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As the Food and Drug Administration’s chief of neurology drugs, Billy Dunn was known as a hard-nosed regulator who later shepherded controversial medicines to approval under the guise of FDA “flexibility.” Now, Dunn has announced he’s retiring from the FDA, leaving the office to a regulator who is largely an unknown entity but whose decisions will carry huge weight.

Teresa Buracchio, a physician and 10-year veteran of the FDA, was named Monday the acting director of the Office of Neuroscience. She is stepping into an increasingly powerful position at the agency, overseeing an office that is set to make several critical approval decisions in the coming months.

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The Office of Neuroscience has become busier and its decisions more consequential as drugmakers have harnessed new scientific understandings to develop first-ever treatments ranging from rare, genetic diseases affecting children to ailments like Alzheimer’s disease that impact millions of older people.

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