The NIH continues to lose senior leadership as National Institute of Neurological Disorders and Stroke (NINDS) director Walter Koroshetz, M.D., departs, leaving many institutes under interim leadership. Reports cite growing instability at the agency, with multiple leadership exits contributing to concerns about program continuity and strategic direction. The departures come at a time when NIH faces policy and budget pressures; institute reorganization and interim appointments could slow grant reviews, strategic initiatives and translational partnerships. Academic and industry stakeholders are watching for signals on NIH research priorities and funding stability for neuroscience programs.