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
•  ...
What is cognitive enhancement?
• Improving the cognition of a cognitively
  normal person
• Corneliu Giurgea, mid-century ...
Outline of lecture
•   Definition: What is a CE?
•   Stimulants: (How) do they work as CEs?
•   Epidemiology of CE use
•  ...
Stimulants as CEs
• Amphetamine (most
  commonly as
  Adderall)
• Methylphenidate
  (aka Ritalin)
• How do these drugs
  a...
Stimulants as CEs
Memory enhancement: From: Breitenstein, et al. (2004). Neuropsychopharm.




                           ...
Stimulants as CEs
Executive function enhancement: sharp dependence on
individual characteristics. E.g. Mattay et al. 2003,...
Stimulants as CEs
Executive function enhancement: sharp dependence on individual
characteristics. E.g. Farah et al. 2008, ...
Stimulants as CEs




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

       ...
Outline of lecture
•   Definition: What is a CE?
•   Stimulants: (How) do they work as CEs?
•   Epidemiology of CE use
•  ...
Who’s using, where, why?
• McCabe et al, 2005, Addiction:
  – ~11,000 college students
  – Lifetime prevalence overall: 6....
Nature poll




The Vermont vacation problem…. much to be learned

                                                    12
Outline of lecture
•   Definition: What is a CE?
•   Stimulants: (How) do they work as CEs?
•   Epidemiology of CE use
•  ...
Other drugs with CE potential
•   Atomoxetine (NE)
•   Donepezil and other Ach drugs
•   Modafinil
•   Piracetam
•   Novel...
Devices
          •   TMS
          •   tDCS
          •   DBS
          •   chips




                      15
Outline of lecture
•   Definition: What is a CE?
•   Stimulants: (How) do they work as CEs?
•   Epidemiology of CE use
•  ...
Ethical, legal and social issues
• Safety (note esp addiction risk w stimulants)




                                     ...
Ethical, legal and social issues
• Safety
• Fairness




                                       18
Ethical, legal and social issues
• Safety
• Fairness
• Freedom




                                      19
Ethical, legal and social issues
• Safety
• Fairness
• Freedom




                                      20
Ethical, legal and social issues
•   Safety
•   Fairness
•   Freedom
•   Legality,
    professional
    ethics



        ...
Ethical, legal and social issues
• Safety
• Fairness
• Freedom
• Legality,
  professional
  ethics
• Personhood,
  agency,...
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Cognative Enhancement

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Cognative Enhancement

  1. 1. Neuroethics Learning Collaborative Brain enhancement I: Cognitive enhancement
  2. 2. 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 2
  3. 3. 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 3
  4. 4. 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 4
  5. 5. Stimulants as CEs • Amphetamine (most commonly as Adderall) • Methylphenidate (aka Ritalin) • How do these drugs affect cognition? – catecholamines, esp dopamine 5
  6. 6. Stimulants as CEs Memory enhancement: From: Breitenstein, et al. (2004). Neuropsychopharm. 6
  7. 7. Stimulants as CEs Executive function enhancement: sharp dependence on individual characteristics. E.g. Mattay et al. 2003, PNAS 7
  8. 8. Stimulants as CEs Executive function enhancement: sharp dependence on individual characteristics. E.g. Farah et al. 2008, Psychopharmacology 8
  9. 9. Stimulants as CEs Bottom line: May help some people, with some aspects of cognition, but certainly not all… 9
  10. 10. 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 10
  11. 11. 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 11
  12. 12. Nature poll The Vermont vacation problem…. much to be learned 12
  13. 13. 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 13
  14. 14. Other drugs with CE potential • Atomoxetine (NE) • Donepezil and other Ach drugs • Modafinil • Piracetam • Novel memory drugs 14
  15. 15. Devices • TMS • tDCS • DBS • chips 15
  16. 16. 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 16
  17. 17. Ethical, legal and social issues • Safety (note esp addiction risk w stimulants) 17
  18. 18. Ethical, legal and social issues • Safety • Fairness 18
  19. 19. Ethical, legal and social issues • Safety • Fairness • Freedom 19
  20. 20. Ethical, legal and social issues • Safety • Fairness • Freedom 20
  21. 21. Ethical, legal and social issues • Safety • Fairness • Freedom • Legality, professional ethics 21
  22. 22. Ethical, legal and social issues • Safety • Fairness • Freedom • Legality, professional ethics • Personhood, agency, deserts 22

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