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Journal of Cognitive Enhancement

, Volume 2, Issue 4, pp 364–368 | Cite as

Cognitive Enhancement with Brain Implants: the Burden of Abnormality

  • F. GilbertEmail author
  • P. Tubig
Original Article

Abstract

Reported clinical cases of patients with neurological disorders who have received brain implants which produced some degrees of cognitive enhancement introduce the possibility of using implantable neurotechnologies in healthy individual brains. However, little is known about the phenomenology of using implants for cognitive gains. Even if brain implants could augment one’s cognitive capacities, it would not guarantee a net benefit for the implanted individual. In this article, we examine the potential psychiatric effects of increased cognitive capacities, namely the burden of abnormality. We draw on a parallel phenomenon, known as the burden of normality, from clinical studies when patients who became suddenly symptom free after treatment with deep brain stimulation experienced psychiatric adverse effects. While we agree that cognitive enhancement could generate important postoperative benefits, we argue that patients augmenting their capacities will likely experience abnormality as much as, or perhaps even more so than normality.

Keywords

Brain implant Burden of abnormality Burden of normality Cognitive capacities Cognitive enhancement Deep brain stimulation Parkinson’s disease Psychiatric adverse effects 

Notes

Acknowledgements

We are grateful to the Journal of Cognitive Enhancement anonymous reviewers and editors for their valuable comments.

Funding information

This work was supported by grants from the National Science Foundation (NSF Award #EEC-1028725) and the Australian Research Council (DECRA award Project Number DE150101390).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

References

  1. Adrian, W., Laxton Tang-Wai, D. F., McAndrews, M. P., et al. (2010). A phase I trial of deep brain 436 stimulation of memory circuits in Alzheimer’s disease. Annals of Neurology, 68(4), 521–534.CrossRefGoogle Scholar
  2. Berney, A., Vingerhoets, F., Perrin, A., Guex, P., Villemure, J.-G., Burkhard, P. R., Benkelfat, C., & Ghika, J. (2002). Effect on mood of subthalamic DBS for Parkinson’s disease: a consecutive series of 24 448 patients. Neurology, 59, 1427–1429.CrossRefGoogle Scholar
  3. Bosanac, P., Hamilton, B. E., Lucak, J., et al. (2018). BMC Psychiatry, 18, 186.  https://doi.org/10.1186/s12888-018-1771-2.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Colzato, L. S., & Arntz, F. E. (2017). Ritalin. In L. Colzato (Ed.), Theory-driven approaches to cognitive enhancement. Cham: Springer.CrossRefGoogle Scholar
  5. Colzato, L. S., Wolters, G., & Peifer, C. (2018). Transcutaneous vagus nerve stimulation (tVNS) modulates flow experience. Experimental Brain Research, 236, 253.  https://doi.org/10.1007/s00221-017-5123-0.CrossRefPubMedGoogle Scholar
  6. Erler, A. N. (2011) Does Memory Modification Threaten Our Authenticity? 4: 235. doi: https://doi.org/10.1007/s12152-010-9090-4
  7. Garasic, M. D., & Lavazza, A. (2016). Moral and social reasons to acknowledge the use of cognitive enhancers in competitive-selective contexts. BMC Medical Ethics, 17, 18.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Ghanavati, E., Nejati, V., & Salehinejad, M. A. (2018). Transcranial direct current stimulation over the posterior parietal cortex (PPC) enhances figural fluency: implications for creative cognition. J Cogn Enhanc, 2, 88.  https://doi.org/10.1007/s41465-017-0059-7.CrossRefGoogle Scholar
  9. Gilbert, F. (2018). Deep brain stimulation: inducing self-estrangement. Neuroethics, 11(2), 157–165.  https://doi.org/10.1007/s12152-017-9334-7.CrossRefGoogle Scholar
  10. Gilbert, F., Goddard, E., JNM, V., et al. (2017a). I miss being me: phenomenological effects of deep brain stimulation. AJOB Neuroscience, 8(2), 96–109.CrossRefGoogle Scholar
  11. Gilbert, F., Cook, M., O’Brien, T., et al. (2017b). Embodiment and estrangement: results from a first-in-human “intelligent BCI” trial. Science and Engineering Ethics.  https://doi.org/10.1007/s11948-017-0001-5.
  12. Gilbert, F. (2015a). Self-estrangement and deep brain stimulation: ethical issues related to forced explantation. Neuroethics, 8(2), 107–114.CrossRefGoogle Scholar
  13. Gilbert, F. (2015b). A threat to autonomy? The intrusion of predictive brain implants. AJOB Neuroscience, 6(4), 4–11.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Gilbert, F. (2013a). Deep brain stimulation for treatment resistant depression: postoperative feelings of self-estrangement, suicide attempt and impulsive-aggressive behaviours. Neuroethics, 6(3), 473–481.CrossRefGoogle Scholar
  15. Gilbert, F. (2013b). Deep brain stimulation and postoperative suicidability among treatment resistant depression patients: should eligibility protocols exclude patients with history of suicide attempts and anger/impulsivity? AJOB Neuroscience, 4(1), 28–35.CrossRefGoogle Scholar
  16. Gilbert, F. (2012). The burden of normality: from ‘chronically ill’ to ‘symptom free’. New ethical challenges for deep brain stimulation postoperative treatment. Journal of Medical Ethics, 38, 408–412.CrossRefPubMedGoogle Scholar
  17. Hamani, C., McAndrews, M. P., Cohn, M., Oh, M., Zumsteg, D., Shapiro, C. M., Wennberg, R. A., & Lozano, A. M. (2008). Memory enhancement induced by hypothalamic/fornix deep brain stimulation. Ann 495 Neurol, 63, 119–123.CrossRefGoogle Scholar
  18. Haq, I., Foote, K., Goodman, W., Ricciuti, N., Ward, H., Sudhyadhom, A., Jacobson, C., Siddiqui, M., & Okun, M. (2010). A case of mania following deep brain stimulation for obsessive compulsive disorder. 498. Stereotact Funct Neurosurg, 88, 322–328.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Houeto, J. L., Mesnage, V., Mallet, L., Pillon, B., Gargiulo, M., du Moncel, S. T., et al. (2002). Behavioural 509 disorders, Parkinson’s disease and subthalamic stimulation. Journal of Neurology, Neurosurgery, and Psychiatry, 510(72), 701–707.CrossRefGoogle Scholar
  20. Juth, N. (2011). Enhancement, autonomy, and authenticity. In J. Savulescu, R. ter Meulen, & G. Kahane (Eds.), Enhancing human capacities (pp. 34–48). Oxford: Blackwell Publishing Ltd.Google Scholar
  21. Lavazza, A. T. (2017). Moral bioenhancement through memory-editing: a risk for identity and authenticity?  https://doi.org/10.1007/s11245-017-9465-9.
  22. Lavazza, A., & Garasic, M. D. (2017). How non-invasive brain stimulation might invade our sphere of justice. J Cogn Enhanc, 1, 31.  https://doi.org/10.1007/s41465-017-0008-5.CrossRefGoogle Scholar
  23. Savulescu, J., Sandberg, A., & Kahane, G. (2011). Well-being and enhancement. In J. Savulescu, R. ter Meulen, & G. Kahane (Eds.), Enhancing human capacities (pp. 3–18). Oxford: Blackwell Publishing Ltd.CrossRefGoogle Scholar
  24. Schupbach, M., Gargiulo, M., Welter, M. L., et al. (2006). Neurosurgery in Parkinson disease: a distressed mind in a repaired body? Neurology, 66, 1811–1816.CrossRefPubMedGoogle Scholar
  25. Tsai, H. C., Chen, S. Y., Tsai, S. T., Hung, H. Y., & Chang, C. H. (2010). Hypomania following bilateral ventral 564 capsule stimulation in a patient with refractory obsessive-compulsive disorder. Biological Psychiatry, 565(68), 7–8.CrossRefGoogle Scholar
  26. Viaña, J. N. M., Bittlinger, M., et al. (2017a). Ethical considerations for deep brain stimulation trials in patients with early-onset Alzheimer’s disease. Journal of Alzheimer’s Disease, 58(2), 289–301.  https://doi.org/10.3233/JAD-161073.CrossRefPubMedGoogle Scholar
  27. Viaña, J. N. M., Vickers, J. C., et al. (2017b). Currents of memory: recent progress, translational challenges, and ethical considerations in fornix deep brain stimulation trials for Alzheimer’s disease. Neurobiology of Aging, 56, 202–210.  https://doi.org/10.1016/j.neurobiolaging.2017.03.001.CrossRefPubMedGoogle Scholar
  28. Weber K, Baertschi M, Radomska M. Flores Alves dos Santos, Canuto a. (2017) Post-treatment burden of normality after deep brain stimulation in neurological disorders. Brain Stimulation 2017;10(2):371.Google Scholar
  29. Wilson, S., Bladin, P., & Saling, M. (2007). The burden of normality: a framework for rehabilitation after epilepsy surgery. Epilepsia, 48(9), 13–16.CrossRefPubMedGoogle Scholar
  30. Wilson, S., Bladin, P., & Saling, M. (2001). The “burden of normality”: concepts of adjustment after surgery for seizures. Journal of Neurology, Neurosurgery, and Psychiatry, 70(5), 649–656.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.School of HumanitiesUniversity of TasmaniaHobartAustralia
  2. 2.Centre for NeurotechnologyUniversity of WashingtonSeattleUSA
  3. 3.Department of PhilosophyUniversity of WashingtonSeattleUSA

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