[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:07.14,0:00:11.69,Default,,0000,0000,0000,,In 1963, a 21-year-old physicist \Nnamed Stephen Hawking
Dialogue: 0,0:00:11.69,0:00:14.87,Default,,0000,0000,0000,,was diagnosed with a rare\Nneuromuscular disorder
Dialogue: 0,0:00:14.87,0:00:19.59,Default,,0000,0000,0000,,called amyotrophic lateral sclerosis, \Nor ALS.
Dialogue: 0,0:00:19.59,0:00:22.02,Default,,0000,0000,0000,,Gradually, he lost the ability to walk,
Dialogue: 0,0:00:22.02,0:00:23.33,Default,,0000,0000,0000,,use his hands,
Dialogue: 0,0:00:23.33,0:00:24.74,Default,,0000,0000,0000,,move his face,
Dialogue: 0,0:00:24.74,0:00:26.76,Default,,0000,0000,0000,,and even swallow.
Dialogue: 0,0:00:26.76,0:00:29.86,Default,,0000,0000,0000,,But throughout it all,\Nhe retained his incredible intellect,
Dialogue: 0,0:00:29.86,0:00:32.27,Default,,0000,0000,0000,,and in the more\Nthan 50 years that followed,
Dialogue: 0,0:00:32.27,0:00:36.83,Default,,0000,0000,0000,,Hawking became one of history’s most \Naccomplished and famous physicists.
Dialogue: 0,0:00:36.83,0:00:39.46,Default,,0000,0000,0000,,However, his condition went uncured
Dialogue: 0,0:00:39.46,0:00:44.28,Default,,0000,0000,0000,,and he passed away in 2018 \Nat the age of 76.
Dialogue: 0,0:00:44.28,0:00:46.05,Default,,0000,0000,0000,,Decades after his diagnosis,
Dialogue: 0,0:00:46.05,0:00:49.08,Default,,0000,0000,0000,,ALS still ranks as one \Nof the most complex,
Dialogue: 0,0:00:49.08,0:00:50.28,Default,,0000,0000,0000,,mysterious,
Dialogue: 0,0:00:50.28,0:00:53.92,Default,,0000,0000,0000,,and devastating \Ndiseases to affect humankind.
Dialogue: 0,0:00:53.92,0:00:57.87,Default,,0000,0000,0000,,Also called motor neuron disease \Nand Lou Gehrig’s Disease,
Dialogue: 0,0:00:57.87,0:01:03.44,Default,,0000,0000,0000,,ALS affects about two out of every\N100,000 people worldwide.
Dialogue: 0,0:01:03.44,0:01:05.45,Default,,0000,0000,0000,,When a person has ALS,
Dialogue: 0,0:01:05.45,0:01:06.77,Default,,0000,0000,0000,,their motor neurons,
Dialogue: 0,0:01:06.77,0:01:11.02,Default,,0000,0000,0000,,the cells responsible for all voluntary \Nmuscle control in the body,
Dialogue: 0,0:01:11.02,0:01:13.05,Default,,0000,0000,0000,,lose function and die.
Dialogue: 0,0:01:13.05,0:01:16.70,Default,,0000,0000,0000,,No one knows exactly why\Nor how these cells die
Dialogue: 0,0:01:16.70,0:01:20.36,Default,,0000,0000,0000,,and that’s part of what \Nmakes ALS so hard to treat.
Dialogue: 0,0:01:20.36,0:01:22.44,Default,,0000,0000,0000,,In about 90% of cases,
Dialogue: 0,0:01:22.44,0:01:26.52,Default,,0000,0000,0000,,the disease arises suddenly, \Nwith no apparent cause.
Dialogue: 0,0:01:26.52,0:01:29.38,Default,,0000,0000,0000,,The remaining 10% of cases are hereditary,
Dialogue: 0,0:01:29.38,0:01:34.91,Default,,0000,0000,0000,,where a mother or father with ALS passes \Non a mutated gene to their child.
Dialogue: 0,0:01:34.91,0:01:38.60,Default,,0000,0000,0000,,The symptoms typically first appear \Nafter age 40.
Dialogue: 0,0:01:38.60,0:01:43.63,Default,,0000,0000,0000,,But in some rare cases, like Hawking’s,\NALS starts earlier in life.
Dialogue: 0,0:01:43.63,0:01:49.62,Default,,0000,0000,0000,,Hawking’s case was also a medical marvel \Nbecause of how long he lived with ALS.
Dialogue: 0,0:01:49.62,0:01:55.19,Default,,0000,0000,0000,,After diagnosis, most people with \Nthe disease live between 2 to 5 years
Dialogue: 0,0:01:55.19,0:02:00.10,Default,,0000,0000,0000,,before ALS leads to respiratory problems \Nthat usually cause death.
Dialogue: 0,0:02:00.10,0:02:04.12,Default,,0000,0000,0000,,What wasn’t unusual in Hawking’s case\Nwas that his ability to learn,
Dialogue: 0,0:02:04.12,0:02:04.96,Default,,0000,0000,0000,,think,
Dialogue: 0,0:02:04.96,0:02:08.08,Default,,0000,0000,0000,,and perceive with his senses \Nremained intact.
Dialogue: 0,0:02:08.08,0:02:12.40,Default,,0000,0000,0000,,Most people with ALS do not experience\Nimpaired cognition.
Dialogue: 0,0:02:12.40,0:02:16.00,Default,,0000,0000,0000,,With so much at stake \Nfor the 120,000 people
Dialogue: 0,0:02:16.00,0:02:18.40,Default,,0000,0000,0000,,who are diagnosed with ALS annually,
Dialogue: 0,0:02:18.40,0:02:22.04,Default,,0000,0000,0000,,curing the disease has become one of \Nour most important scientific
Dialogue: 0,0:02:22.04,0:02:23.88,Default,,0000,0000,0000,,and medical challenges.
Dialogue: 0,0:02:23.88,0:02:25.72,Default,,0000,0000,0000,,Despite the many unknowns,
Dialogue: 0,0:02:25.72,0:02:31.04,Default,,0000,0000,0000,,we do have some insight into how ALS \Nimpacts the neuromuscular system.
Dialogue: 0,0:02:31.04,0:02:36.08,Default,,0000,0000,0000,,ALS affects two types of nerve cells \Ncalled the upper and lower motor neurons.
Dialogue: 0,0:02:36.08,0:02:39.02,Default,,0000,0000,0000,,In a healthy body, \Nthe upper motor neurons,
Dialogue: 0,0:02:39.02,0:02:40.92,Default,,0000,0000,0000,,which sit in the brain’s cortex,
Dialogue: 0,0:02:40.92,0:02:44.46,Default,,0000,0000,0000,,transmit messages\Nfrom the brain to the lower motor neurons,
Dialogue: 0,0:02:44.46,0:02:46.44,Default,,0000,0000,0000,,situated in the spinal cord.
Dialogue: 0,0:02:46.44,0:02:49.88,Default,,0000,0000,0000,,Those neurons then transmit \Nthe message into muscle fibers,
Dialogue: 0,0:02:49.88,0:02:52.84,Default,,0000,0000,0000,,which contract or relax in response,
Dialogue: 0,0:02:52.84,0:02:54.78,Default,,0000,0000,0000,,resulting in motion.
Dialogue: 0,0:02:54.78,0:02:57.24,Default,,0000,0000,0000,,Every voluntary move we make occurs
Dialogue: 0,0:02:57.24,0:03:00.74,Default,,0000,0000,0000,,because of messages transmitted \Nalong this pathway.
Dialogue: 0,0:03:00.74,0:03:03.100,Default,,0000,0000,0000,,But when motor neurons degenerate in ALS,
Dialogue: 0,0:03:03.100,0:03:06.98,Default,,0000,0000,0000,,their ability to transfer \Nmessages is disrupted,
Dialogue: 0,0:03:06.98,0:03:10.78,Default,,0000,0000,0000,,and that vital signaling system \Nis thrown into chaos.
Dialogue: 0,0:03:10.78,0:03:14.15,Default,,0000,0000,0000,,Without their regular cues, \Nthe muscles waste away.
Dialogue: 0,0:03:14.15,0:03:17.07,Default,,0000,0000,0000,,Precisely what makes \Nthe motor neurons degenerate
Dialogue: 0,0:03:17.07,0:03:19.96,Default,,0000,0000,0000,,is the prevailing \Nmystery of ALS.
Dialogue: 0,0:03:19.96,0:03:24.53,Default,,0000,0000,0000,,In hereditary cases, parents pass genetic \Nmutations on to their children.
Dialogue: 0,0:03:24.53,0:03:27.76,Default,,0000,0000,0000,,Even then, ALS involves multiple genes
Dialogue: 0,0:03:27.76,0:03:31.13,Default,,0000,0000,0000,,with multiple possible impacts \Non motor neurons,
Dialogue: 0,0:03:31.13,0:03:34.12,Default,,0000,0000,0000,,making the precise triggers\Nhard to pinpoint.
Dialogue: 0,0:03:34.12,0:03:38.83,Default,,0000,0000,0000,,When ALS arises sporadically,\Nthe list of possible causes grows:
Dialogue: 0,0:03:38.83,0:03:39.64,Default,,0000,0000,0000,,toxins,
Dialogue: 0,0:03:39.64,0:03:40.47,Default,,0000,0000,0000,,viruses,
Dialogue: 0,0:03:40.47,0:03:41.27,Default,,0000,0000,0000,,lifestyle,
Dialogue: 0,0:03:41.27,0:03:45.19,Default,,0000,0000,0000,,or other environmental factors \Nmay all play roles.
Dialogue: 0,0:03:45.19,0:03:47.54,Default,,0000,0000,0000,,And because there are \Nso many elements involved,
Dialogue: 0,0:03:47.54,0:03:53.40,Default,,0000,0000,0000,,there’s currently no single test that\Ncan determine whether someone has ALS.
Dialogue: 0,0:03:53.40,0:03:57.48,Default,,0000,0000,0000,,Nevertheless, our hypotheses \Non the causes are developing.
Dialogue: 0,0:03:57.48,0:04:01.77,Default,,0000,0000,0000,,One prevailing idea is that certain\Nproteins inside the motor neurons
Dialogue: 0,0:04:01.77,0:04:03.64,Default,,0000,0000,0000,,aren’t folding correctly,
Dialogue: 0,0:04:03.64,0:04:05.73,Default,,0000,0000,0000,,and are instead forming clumps.
Dialogue: 0,0:04:05.73,0:04:10.49,Default,,0000,0000,0000,,The misfolded proteins and clumps \Nmay spread from cell to cell.
Dialogue: 0,0:04:10.49,0:04:13.47,Default,,0000,0000,0000,,This could be clogging up normal\Ncellular processes,
Dialogue: 0,0:04:13.47,0:04:17.55,Default,,0000,0000,0000,,like energy and protein production, \Nwhich keep cells alive.
Dialogue: 0,0:04:17.55,0:04:21.29,Default,,0000,0000,0000,,We’ve also learned that along with \Nmotor neurons and muscle fibers,
Dialogue: 0,0:04:21.29,0:04:24.35,Default,,0000,0000,0000,,ALS could involve other\Ncell types.
Dialogue: 0,0:04:24.35,0:04:29.16,Default,,0000,0000,0000,,ALS patients typically have inflammation \Nin their brains and spinal cords.
Dialogue: 0,0:04:29.16,0:04:34.28,Default,,0000,0000,0000,,Defective immune cells may also play \Na role in killing motor neurons.
Dialogue: 0,0:04:34.28,0:04:38.35,Default,,0000,0000,0000,,And ALS seems to change the\Nbehavior of specific cells
Dialogue: 0,0:04:38.35,0:04:41.03,Default,,0000,0000,0000,,that provide support for neurons.
Dialogue: 0,0:04:41.03,0:04:43.92,Default,,0000,0000,0000,,These factors highlight \Nthe disease’s complexity,
Dialogue: 0,0:04:43.92,0:04:47.96,Default,,0000,0000,0000,,but they may also give us a fuller\Nunderstanding of how it works,
Dialogue: 0,0:04:47.96,0:04:50.13,Default,,0000,0000,0000,,opening up new avenues for treatment.
Dialogue: 0,0:04:50.13,0:04:54.14,Default,,0000,0000,0000,,And while that may be gradual,\Nwe’re making progress all the time.
Dialogue: 0,0:04:54.14,0:04:56.28,Default,,0000,0000,0000,,We’re currently developing new drugs,
Dialogue: 0,0:04:56.28,0:04:59.23,Default,,0000,0000,0000,,new stem cell therapies \Nto repair damaged cells,
Dialogue: 0,0:04:59.23,0:05:03.59,Default,,0000,0000,0000,,and new gene therapies \Nto slow the advancement of the disease.
Dialogue: 0,0:05:03.59,0:05:06.04,Default,,0000,0000,0000,,With our growing arsenal of knowledge,
Dialogue: 0,0:05:06.04,0:05:09.00,Default,,0000,0000,0000,,we look forward to discoveries\Nthat can change the future
Dialogue: 0,0:05:09.00,0:05:11.01,Default,,0000,0000,0000,,for people living with ALS.