Last month we saw a big shift in the federal government’s approach to psychedelic medicine.

Specifically, following an executive order by President Trump, the FDA announced it is fast-tracking its review of several clinical trials of psychedelic drugs for patients with mental health disorders. The executive order also directed more funds towards psychedelic research and a review of psychedelics’ status as highly restricted Schedule 1 substances.

To help us understand what all this means for the future of psychedelic medicine and the neuroscience of psychedelics, we’re joined by Boris Heifets, an anesthesiologist at Stanford Medicine who runs a lab studying how psychedelics affect the nervous system and their impact on patients with psychiatric conditions.

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Today’s episode is about the neuroscience of hard work—or maybe more specifically, the value we place on hard work.

There’s something different about hiking to the top of a mountain versus taking a helicopter. The view from the top is exactly the same, but if you’ve done the hard slog to get there, the payoff is going to be much more rewarding.

The question is, how does the brain know the difference? To answer this, we need to take a deep dive into the brain’s reward system, and one of our favorite neurotransmitters, dopamine. And it turns out, the way dopamine operates is more complicated than we thought.

Our guest today, Stanford Medicine psychiatrist Neir Eshel, tells us about new research that’s starting to reveal exactly how the brain pushes us to work hard for the things that matter to us.

Learn More

• Eshel's Stanford Translational Addiction and Aggression Research (STAAR) Lab
• Why we value things more when they cost us more (Stanford Medicine, 2026)
• Cholinergic modulation of dopamine release drives effortful behaviour (Nature, 2026)
• Striatal dopamine integrates cost, benefit, and motivation (Neuron, 2023)
• Dopamine and serotonin work in opposition to shape learning (Wu Tsai Neuro, 2024)
• Why we do what we do (From Our Neurons to Yours, 2024)

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Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience.

We want to hear from your neurons! Email us at at neuronspodcast@stanford.edu

Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.

Traditionally, we think of Parkinson's as a movement disorder—defined by slowed movement, stiff muscles, and involuntary shaking. But it turns out there are other symptoms that appear years or even decades before movement problems bring patients to the clinic: sleep disturbances, chronic constipation, and loss of smell.

For today's guest, these early symptoms represent an incredible opportunity to understand where Parkinson's begins and to identify patients much earlier in the disease.

Kathleen Poston is a neurologist and division chief for movement disorders at Stanford Medicine. She's also a member of the steering committee for the Knight Initiative for Brain Resilience at Wu Tsai Neuro, and advises the Michael J. Fox Foundation and pharmaceutical companies on Parkinson's research.

We discuss why non-motor symptoms might hold the key to early diagnosis, how new biomarkers are redefining the disease, and whether Parkinson's might actually start in the gut.

Learn More

• Learn about Poston's research on her lab site
• Learn about the Stanford Lewy Body Dementia Research Center of Excellence
• Redefining Parkinson's Disease | Our previous conversation with Poston, in which we learned about a sea change in our understanding of Parkinson's Disease.
• Neuroscientists dive into the gut (Wu Tsai Neuro, 2025) | Our 2025 Symposium explored how our brains and bodies communicate—and what that means for our health and well-being
• Parkinson’s comes in many forms. New biomarkers may explain why (Knight Initiative, 2025) | Blood and cerebrospinal fluid markers tied to inflammation and metabolism sort some patients into subgroups, a step toward predicting progression and tailoring care.
• A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research (The Lancet - Neurology, 2024)
• International Working Group Proposes New Framework for Defining Parkinson Disease Based on Biology, Not Symptoms (Neurology Live article)

Send us a text!

Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience.

We want to hear from your neurons! Email us at at neuronspodcast@stanford.edu

Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.