Neuroethics Learning Collaborative

Brain enhancement I: Cognitive enhancement

Outline of lecture

• Definition: What is a CE?

• Stimulants: (How) do they work as CEs?

• Epidemiology of CE use

• Beyond stimulants: Other CEs– Drugs

– Devices

• Ethical, legal and social issues

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What is cognitive enhancement?

• Improving the cognition of a cognitively normal person

• Corneliu Giurgea, mid-century Romanian psychopharmacologist: “Man is not going to wait passively for millions of years before evolution offers him a better brain”

• Virtually all CE drugs were developed for treating neuropsychiatric illness

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Outline of lecture

• Definition: What is a CE?

• Stimulants: (How) do they work as CEs?

• Epidemiology of CE use

• Beyond stimulants: Other CEs– Drugs

– Devices

• Ethical, legal and social issues

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Stimulants as CEs• Amphetamine (most

commonly as Adderall)

• Methylphenidate (aka Ritalin)

• How do these drugs affect cognition?– catecholamines, esp

dopamine

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Stimulants as CEs

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Memory enhancement: From: Breitenstein, et al. (2004). Neuropsychopharm.

Stimulants as CEs

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Executive function enhancement: sharp dependence on individual characteristics. E.g. Mattay et al. 2003, PNAS

Stimulants as CEs

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Executive function enhancement: sharp dependence on individual characteristics. E.g. Farah et al. 2008, Psychopharmacology

Stimulants as CEs

Bottom line: May help some people, with some aspects of cognition, but certainly not all…

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Outline of lecture

• Definition: What is a CE?

• Stimulants: (How) do they work as CEs?

• Epidemiology of CE use

• Beyond stimulants: Other CEs– Drugs

– Devices

• Ethical, legal and social issues

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Who’s using, where, why?

• McCabe et al, 2005, Addiction:– ~11,000 college students

– Lifetime prevalence overall: 6.9%

– Campuses ranged from 0-25% past year prevalence

• Reasons, methods, frequencies… much to be learned

• People other than US college students… much to be learned

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Nature poll

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The Vermont vacation problem…. much to be learned

Outline of lecture

• Definition: What is a CE?

• Stimulants: (How) do they work as CEs?

• Epidemiology of CE use

• Beyond stimulants: Other CEs– Drugs

– Devices

• Ethical, legal and social issues

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Other drugs with CE potential

• Atomoxetine (NE)

• Donepezil and other Ach drugs

• Modafinil

• Piracetam

• Novel memory drugs

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Devices• TMS

• tDCS

• DBS

• chips

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Outline of lecture

• Definition: What is a CE?

• Stimulants: (How) do they work as CEs?

• Epidemiology of CE use

• Beyond stimulants: Other CEs– Drugs

– Devices

• Ethical, legal and social issues

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Ethical, legal and social issues

• Safety (note esp addiction risk w stimulants)

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Ethical, legal and social issues

• Safety

• Fairness

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Ethical, legal and social issues

• Safety

• Fairness

• Freedom

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Ethical, legal and social issues

• Safety

• Fairness

• Freedom

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Ethical, legal and social issues

• Safety

• Fairness

• Freedom

• Legality, professional ethics

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Ethical, legal and social issues

• Safety

• Fairness

• Freedom

• Legality, professional ethics

• Personhood, agency, deserts

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