

20:16

the blood-brain barrier. This tight

20:18

filter of cells line the blood vessels

20:21

to keep toxins from leaking into the

20:23

brain, but it also prevents almost

20:25

all of the medication from getting in

20:27

too. We think that that's what's

20:29

causing maybe disruption by opening this year. Dr. Rizai

20:31

thought he could be a skull

20:47

and can be focused like sunlight

20:50

through a magnifying glass to help

20:52

open the blood-brain barrier and allow the drugs

20:55

to rush in. This way we're getting the

20:57

payload, the therapeutic payload exactly to the area

20:59

needs to go with a high penetration. But

21:01

we got to be careful because we want

21:03

to be safe about this. You don't want

21:06

to deliver too much. Don't want

21:08

to open the blood-brain barrier too much. Because if you open

21:10

it too much what could happen? If you get bleeding in

21:12

the brain, you can get swelling in the brain, you

21:14

can get many other problems. So you have to

21:16

get it just right. We will

21:18

show you exactly how that worked and the

21:20

early results in a minute. But

21:23

to understand why one of the

21:25

country's most accomplished brain surgeons is

21:27

betting on ultrasound, you have to go

21:30

back to 2002 when

21:33

Dr. Rizai first caught our

21:35

attention in a story morally

21:37

safer reported on treating Parkinson's

21:40

disease. But it also

21:42

prevents almost all of the medication from

21:44

getting in too. We think

21:46

that that's what's causing the baby disruption by

21:48

opening this year. Dr. Rizai thought he could

21:50

solve that problem with ultrasound. The

21:53

same technology that's been used for 70 years

21:56

to give doctors a view of organs and

21:58

fetal development. You're

22:00

not a man. He chose ultrasound because

22:02

it easily penetrates the school and can

22:04

be focused like sunlight through a magnifying

22:06

glass to help open the blood brain

22:09

barrier and allow the drugs to rush

22:11

in. This way, we're getting the payload,

22:13

the therapeutic payload exactly to the area

22:15

of this to go with the high

22:17

penetration. But we gotta be careful because

22:19

we want to be safe about this

22:21

Utilize deliver too much, don't want to

22:23

open the blood brain barrier too much

22:25

success as he opened his too much.

22:27

What said? How do that leading the

22:29

branding. The swelling in the brain. He. Can

22:32

gets video the problem sir. Yes to get

22:34

it just makes. You say

22:36

you exactly how that worked and

22:38

the early results in a minute

22:40

to understand why one of the

22:42

country's most accomplished brain surgeon is

22:44

setting on ultrasound? Okay of an

22:47

uncle's house for me to go

22:49

back to. Two thousand and Two

22:51

When doctors I first caught our

22:53

attention in a story Morley Safer

22:55

reported on treating parkinson's disease or

22:58

got some your teeth said a

23:00

tie up burger that to resign.

23:02

Was among the first to implant

23:04

a Peacemaker type device in the

23:07

plane which stopped uncontrollable moose and

23:09

suffered. By Parkinson's patients like traveling

23:11

through elaborate as in the of

23:13

weakness and around every corner has

23:15

a bloodthirsty mauser. second jump on your

23:17

so you want to be careful to

23:20

avoid these areas. That kind

23:22

of in san surgery is now routine

23:24

for advanced carson since the reason I

23:27

went on to write hundreds of scientific

23:29

papers, secure dozens of patterns, and present

23:31

his cousins and research different. this and

23:34

why. He could have

23:36

the and any big city research center

23:38

that's true to form. He chose to

23:40

try something different and move to move

23:42

in town West Virginia. Who. He

23:44

is the Executive Director of

23:46

the Rockefeller Neuroscience Institute. It.

23:49

Was a fantastic move because we're able to

23:51

achieve so many things that would have been

23:53

difficult that other institutions sometimes into biggest fish

23:55

as you may not be hungry as much

23:58

for he may have a thousand difference. Agendas

24:00

and priorities here. We think we ever

24:02

a nimble. an agile team that can

24:05

quickly get outcomes like and twenty nine

24:07

teams this is video doctor his eyes

24:09

team tough when they were among the

24:11

first to use ultrasound to treat tremors

24:14

go to for fifteen years The and

24:16

Wall. Had been suffering from essential.

24:18

Tremor a neurological disorder.

24:22

Had on know or I've heard

24:24

it was either team focused. Ultrasound

24:26

into a part of the brain called

24:28

the thalamus. To destroy a

24:30

pinpoint size patted tissue doctors believed

24:32

was responsible for the tremors said

24:35

that I hundred eighty hours and

24:37

verge of I said while was

24:39

awake during the procedure. After

24:43

two hours and seventy one

24:46

year olds tremors wisdom of

24:48

feel free to wander off

24:50

of it was very.and rub

24:53

off. On.

24:59

That success helped convince.to

25:01

resign morning. That focused ultrasound

25:03

could be adapted to patients

25:05

with other brain disorders including.

25:07

Alzheimer's disease my first symptoms

25:10

that on notice. Aware.

25:12

That I was having trouble. Typing

25:14

and work. To do you

25:16

think you had Alzheimer's. No. I

25:18

didn't. Dan Miller is just sixty

25:20

one. Years old, his wife Kathy

25:23

began noticing changes for years

25:25

ago. He can't hit it

25:27

pretty well. and then another t

25:29

was some. Having trouble with his

25:31

closet be backwards. And

25:34

as concert Thanks this little thing. Just

25:36

little things as a scan of his

25:38

brain revealed would Dan had been hiding.

25:41

Mr. Miller had a very large

25:43

amounts of beta amyloid. The red

25:45

spots. Indicated a build up of

25:47

those beta amyloid proteins. the so

25:50

called brain Plat, a marker of.

25:52

Alzheimer's. Doctor resign

25:54

plane to miller. he couldn't sort of

25:56

the disease but he hoped to snowbirds

25:59

progressive Why take

26:01

part in the trial if it's not a cure?

26:04

I have to explain to you that I was

26:06

at the point, you know, like in Dante's Inferno,

26:09

where it says abandon all hope,

26:11

you enter here. For me,

26:13

it was just, you know, let's do this, you know.

26:16

What do I have to lose? And you are

26:18

infused in certain... Here's how it worked. Hours

26:21

before the procedure, Miller was given

26:23

an IV treatment of Atacanumab, one

26:26

of his two new drugs to reduce beta

26:28

amyloid plaque. Miller

26:31

was then fitted with this million-dollar

26:34

helmet, similar to the one the team

26:36

used to treat tremor patients. It

26:38

directs nearly a thousand beams of

26:41

ultrasound energy at a target the

26:43

size of a pencil point. Basically,

26:45

the patient lies on the MRI

26:47

table, and the head goes

26:49

inside the helmet, and the patient

26:52

is immobilized with a halo or with a

26:54

mouthpiece because we don't want movements to cause

26:56

errors in our targeting of the brain. Is

26:59

that comfortable? Mm-hmm. That sounds good.

27:01

Once inside, the MRI machine gave Dr.

27:04

Rezei a 3D view of the plaque

27:06

he would target in Dan Miller's brain.

27:09

The next step was an IV solution

27:11

that contained microscopic bubbles. When

27:14

hit with ultrasound energy, the bubbles

27:16

pry open that blood-brain barrier. Okay,

27:19

ready. We can sound like a mouse. There we

27:21

go. The

27:24

bubbles start vibrating. They're moving. They're

27:27

moving. They start expanding.

27:30

So you can open the

27:32

barrier temporarily. Now it's open

27:34

for 24 to 48 hours, and then it reseals. So

27:38

this gives you a tremendous opportunity for 24 to 48

27:40

hours with the barrier being opened. So

27:43

now therapeutics can get inside the brain. You

27:48

can't hear ultrasound. That noise

27:50

is a signal to tell Rezei's team

27:52

the ultrasound is doing its work. Very

27:55

nice opening of the blood-brain barrier. Each

27:59

dot. represents an area where all the

28:01

waves, all the ultrasound waves converge and

28:03

open the blood-brain barrier. So this is

28:05

just one blast if you will. One

28:07

blast getting there. And you're hitting one

28:09

point. One point and then it moves

28:11

to the next one. Even

28:15

though patients were awake they told us they

28:17

didn't feel a thing. It all took

28:19

a couple of hours and they went home when it

28:21

was over. The three patients were

28:24

given the treatments of ultrasound with infusion

28:26

once a month over six months. That's

28:28

another target right there. The result? Beta

28:31

amyloid plaque targeted with ultrasound

28:33

were reduced 50% more

28:36

than areas treated by infusion alone.

28:39

That's the top of the head right there.

28:41

Dr. Azai shared the three patients' brain scans

28:43

with us. And the red

28:45

indicates more density of beta

28:48

amyloid plaques in the brain. So you can

28:50

see as you treat it with ultrasound. Look

28:52

closely at the areas outlined in white

28:54

that were targeted with ultrasound and the

28:56

drug. You get reduction. Whoa, that's

28:59

after. That's after you can see

29:01

the plaques are very significantly reduced by

29:03

opening the blood-brain barrier just in one

29:06

area. Dan

29:08

Miller and the third patient in the

29:10

trial had larger areas of their brain

29:13

targeted with ultrasound. And this is his

29:15

baseline and then you can see here after 26

29:18

weeks there's a very

29:20

dramatic reduction in the beta

29:22

amyloid in the areas as

29:25

outlined by this white mark. And

29:27

now we're in with a patient number three. And

29:30

this patient underwent antibody infusion therapy

29:32

plus ultrasound. You can see this

29:34

area which is really amazing. The

29:37

ultrasound opened the blood-brain barrier and

29:39

the antibody went in faster and

29:41

cleaned out the plaques. What

29:44

was your reaction when you saw this scan?

29:46

I mean my jaw dropped out like whoa I

29:48

was actually even in the clinic seeing

29:50

patients and the PET scan technician called

29:52

and said oh yeah there's a big

29:55

change. I'm like how do you know we have to analyze

29:57

it. It's like no you can see it on the screen.

29:59

What did you think? when Dr.

30:01

Rosai shared the scans

30:04

with you. It

30:06

was surreal. You can really see

30:08

it. You don't have to be a

30:10

doctor and there's nothing on there. Absolutely not. Yeah. Even

30:13

the red is decreasing. That's amazing. Kathy Miller

30:15

says she can see it in her husband

30:17

too, who slips up once

30:20

in a while, but hasn't slipped further

30:22

away. He has trouble finding things.

30:24

I'll send him into the kitchen to get something

30:26

and he's like, it's not there. And

30:29

I'm like, yes, it is. I can see it,

30:31

but he can't see it. But

30:33

if that's the worst, that's

30:36

nothing. You'll take it. I'll take it. You

30:39

feel hopeful about the future? I

30:41

do, yes. I learned that

30:43

what I needed to do is accept

30:46

that the old Dan

30:49

is gone and then

30:52

start working on the new me, which

30:55

has a future. Dr.

30:58

Rezai's team told us there's been no

31:00

change in the ability of the three

31:02

patients to do their daily activities since

31:04

the ultrasound treatments ended in July. Now

31:07

that Dr. Rezai has shown focus

31:09

ultrasound can clear beta amyloid plaques

31:11

faster. He has FDA

31:14

approval to use ultrasound to try

31:16

and restore brain cell function lost

31:18

to Alzheimer's. What's the result

31:20

of breaking up all those plaques to the

31:23

damage that's already been done to the brain?

31:25

We don't know if it's gonna reverse

31:27

the damage to the brain because Alzheimer's,

31:30

the underlying cause is still occurring. So

31:32

we have another study that we're looking

31:34

at with ultrasound. First, clear

31:37

the plaques, then deliver

31:39

ultrasound in a different dose to see now

31:41

if we can reverse it

31:43

or boost the brain more for

31:45

people with Alzheimer's. When

31:48

we come back, we'll show you Dr. Rezai's new way

31:51

to use ultrasound to reset the brain

31:54

and help people suffering from drug

31:56

addiction. The

32:08

human brain contains a hundred billion

32:11

neurons. That's as many cells as

32:13

there are stars across the Milky Way. Dr.

32:16

Ali Rezai has spent 25 years

32:18

exploring this frontier of medicine. The

32:21

surgical techniques and therapies he pioneered are

32:23

in use around the world. Dr.

32:26

Rezai allowed us to see his

32:29

latest research over the last year

32:31

at the Rockefeller Neuroscience Institute in

32:33

Morgantown, West Virginia. It

32:36

includes revolutionary treatments for a brain disease

32:38

suffered by 24 million Americans

32:40

— addiction. The results

32:43

so far have been life-changing for

32:45

the people we met once trapped

32:47

by drugs. Looking

32:49

back, I didn't have a chance. What

32:52

do you mean you didn't have a chance?

32:54

I couldn't do anything without having that drug

32:57

in my system. Jared

33:01

Buckhalter is the son of a coal miner.

33:04

At 6'3", he was a high school

33:06

football standout who dreamed of playing

33:08

wide receiver at Penn State. But

33:11

after a shoulder injury, he got

33:13

hooked on painkillers. The

33:15

very first time that I took that first

33:17

pill, I

33:19

knew that I wanted that feeling for the rest of my

33:22

life. What does it feel like? It's

33:24

just pure euphoria. He

33:26

took us to where he said he often went to

33:28

buy drugs, including heroin. Everybody

33:30

in Morgantown knows to come

33:32

here. Probably 17, 18 years old, you know,

33:34

just a kid. Buckhalter

33:38

still looks like an athlete. It's hard

33:40

to imagine he was an addict for

33:42

more than 15 years. He

33:45

told us he does not remember how many times

33:47

he overdosed and that he couldn't stay clean

33:49

for more than four days at a time.

33:52

I didn't know where I was going to sleep some

33:54

nights. You know, my family didn't want me around anymore.

33:57

I just I did so many things. to

34:00

hurt them that, you know, it was just too

34:02

much for them to deal with. Four years ago,

34:04

a psychologist who'd worked with

34:06

Buckhalter introduced him to Dr. Ali

34:09

Rezai, who was gearing up to

34:11

perform a new kind of brain

34:13

surgery to treat severe addiction. Our

34:16

protocol was people that have

34:18

failed everything. Once you've tried

34:21

everything. Everything. Residential programs, multiple

34:23

failures, detox multiple times, outpatient,

34:26

inpatient, multiple overdoses.

34:29

I think he classified it as end stage

34:31

drug user. I mean, end stage makes

34:34

you think that this is the end of your life.

34:36

Correct. And hearing that at the age

34:38

of 34, it was crazy. Dr.

34:45

Rezai thought he might be able

34:47

to adapt technology. He helped develop

34:49

years earlier to treat Parkinson's disease

34:51

to treat people with severe addiction.

34:55

We've been able to map out with

34:57

neuroscience, imaging. There's a specific part of

34:59

the brain that is

35:01

electrically and chemically malfunctioning that

35:04

is associated with addiction. So it's not

35:06

just willpower. It's what's happening

35:09

in the brain. It's a brain disease.

35:11

It's an electrical and chemical abnormality

35:13

in the brain that occurs over

35:15

time with recurrent use of

35:18

drugs. And this can be any substance. Alcohol

35:21

can be opioids, amphetamines, cocaine,

35:23

and they all are involving the

35:25

same part of the brain. And

35:27

so your idea was what? That

35:30

the implant. Parkinson's, we implant that in

35:32

the movement part of the brain. That

35:35

is electrically malfunctioning, causing shaking. In

35:37

this case, we're going into behavioral

35:40

regulation, anxiety, and craving parts

35:42

of the brain. Dr.

35:44

Rezai has seen the impact of addiction

35:47

in his community. The problem is

35:49

so severe in Morgantown, a

35:51

vending machine dispenses the overdose

35:53

antidote, Narcan, for free. The

35:56

National Institute on Dred Abuse

35:58

agreed to support Dr. Rezai's

36:00

attempt to fight addiction with a brain

36:03

implant. In 2019, the FDA gave him

36:05

a green light

36:07

to attempt the groundbreaking surgery.

36:11

That is Jared Buckhalter. He

36:13

agreed to be the first addiction patient in

36:16

the U.S. to get the implant. Dr.

36:18

Rezai's team interviewed him the day

36:20

before the surgery. The best outcome

36:24

possible would be, you know,

36:26

just to cut the cravings out and

36:28

make me feel a little bit better.

36:30

If, you know, if those

36:32

couple things happen, you know, that's

36:37

all I could possibly ask for. At that

36:39

time, I was so desperate for a better life

36:42

that I was willing to do just about anything and

36:45

I signed up to do it. I

36:48

think some people might look at this and think an

36:50

electronic implant in the brain sounds

36:53

a little creepy. People, maybe

36:55

50 years ago, they say an implant in

36:57

the heart sounds creepy. Now it's like normal.

36:59

25 years ago,

37:01

people were saying, what are you doing? You're

37:04

putting an implant in the brain for Parkinson's,

37:06

but now it is routine part

37:08

of standard of care for advanced

37:10

Parkinson's. This

37:12

is video from the seven-hour procedure.

37:16

Surgery so new it didn't have a name yet.

37:18

Dr. Rezai opened a nickel-sized

37:21

hole in Buckhalter's skull. Then

37:23

he directed a thin wire with

37:25

four electrodes deep inside. Are

37:27

you okay? Yes, sir.

37:30

All right. Jared was awake during the

37:32

surgery. Why was that necessary? To map

37:34

the brain, we have tiny microphones the

37:36

size of a hair we put inside

37:38

the brain and they're going

37:40

slowly with micro robots. They go at increments

37:43

of a thousandth of a millimeter. Very slow.

37:45

We drive them into the brain and we're

37:47

listening to the neurons talking to each other.

37:49

In addiction, we want to find the area

37:52

in the reward center so that

37:54

confirms where we are in the brain. Once

37:57

we listen and say, okay, that's the right

37:59

sound, then And then we put the final

38:01

therapeutic pacemaker. What does it sound like? Static

38:04

electricity, which may be electricity to you, but

38:06

it's music to my ears. Music,

38:09

because Dr. Rezai says it's a

38:11

signal that he found

38:13

the right spot in the brain for the implant.

38:17

Once in place, the wire was

38:19

connected to a device placed below

38:21

the collarbone. The electrical

38:23

pulses it sends for the brain

38:25

are intended to suppress cravings. Heather

38:28

said it was painless. Post-surgery,

38:30

the system is adjusted remotely

38:32

with a tablet computer as

38:34

needed. When they turned the

38:37

unit on, it was an immediate change.

38:39

What was the change? Just

38:41

felt better. You know, just felt

38:44

like I did prior to ever using drugs,

38:47

but a little bit better. And it was

38:49

at that point that I knew that I

38:52

was gonna have a legitimate shot at doing well.

38:56

In all, four patients with severe

38:58

drug addiction had the implant surgery. One

39:01

had a minor relapse. Another

39:03

dropped out of the trial completely. But

39:06

two have been drug-free since their

39:08

operations, including Jared

39:10

Buckhalter, who's been clean for four

39:12

years. If you hadn't met

39:15

Dr. Rezai, if you hadn't gone through

39:17

this implant, do you think

39:19

you'd be sitting here talking to me today? You

39:21

may be talking to my parents, you know, those

39:24

that have lost their loved

39:26

ones to a drug overdose, but

39:29

you wouldn't be talking to me. There's no doubt

39:32

about that. Ah, beautiful,

39:34

beautiful. The surgery

39:36

was a success, but opening

39:38

someone's skull is always risky.

39:41

Dr. Rezai thought he could reach more

39:43

patients quickly if he used

39:45

ultrasound. He was already

39:47

using it to treat other brain

39:50

disorders and was convinced focused ultrasound

39:52

could target the same area of the

39:54

brain as the implant. Is

39:56

this brain surgery without a knife? It

39:59

is, indeed. So there's no

40:01

skin cutting, there's no opening the

40:03

skull, so it is brain surgery

40:05

without cutting the skin, indeed. How

40:07

would you develop your brain? Dr.

40:09

Azai explained how his team would be

40:11

the first to treat addicts by aiming

40:13

hundreds of beams of ultrasound to a

40:16

precise point deep inside the

40:18

brain. So the area that

40:20

we're treating is the reward

40:22

center in the brain, which is the

40:25

nucleus accumbens, which is right down

40:28

at the base of this dark area. And

40:31

then we deliver ultrasound waves

40:34

to that specific part of the brain,

40:37

and we watch how acutely on the

40:39

table your cravings and your

40:41

anxiety changes in response to ultrasound.

40:44

How is the ultrasound making

40:46

a change here? Ultrasound

40:48

energy is changing the electrical

40:50

and chemical milieu or

40:53

activity in this structure in

40:55

the brain involving addiction cravings.

40:58

Just resetting them and giving them kind of

41:00

a fresh start? At

41:02

this point, it seems like the brain is being

41:04

reset or rebooting of the brain, and

41:07

the cravings are less, they're

41:09

managed, anxiety is better. So

41:11

now that allows them to interact with the

41:13

therapist. It's very important to know

41:15

that this is not a cure,

41:17

but an augmentation of the therapy

41:19

by reducing the cravings and anxiety

41:21

that's so overwhelming that the therapist

41:24

has difficulty working with the patient.

41:26

Last February, we watched Dr.

41:28

Reza use spoken ultrasound to

41:31

treat Dave Martin, who told

41:33

us he's been surrounded by friends and

41:35

family who use drugs his whole life.

41:38

When did you start using drugs? When I

41:40

was seven years old. Seven? Yes.

41:43

I did drugs for 37 years. What

41:45

kind of drugs were you using? Something

41:48

I can get my hands on. Inside

41:51

the MRI, Martin was shown these images

41:53

of drug use to stoke his cravings.

41:56

His legs were moving a lot and

41:58

he's very agitated. simultaneous

42:00

brain scan allowed Dr. Rezei and

42:03

his team to immediately spot the

42:05

area in the nucleus accumbens that

42:07

was most active. I'd like to see

42:09

the targets one more time. 90 watts

42:11

of ultrasound energy were beamed at a

42:13

target the size of a gumdrop. Ready,

42:16

sonicate. All right, there we go. Within

42:19

minutes, we noticed Martin's foot that

42:21

had been anxiously bouncing was still.

42:24

And he told Rezei's team that those same

42:26

images of drugs he was shown earlier

42:28

were now not sparking the need for

42:30

a fix. Carowind is going down. Meth

42:33

is also going down. Marijuana

42:35

is down. Marijuana is down. A lot,

42:37

actually. Okay. Keep on

42:40

sonicating. The day

42:42

the procedure, it was the best day of

42:44

my life. I didn't experience

42:46

the same effect as,

42:49

like, the times before the... You didn't

42:51

feel like I need that? I want that. No, I

42:54

didn't feel like I needed that. The urge or the

42:56

desire to use wasn't there

42:58

anymore. So within 15 to 20

43:00

minutes of treatment, the craving

43:02

and anxiety melts away. And

43:05

we're seeing this pattern in multiple instances.

43:07

Then they can walk away after this?

43:09

They get off the table and go home. And

43:13

how long does this entire procedure... One

43:15

hour. One hour. One

43:17

hour. Have you been around people still using drugs?

43:20

Yes, yes. Unfortunately, I have. And

43:22

what happened? It didn't even trigger

43:24

me. I

43:26

used to use it in the reniously with

43:28

needles. And it was a

43:30

little while ago. Dr. Ali

43:33

Rezai is trying the same ultrasound

43:35

therapy on 45 more addiction patients

43:37

and is already thinking about expanding

43:40

the use of ultrasound to help

43:42

people with other brain disorders, including

43:46

post-traumatic stress disorder and obesity.

43:49

This is serious business. Research

43:51

has never been done before. We have to

43:54

learn more. We have to replicate our findings.

43:56

Is there any risk at running towards

43:58

something quickly? There's

44:00

always risk, but you cannot

44:02

advance and make discoveries

44:04

without risk but we need to

44:06

push forward and take the risk because People

44:09

with addiction and Alzheimer's

44:12

is not going away. It's here. So

44:14

why wait 10 20 years? Do

44:17

it now You Now

44:24

an update of our story who is

44:27

ray epps in April We

44:29

spoke with the January 6th rioter and

44:31

his wife in hiding and fearing for

44:33

their lives Ray epps

44:35

had become the target of a conspiracy theory

44:38

offering no evidence the Conspiricists

44:40

portrayed epps as an FBI

44:42

informant sent to incite the

44:44

rioters did anyone

44:48

from the federal government Direct

44:51

you to be here at the

44:53

Peace Circle at this time. No

44:56

known from the FBI. No Your

44:59

old comrades with the oath

45:02

keepers. No Ray

45:04

epps pleaded guilty to entering a

45:06

restricted area on the Capitol grounds

45:09

this past Tuesday He was sentenced to

45:11

a year's probation and community service for

45:13

his role in the