Journal of Cognitive Enhancement

, Volume 2, Issue 4, pp 356–363 | Cite as

Neuroethical Implications of Neurocognitive Enhancement in Managerial Professional Contexts

  • Giulia Fronda
  • Michela Balconi
  • Davide Crivelli


In last years, neurocognitive enhancement represents a field of great interest and a debated topic in literature. The neuroenhancement concerns the use of different neuroscientific methods that increase individuals’ cognitive performance operating on the brain and the nervous system. Recent studies have indeed highlighted how neuroscientific techniques could improve specific functions such as attention, perception, and memory in clinical and experimental contexts. The development of new and different techniques of neurocognitive enhancement leads to the necessity to investigate the ethical and legal implications related to the use of these tools for the enhancement of mental and physical functions. In particular, this work highlights the ethical and moral implications of the use of neurocognitive tools and techniques based on awareness practices and supported by the use of a wearable device. This paper, therefore, offers an overview of the criticalities and benefits of the use of neurocognitive enhancement techniques on individuals and society, highlighting particularly the use of neurocognitive enhancement within professional contexts in the improvement of organizations effectiveness, coordination, and productivity.


Neurocognitive enhancement Neuroethics Professional contexts Manager Wearable devices 

What Is the Neurocognitive Enhancement?

The scientific definition of enhancement concept appears to be difficult. One of the main questions related to this topic concerns the fact whether the enhancement can be considered as the improvement of a specific function compared to its previous operation or over a certain point.

The term neuroenhancement, indeed, refers, generally, to the increase and the improvement of cognitive functioning (Farah 2005; Lucke and Partridge 2013; Nagel 2010a, 2014; O’Connor and Nagel 2017; Parens 1998), through the use of different neuroscientific technologies and tools, that operating on the brain and central or peripheral nervous system, altering their properties during the development of a specific cognitive task. Considering, therefore, the multicomponential nature of cognition as a set of processes and functions, such as perception, attention, memory, and learning, neurocognitive enhancement interventions can be aimed at improving one or some of these abilities, extending mental cognition through the improvement of internal and external information processing systems. In particular, specific training for neurocognitive enhancement can be aimed at improving and enhancing a specific cognitive function or certain cognitive strategies (Chapman and Mudar 2014; Clare and Woods 2004; Martin et al. 2011).

Neurocognitive enhancement has been mainly interpreted in terms of increase, decrease, and optimization. According to increase meaning, neurocognitive enhancement refers to interventions aimed at improving cognitive abilities’ operation over normal functionality (Bostrom and Sandberg 2009; Harris 2007). In this case, the improvement is considered as an intervention finalized to enhance human operation beyond the necessary for the maintenance of a good human health condition (Juengst 1998). Neurocognitive enhancement has also been interpreted in terms of individual general well-being improvement by decreasing the functionality of a capacity or its effects (Earp et al. 2014; Savulescu et al. 2011). The third concept of neurocognitive enhancement, finally, considers the enhancement of any intervention aimed at optimizing specific cognitive functions to support performance in day-to-day tasks (Anand et al. 2011; Metzinger and Hildt 2011).

The aim of neurocognitive enhancement interventions is, therefore, to modulate cognitive operation, through the increase or decrease of some cognitive functions, not only to improve performance and achieve an optimal level of functioning in a given specific task (Agar 2014b) but also to promote flexible behaviors to the external environment. Several pieces of research, indeed, have shown that the application of cognitive training to improve cognitive functions is useful for the development of different performances during daily activities (Anguera et al. 2013; Carlson et al. 2009; Chapman and Mudar 2013; Dahlin et al. 2008; Nyberg et al. 2003; Jaeggi et al. 2008; Valenzuela et al. 2008; Zelinski 2009).

How to Obtain Neurocognitive Enhancement

The interest in definition, use, and ethical implications of neurocognitive enhancement has increased in recent years. In particular, the interest of neuroscience studies has focused on various types of interventions that allow enhancing brain functions and human capabilities (Cohen Kadosh et al. 2012; Hyman 2011). Recently, in addition to stabilizing pharmacological treatments, the effects of new non-invasive cognitive enhancement treatments have been explored for their induction of neuromodulatory or neurostimulatory effects on the brain. Specifically, several studies (Berryhill and Jones 2012; Coffman et al. 2014) have observed the efficacy of non-invasive brain stimulation techniques (NIBS) and electrical stimulation (TES) on the enhancement of cognitive functions (Brunoni et al. 2012; Flöel et al. 2011). Moreover, different studies have demonstrated the effects of methodological techniques, especially awareness-based, on cognitive enhancement through cognitive processes regulation and changes in brain structure (Balconi et al. 2017; Schooler 1984; Schooler et al. 1999). In particular, following a training (Engvig et al. 2012; Lewis et al. 2009; Lövdén et al. 2010; Strenziok et al. 2014; Voss et al. 2012) aimed to increase specific cognitive functions (Madden et al. 2009a), there were modifications in structural and functional brain connectivity. In addition to neuromodulatory techniques, several studies have reported the efficacy of neurofeedback in cognitive enhancement on healthy individuals (Brunoni et al. 2012; Flöel et al. 2011). Neurofeedback, indeed, is a technique that, based on the principle of operating conditioning, allows individuals to learn to self-regulate their cortical activity. The basic principle of neurofeedback is to measure brain activity, process the brain patterns of interest, and provide the user feedback stimuli related to the activity of processed cortical rhythms. In addition to neurofeedback, biofeedback is also a technique that allows physiological self-regulation, permitting central and peripheral nervous system functions voluntary control. Specifically, this self-regulation is acquired through a form of “instrumental learning” that allows individuals to regulate their behavior in response to actions consequences, repeating or avoiding their conduct (Balconi and Bortolotti 2012; Gruzelier and Egner 2004).

Another cognitive enhancement technique is the mental and motor imagination practice used with the intention to improve individuals’ performance (Mulder et al. 2004; Papadelis et al. 2007). Specifically, several studies have shown how mental images can influence some cognitive and behavioral components useful for performing various activities, such as muscle strength and movement speed (Gentili et al. 2006; Pascual-Leone et al. 1995). In addition, other studies have demonstrated the effectiveness of this technique in enhancing and improving cognitive and motor skills (Denis 1985; Finke and Kosslyn 1980; Papadelis et al. 2007). The evidence on mental imagination effectiveness for performance improvement has extended the use of this techinique in clinical settings for the rehabilitation of certain deficits that compromise several neurological functions (Page et al. 2001). The functionality of this technique in improving both cognitive and motor performances may be due to the fact that the prolonged performance of imagination tasks provides marked physiological changes (Decety et al. 1991, 1993; Ingvar and Philipson 1977; Jacobson 1932; Roland et al. 1980). In addition to neuromodulation, physiological self-control, and mental imagination techniques, other studies have, instead, observed the efficacy of awareness-based practices, such as mindfulness, on neurocognitive improvement. Specifically, mindfulness, consisting of a particular form of meditation therapy, has recently been objected of specific attention following the increasing application of individual psychological well-being (Balconi et al. 2017; Crivelli et al. 2018; Keng et al. 2011; Khoury et al. 2013). Mindfulness practices, indeed, allow individual to perceive and accept consciously his own mental states and the associated physiological feelings (Hayes and Feldman 2004; Kabat-Zinn 1990; Keng et al. 2011). Several pieces of research have shown the efficacy of mindfulness training in attention self-regulation (Bishop et al. 2004; Brown and Ryan 2003; Crivelli et al. 2018; Lau et al. 2006), memory, and other cognitive functions (Gunaratana 1993; Kapleau 1965; Teasdale et al. 1995). Specifically, some studies have shown the efficacy of brief awareness-based training in the improvement of sustained attention, decreasing anxiety (Rooks et al. 2017) and working memory decline (Jha et al. 2017).

Mindfulness training and practices also involve advantages in psychological state, reducing cognitive reactivity and mental rumination (Kumar et al. 2008; Raes et al. 2009), decreasing physiological stress reactivity markers (Pascoe and Crewther 2016) and sympathetic nervous system activation (Nesse et al. 2016). In particular, a study of Balconi et al. (2017) has observed the conscious and unconscious mechanisms of a mindfulness training, supported by the use of a wearable device, in emotion regulation and stress management, demonstrating how mindfulness practices are useful in the control of affective reactions to external stimuli and stressful events, improving the ability to manage negative emotions at unconscious level.

Moreover, Cahn and Polich (2009) have observed the electroencephalographic (EEG) cortical patterns associated with mental relaxation states due to mindfulness practices, finding an increase in alpha and theta frontal area activities, related to change and relevance of attention function, and an increase of left-side frontal activation, related to the development of positive emotions (Davidson 1995; Everhart et al. 2003) according to the dual system model (Balconi and Pozzoli 2008; Balconi and Mazza 2009, 2010; Davidson and Irwin 1999).

Furthermore, Creswell et al. (2007) have observed a decrease of bilateral activation of the amygdala related to mindfulness practices, associated to the absence of depressive symptoms and to a greater activation of the prefrontal cortex, particularly involving in emotional regulation processes (Balconi et al. 2015).

Many of neurocognitive enhancement techniques were originally developed for clinical application and are now increasing in the empowerment of healthy individuals. Indeed, neurocognitive enhancement techniques and tools have been used, in clinical field, for the treatment and rehabilitation of patients with diseases caused by neurological deficits and psychiatric disorders (Clark and Parasuraman 2014), proving efficacy in the improvement and compensation of specific brain deficits and dementias (Ayaz et al. 2006; Hunter et al. 2013; McKendrick et al. 2015).

Several studies, moreover, have shown the beneficial effects of neurocognitive enhancement on health promotion, autonomy, and success (Bostrom and Sandberg 2009; Clark and Parasuraman 2014; Greely et al. 2008; Harris 2007; Savulescu et al. 2011) and increase in learning and acquiring skills in complex tasks (Flöel 2014). Specifically, different studies have shown the efficacy of healthy individuals’ neurocognitive enhancement techniques in improving human performance in complex tasks and in acquiring skills related to demanding professions (Coffman et al. 2014; Parasuraman and Mckinley 2014).

Some Ethical Issues

Neurocognitive improvement is a debated topic for its neuroethics implications, in terms of safety, autonomy (Farah et al. 2004; Nagel 2010a; O’Connor and Nagel 2017; Parens 1998), justice (Nagel 2015; O’Connor and Nagel 2017; Ray 2016; Singh and Kelleher 2010), moral, and potential negative impacts on society (Sandel 2009; Schelle et al. 2014). Neuroethics, indeed, can be defined as the discipline that investigates ethical, legal, and social implications related to neuroscience developments and technologies applied to various social fields (Marcus 2002). In recent years, neuroethics interest has focused mainly on the development and use of neurocognitive enhancement techniques on healthy individuals (Farah et al. 2004). From an ethical perspective, the main concerns related to neurocognitive enhancement techniques have focused on the possible secondary effects and undesired consequences of brain structures and functions caused by cognitive improvement tools (Bostrom and Sandberg 2009; Farah et al. 2004; Farah 2005). Considering the evidences emerged on negative neuroethics implications of neurocognitive improvement, several studies have observed the impact of healthy individuals’ cognitive enhancement on society (Caplan and Mobley 2002; Fuchs 2006), evaluating it as a threat to inter-individual equity that leads to the creation of a homogeneous population, suppressing individual differences (Butcher 2003). Moreover, other studies have criticized healthy individuals’ neurocognitive enhancement as an intervention that can change individuals personality (Elliott 1998; Farah 2005; Farah et al. 2004; Wolpe 2002), removing differences and lacking skills that represent individuals’ distinctive personality traits (Farah et al. 2004).

On the contrary, considering the potential positive effects and the usefulness of neurocognitive enhancement, other studies have observed the possibility, provided by neurocognitive improvement techniques, to remove social unfair inequalities (Bostrom and Sandberg 2009) and to produce individuals and social positive effects, demonstrated by the increase of some functions operation such as working memory, attention, and cognition, and by the improvement of performance and successful activities (Sahakian and Morein-Zamir 2007). Specifically, several pieces of research have shown the efficacy of neurocognitive enhancement techniques in the improvement of cognitive processes that particularly involve attention and response processing speed (Lezak et al. 2012; Marraccini et al. 2016; Riccio et al. 2001; Schlösser et al. 2009). Moreover, other studies have observed the usefulness of neurocognitive enhancement techniques in increasing several abilities, such as action planning and decision-making, that involve the use of memory, impulse control, and sustained attention (Ilieva et al. 2015; Lezak et al. 2012; Marraccini et al. 2016; Koelega 1993; Riccio et al. 2001).

Neurocognitive Enhancement Within Professional Contexts

Considering the controversies that emerged in the previous paragraph related to neurocognitive enhancement on healthy individuals emerges the requirement to highlight conditions that allow defining neurocognitive enhancement intervention as acceptable and even desirable in terms of safety and moral impacts on society. According firstly to neuroethics safety principles respect, neurocognitive enhancement has to consider the typology of technology used for cognition improving. Indeed, differently from psychotropic drugs and brain-computer technologies, the employment of external devices for neuroenhancement, for example, is considered conventional and culturally accepted for the widespread effects on cognition, improving a greater number of cognitive abilities (Bostrom and Sandberg 2009). Several pieces of research, indeed, have demonstrated the usefulness of body-sensing devices, able to control and provide a feedback on improvements, in cognition enhancement (Balconi et al. 2017; Crivelli et al. 2018).

In particular, a study of Balconi et al. (2017) has observed the efficacy of a neurocognitive enhancement intervention, supported by the use of a wearable device with a system EEG recording connected to a dedicated smartphone app designed to support meditation practices, in cognitive performance improvement.

Moreover, a right ethically usefulness of a neurocognitive enhancement training has to consider the possible impacts and benefits on society. Indeed, the positive effects of neurocognitive enhancement on individuals and society represent, from an ethical perspective, the condition that allows defining as acceptable some neurocognitive strengthening techniques. As shown by several studies, indeed, neurocognitive enhancement can be considered an instrumental value from which society could benefit from individual improvement (Bostrom and Sandberg 2009; Harris 2009). Specifically, the usefulness of neurocognitive enhancement techniques for the enhancement of individuals and society has been demonstrated by a study of Balconi et al. (2017) that has observed the effects of neurocognitive enhancement in the improvement of tasks requiring high responsibilities and organizational skills (Santoni de Sio et al. 2014) within a managerial context. Specifically, the efficacy of a neurocognitive enhancement training based on 14-day mindfulness practices consisting of daily sessions has been demonstrated in the improvement of cognitive performance within a professional managerial context, where professionals occupying managerial positions are often submitted to the development of tasks requiring a high load of cognitive resources, which can increase the levels of negative stress (distress) causing a worsening of performance. In particular, the use of a cognitive enhancement training based on mindfulness practices, supported by a wearable sensing brain device, has provided a decrease in anxiety and perceived stress levels and an increase in control and inhibition processes during demanding task execution, leading to the development of successful performance and to the reduction of perceived stress. Work-related stress, indeed, influences the brain and cognition, compromising the operation of executive functions, attention, decision-making, and memory, causing a worsening of cognitive performance (Roozendaal et al. 2009). Neurocognitive enhancement within professional contexts and companies, therefore, can be considered useful to individuals cognition and abilities, improving individuals’ required activities learning skills and workers motivation. Moreover, neurocognitive enhancement in managerial contexts results to be useful in the reduction of physical and psychological stress levels work-related (Balconi et al. 2017). Specifically, within managerial and professional contexts, neurocognitive enhancement is efficacy in increasing employees performance and enhancing the efficiency of the organization. Indeed, the use of specific neurocognitive enhancement training for individuals working in organizations allows companies to improve factors that could limit performance achievement, to increase workers efficiency, and to facilitate the resolution of difficult working situations, especially in professions that require responsibility towards others.


This article provides, therefore, a current overview of the neurocognitive enhancement topic, highlighting critical and good aspects of the improvement of healthy individuals’ cognitive performances. Neuroethics, indeed, appears to be a complex discipline that investigates the ethical and moral norms of neurocognitive enhancement techniques employed to achieve individuals’ optimal cognitive performances. The main topics examined by neuroethics concern the explanation of corrective and safe methods for the facilitation and strengthening of different cognitive abilities (Butcher 2003; Chatterjee 2013; Cohen Kadosh 2013; Hildt and Franke 2013; Metzinger and Hildt 2011; Sahakian and Morein-Zamir 2011; Sandberg 2011). The technological advances that support neurocognitive enhancement, indeed, aim to enhance different sensory, communicative, motor, cognitive, and social functions. The neuroethics debate on healthy individuals’ cognitive enhancement focuses particularly on the definition of two fundamental points. The first concerns the specification of “normal” and “enhanced” brain (Caplan and Mobley 2002; Marcus 2002), while the second investigates the consequences that the use of different neurocognitive enhancement techniques and tools could have on individuals and society (Shook et al. 2014). Indeed, considering the extent of individual cognitive performance enhancement on the community, neuroethics must consider the positive and negative aspects of neurocognitive enhancement in public and social contexts. In this regard, the main worries about neurocognitive enhancement on society concern the inhomogeneity that could be created by healthy individuals’ cognitive enhancement, or, on the contrary, the possible individuals’ homologation that would lead to a loss of individual differences (Farah et al. 2004; Farah 2005). On the contrary, neurocognitive enhancement benefits on society are related to the improvement of useful functions in professional field improving workers performances and allowing companies to achieve a greater profit limiting certain compromising factors (Balconi et al. 2017). These benefits have demonstrated by several pieces of research that observed how neurocognitive enhancement leads society to greater benefits than costs (Heinz et al. 2012; Sandberg 2011). This last point appears to be relevant for neuroethics because a correct use of neurocognitive enhancement techniques must consider the benefits generated for society (Shook et al. 2014). Considering previous highlighted aspects, this article wants therefore to explore the possible neuroethics implications of the use of neurocognitive enhancement new devices on individuals and society, confirming the benefits of neurocognitive enhancement techniques based on the awareness practices in the improvement of individuals’ performances within professional and organizational contexts (Balconi et al. 2017; Harris 2009). In particular, this work wants to show the efficacy of the use of awareness-based neurocognitive enhancement techniques supported by the use of a wearable device in the improvement of performances requiring high levels of responsibility and in the development of excellent organizational management skills (Balconi et al. 2017), decreasing those factors that lead to a performance deterioration (Balconi et al. 2017; Roozendaal et al. 2009). The advantages reported on the efficacy of neurocognitive enhancement techniques within managerial contexts, therefore, open the way for the use of new neurocognitive enhancement methods within professional and company environments to increase workers functional and motivational skills, allowing the achievement of optimal results and the improvement of organizational efficiency, productivity, and coordination ensuring greater workers well-being.


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Authors and Affiliations

  1. 1.Research Unit in Affective and Social NeuroscienceCatholic University of the Sacred HeartMilanItaly
  2. 2.Department of PsychologyCatholic University of the Sacred HeartMilanItaly

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