Neurocognitive Enhancement: Applications and Ethical Issues
DOI:
https://doi.org/10.15540/nr.6.3.161Keywords:
neuroethics, neurocognitive enhancement, peak performance, wearable devices, sportsAbstract
In recent years, the interest in neurocognitive empowerment has increased, thus making it a hot topic, especially because of possible ethical implications. Specifically, the term neurocognitive empowerment refers to the use of different neuroscientific techniques and tools that increase the cognitive functioning of the individual beyond the normal threshold—on the one hand, improving functions such as attention, perception, and memory—and, on the other hand, physical and motor functions. Neuroethics is peculiarly interested in monitoring and discussing ethical implications and possible consequences or undesirable effects of neurocognitive strengthening techniques. In particular, the use of different tools for neurocognitive enhancement requires an in-depth analysis of the ethical and legal principles in terms of security and social justice that allow the improvement of mental and physical functions of an individual. The present work aims at introducing the use of specific techniques—such as neurofeedback devices for the enhancement of attention regulation skill—in specific application contexts; that is, sports in which athletes are continuously subjected to external pressures for performance and constant improvement. Furthermore, this document explores possible ethical critical issues raised by such use of neurocognitive enhancement techniques.
References
Agar, N. (2013). Truly human enhancement: A philosophical defense of limits. Cambridge, MA: MIT Press.
Alexeeva, M. V., Balios, N. V., Muravlyova, K. B., Sapina, E. V, & Bazanova, O. M. (2012). Training for voluntarily increasing individual upper alpha power as a method for cognitive enhancement. Human Physiology, 38(1), 40–48. https://doi.org/10.1134/S0362119711060028
Anguera, J. A., Boccanfuso, J., Rintoul, J. L., Al-Hashimi, O., Faraji, F., Janowich, J., … Gazzaley, A. (2013). Video game training enhances cognitive control in older adults. Nature, 501(7465), 97–101. https://doi.org/10.1038/nature12486
Antal, A., Nitsche, M. A., Kincses, T. Z., Kruse, W., Hoffmann, K.-P., & Paulus, W. (2004). Facilitation of visuo-motor learning by transcranial direct current stimulation of the motor and extrastriate visual areas in humans. European Journal of Neuroscience, 19(10), 2888–2892. https://doi.org/10.1111/j.1460-9568.2004.03367.x
Balconi, M., Fronda, G., & Crivelli, D. (2018). Effects of technology-mediated mindfulness practice on stress: Psychophysiological and self-report measures. Stress, 22(2), 200–209. https://doi.org/10.1080/10253890.2018.1531845
Balconi, M., Fronda, G., Venturella, I., & Crivelli, D. (2017). Conscious, pre-conscious and unconscious mechanisms in emotional behaviour. Some applications to the mindfulness approach with wearable devices. Applied Sciences, 7(12), 1280. https://doi.org/10.3390/app7121280
Balconi, M., Pala, F., Crivelli, D., & Milone, V. (2019). From investigation to intervention. Biofeedback and neurofeedback biomarkers in sport. In R. Carlstedt & M. Balconi (Eds.), Handbook of Sport Neuroscience and Psychophysiology (pp. 151–168). New York, NY: Routledge.
Bell, M., Bryson, G., Greig, T., Corcoran, C., & Wexler, B. E. (2001). Neurocognitive enhancement therapy with work therapy: Effects on neuropsychological test performance. Archives of General Psychiatry, 58(8), 763–768. https://doi.org/10.1001/archpsyc.58.8.763
Bell, S., Partridge, B., Lucke, J., & Hall, W. (2013). Australian university students’ attitudes towards the acceptability and regulation of pharmaceuticals to improve academic performance. Neuroethics, 6(1), 197–205. https://doi.org/10.1007/s12152-012-9153-9
Borducchi, D. M. M., Gomes, J. S., Akiba, H., Cordeiro, Q., Borducchi, J. H. M., Valentin, L. S. S., ... Dias, Á. M. (2016). Transcranial direct current stimulation effects on athletes’ cognitive performance: An exploratory proof of concept trial. Frontiers in Psychiatry, 7, 183. https://doi.org/10.3389/fpsyt.2016.00183
Bostrom, N., & Roache, R. (2011). Smart policy: Cognitive enhancement and the public interest. In J. Savulescu, R. ter Muelen, & G. Kahane (Eds.), Enhancing Human Capacities (pp. 138–152). Oxford, UK: Wiley-Blackwell.
Bostrom, N., & Sandberg, A. (2009). Cognitive enhancement: Methods, ethics, regulatory challenges. Science and Engineering Ethics, 15(3), 311–341. https://doi.org/10.1007/s11948-009-9142-5
Butcher, J. (2003). Cognitive enhancement raises ethical concerns. The Lancet, 362(9378), 132–133. https://doi.org/10.1016/s0140-6736(03)13897-4
Chapman, S. B., Aslan, S., Spence, J. S., DeFina, L. F., Keebler, M. W., Didehbani, N., & Lu, H. (2013). Shorter term aerobic exercise improves brain, cognition, and cardiovascular fitness in aging. Frontiers in Aging Neuroscience, 5, 75. https://doi.org/10.3389/fnagi.2013.00075
Chatterjee, A. (2004). Prospects for a cognitive neuroscience of visual aesthetics. Bulletin of Psychology and the Arts, 4(2), 55–60. https://doi.org/10.1037/e514602010-003
Cohen Kadosh, K., Johnson, M. H., Dick, F., Cohen Kadosh, R., & Blakemore, S. J. (2013). Effects of age, task performance, and structural brain development on face processing. Cerebral Cortex, 23(7), 1630–1642. https://doi.org/10.1093/cercor/bhs150
Colzato, L. S., Nitsche, M. A., & Kibele, A. (2017). Noninvasive Brain Stimulation and Neural Entrainment Enhance Athletic Performance—a Review. Journal of Cognitive Enhancement, 1(1), 73–79. https://doi.org/10.1007/s41465-016-0003-2
Crews, D. J., & Landers, D. M. (1993). Electroencephalographic measures of attentional patterns prior to the golf putt. Medicine and Science in Sports and Exercise, 25(1), 116–126. https://doi.org/10.1249/00005768-199301000-00016
Crivelli, D., Fronda, G., Venturella, I., & Balconi, M. (2019). Supporting mindfulness practices with brain-sensing devices. Cognitive and electrophysiological evidences. Mindfulness, 10(2), 301–311. https://doi.org/10.1007/s12671-018-0975-3
Curry, L. A., & Wagman, D. F. (2011). Qualitative description of the prevalence and use of anabolic androgenic steroids by united states powerlifters. Perceptual and Motor Skills, 88(1), 224–233. https://doi.org/10.2466/pms.1999.88.1.224
Dahlin, E., Nyberg, L., Bäckman, L., & Neely, A. S. (2008). Plasticity of executive functioning in young and older adults: Immediate training gains, transfer, and long-term maintenance. Psychology and Aging, 23(4), 720–730. https://doi.org/10.1037/a0014296
Davis, N. J. (2013). Neurodoping: Brain stimulation as a performance-enhancing measure. Sports Medicine, 43(8), 649–653. https://doi.org/10.1007/s40279-013-0027-z
Dodge, T., Williams, K. J., Marzell, M., & Turrisi, R. (2012). Judging cheaters: Is substance misuse viewed similarly in the athletic and academic domains? Psychology of Addictive Behaviors, 26(3), 678–682. https://doi.org/10.1037/a0027872
Engvig, A., Fjell, A. M., Westlye, L. T., Skaane, N. V., Sundseth, Ø., & Walhovd, K. B. (2012). Hippocampal subfield volumes correlate with memory training benefit in subjective memory impairment. NeuroImage, 61(1), 188–194. https://doi.org/10.1016/j.neuroimage.2012.02.072
Enriquez-Geppert, S., Huster, R. J., & Herrmann, C. S. (2013). Boosting brain functions: Improving executive functions with behavioral training, neurostimulation, and neurofeedback. International Journal of Psychophysiology, 88(1), 1–16. https://doi.org/10.1016/j.ijpsycho.2013.02.001
Farah, M. J. (2005). Neuroethics: The practical and the philosophical. Trends in Cognitive Sciences, 9(1), 34–40. https://doi.org/10.1016/j.tics.2004.12.001
Farah, M. J., Illes, J., Cook-Deegan, R., Gardner, H., Kandel, E., King, P., … Wolpe, P. R. (2004). Neurocognitive enhancement: What can we do and what should we do? Nature Reviews Neuroscience, 5(5), 421. https://doi.org/10.1038/nrn1390
Flöel, A., Meinzer, M., Kirstein, R., Nijhof, S., Deppe, M., Knecht, S., & Breitenstein, C. (2011). Short-term anomia training and electrical brain stimulation. Stroke, 42(7), 2065–2067. https://doi.org/10.1161/STROKEAHA.110.609032
Fronda, G., Balconi, M., & Crivelli, D. (2018). Neuroethical implications of neurocognitive enhancement in managerial professional contexts. Journal of Cognitive Enhancement, 2(4), 356–363. https://doi.org/10.1007/s41465-018-0100-5
Fuchs, T. (2006). Ethical issues in neuroscience. Current Opinion in Psychiatry, 2(4), 356–363. https://doi.org/10.1097/01.yco.0000245752.75879.26
Grosprêtre, S., Ruffino, C., & Lebon, F. (2016). Motor imagery and cortico-spinal excitability: A review. European Journal of Sport Science, 16(3), 317–324. https://doi.org/10.1080/17461391.2015.1024756
Hammond, D. C. (2007). Neurofeedback for the enhancement of athletic performance and physical balance. The Journal of the American Board of Sport Psychology, 1(1), 1¬¬¬¬¬–9.
Harvey, J. C. (2008). Enhancing evolution: The ethical case for making better people. JAMA, 299(11), 1369–1370. https://doi.org/10.1001/jama.299.11.1369
Haufler, A. J., Spalding, T. W., Santa Maria, D. L., & Hatfield, B. D. (2000). Neuro-cognitive activity during a self-paced visuospatial task: Comparative EEG profiles in marksmen and novice shooters. Biological Psychology, 53(2–3), 131–160. https://doi.org/10.1016/S0301-0511(00)00047-8
Hung, T. M., & Cheng, M.-Y. (2018). Neurofeedback in sport: Theory, methods, research, and efficacy. In R. Carlstedt & M. Balconi (Eds.), Handbook of Sport Neuroscience and Psychophysiology (pp. 304–319). New York, NY: Routledge. https://doi.org/10.3389/978-2-88919-722-4
Kayser, B., & Broers, B. (2013). Anti-doping policies: Choosing between imperfections. In Weisstub, D. (Ed.), Athletic Enhancement, Human Nature and Ethics (pp. 271–289). Dordrecht, Netherlands: Springer.
Koberda, J. L., Moses, A., Koberda, L., & Koberda, P. (2012). Cognitive enhancement using 19-electrode z-score neurofeedback. Journal of Neurotherapy, 16(3), 224–230. https://doi.org/10.1080/10874208.2012.705769
Jaeggi, S. M., Buschkuehl, M., Jonides, J., & Perrig, W. J. (2008). Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences, 105(19), 6829–6833. https://doi.org/10.1073/pnas.0801268105
Juengst, E. T. (1998). Group identity and human diversity: Keeping biology straight from culture. The American Journal of Human Genetics, 63(3), 673–677. https://doi.org/10.1086/302032
Landers, D. M., Petruzzello, S. J., Salazar, W., Crews, D. J., Kubitz, K. A., Gannon, T. L., & Han, M. (1991). The influence of electrocortical biofeedback on performance in pre-elite archers. Medicine and Science in Sports and Exercise, 23(1), 123–129. https://doi.org/10.1249/00005768-199101000-00018
Lewthwaite, R., & Wulf, G. (2017). Optimizing motivation and attention for motor performance and learning. Current Opinion in Psychology, 16, 38–42. https://doi.org/10.1016/j.copsyc.2017.04.005
Lövdén, M., Bäckman, L., Lindenberger, U., Schaefer, S., & Schmiedek, F. (2010). A theoretical framework for the study of adult cognitive plasticity. Psychological Bulletin, 136(4), 659–676. https://doi.org/10.1037/a0020080
Lucke, J., & Partridge, B. (2013). Towards a smart population: A public health framework for cognitive enhancement. Neuroethics, 6(2), 419–427. https://doi.org/10.1007/s12152-012-9167-3
Mirifar, A., Beckmann, J., & Ehrlenspiel, F. (2017). Neurofeedback as supplementary training for optimizing athletes’ performance: A systematic review with implications for future research. Neuroscience and Biobehavioral Reviews, 75, 419–432. https://doi.org/10.1016/j.neubiorev.2017.02.005
Morente-Sánchez, J., & Zabala, M. (2013). Doping in sport: A review of elite athletes’ attitudes, beliefs, and knowledge. Sports Medicine, 43(6), 395–411. https://doi.org/10.1007/s40279-013-0037-x
Nagel, S. K. (2010). Too much of a good thing? Enhancement and the burden of self-determination. Neuroethics, 3(2), 109–119. https://doi.org/10.1007/s12152-010-9072-6
Nagel, S. K. (2014). Enhancement for well-being is still ethically challenging. Frontiers in Systems Neuroscience, 8, 72. https://doi.org/10.3389/fnsys.2014.00072
Nagel, S. K. (2015). When aid is a good thing: Trusting relationships as autonomy support in health care settings. The American Journal of Bioethics, 15(10), 49–51. https://doi.org/10.1080/15265161.2015.1074316
Nyberg, L., Sandblom, J., Jones, S., Neely, A. S., Petersson, K. M., Ingvar, M., & Bäckman, L. (2003). Neural correlates of training-related memory improvement in adulthood and aging. Proceedings of the National Academy of Sciences, 100(23), 13728–13733. https://doi.org/10.1073/pnas.1735487100
Okano, H., Nakamura, M., Yoshida, K., Okada, Y., Tsuji, O., Nori, S., … Miura, K. (2013). Steps toward safe cell therapy using induced pluripotent stem cells. Circulation Research, 112(3), 523–533. https://doi.org/10.1161/CIRCRESAHA.111.256149
Petróczi, A. (2013). The doping mindset—Part I: Implications of the functional use theory on mental representations of doping. Performance Enhancement and Health, 2(4), 153–163. https://doi.org/10.1016/j.peh.2014.06.001
Ray, K. S. (2016). Not just “study drugs” for the rich: Stimulants as moral tools for creating opportunities for socially disadvantaged students. The American Journal of Bioethics, 16(6), 29–38. https://doi.org/10.1080/15265161.2016.1170231
Reis, J., Schambra, H. M., Cohen, L. G., Buch, E. R., Fritsch, B., Zarahn, E., … Krakauer, J. W. (2009). Noninvasive cortical stimulation enhances motor skill acquisition over multiple days through an effect on consolidation. Proceedings of the National Academy of Sciences, 106(5), 1590–1595. https://doi.org/10.1073/pnas.0805413106
Repantis, D., Schlattmann, P., Laisney, O., & Heuser, I. (2010). Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review. Pharmacological Research, 62(3), 187–206. https://doi.org/10.1016/j.phrs.2010.04.002
Sahakian, B. J., & Morein-Zamir, S. (2011). Neuroethical issues in cognitive enhancement. Journal of Psychopharmacology, 25(2), 197–204. https://doi.org/10.1177/0269881109106926
Salazar, W., Landers, D. M., Petruzzello, S. J., Han, M., Crews, D. J., & Kubitz, K. A. (1990). Hemispheric asymmetry, cardiac response, and performance in elite archers. Research Quarterly for Exercise and Sport, 61(4), 351–359. https://doi.org/10.1080/02701367.1990.10607499
Sandel, M. J. (2004, April). The case against perfection: What’s wrong with designer children, bionic athletes, and genetic engineering (Electronic version). The Atlantic Monthly. Retrieved from http://www.theatlantic.com/doc/prem/200404/sandel.
Schelle, K. J., Faulmüller, N., Caviola, L., & Hewstone, M. (2014). Attitudes toward pharmacological cognitive enhancement¬¬¬¬¬¬¬¬¬¬¬—a review. Frontiers in Systems Neuroscience, 8, 53. https://doi.org/10.3389/fnsys.2014.00053
Schooler, C. (1984). Psychological effects of complex environments during the life span: A review and theory. Intelligence, 8(4), 259–281. https://doi.org/10.1016/0160-2896(84)90011-4
Schooler, C., Mulatu, M. S., & Oates, G. (1999). The continuing effects of substantively complex work on the intellectual functioning of older workers. Psychology and Aging, 14(3), 483–506. https://doi.org/10.1037/0882-7974.14.3.483
Shook, J. R., & Giordano, J. (2016). Defining contexts of neurocognitive (performance) enhancements: Neuroethical considerations and implications for policy. Cognitive Enhancement: Ethical and Policy Implications in International Perspectives, 76. https://doi.org/10.1093/acprof:oso/9780199396818.003.0006
Singh, I., & Kelleher, K. J. (2010). Neuroenhancement in young people: Proposal for research, policy, and clinical management. AJOB Neuroscience, 1(1), 3–16. https://doi.org/10.1080/21507740903508591
Svetlov, S. I., Kobeissy, F. H., & Gold, M. S. (2007). Performance enhancing, non-prescription use of Ritalin performance: A comparison with amphetamines and cocaine. Journal of Addictive Diseases, 26(4), 1–6. https://doi.org/10.1300/J069v26n04_01
Valenzuela-Fernández, A., Cabrero, J. R., Serrador, J. M., & Sánchez-Madrid, F. (2008). HDAC6: A key regulator of cytoskeleton, cell migration and cell-cell interactions. Trends in Cell Biology, 18(6), 291–297. https://doi.org/10.1016/j.tcb.2008.04.003
Vargo, E. J., James, R. A., Agyeman, K., MacPhee, T., McIntyre, R., Ronca, F., & Petróczi, A. (2014). Perceptions of assisted cognitive and sport performance enhancement among university students in England. Performance Enhancement and Health, 3(2), 66–77. https://doi.org/10.1016/j.peh.2015.02.001
Verhaeghen, P., Marcoen, A., & Goossens, L. (1992). Improving memory performance in the aged through mnemonic training: A meta-analytic study. Psychology and Aging, 7(2), 242–251. https://doi.org/10.1037/0882-7974.7.2.242
Vernon, D. J. (2005). Can neurofeedback training enhance performance? An evaluation of the evidence with implications for future research. Applied Psychophysiology Biofeedback, 30(4), 347. https://doi.org/10.1007/s10484-005-8421-4
Vitor-Costa, M., Okuno, N. M., Bortolotti, H., Bertollo, M., Boggio, P. S., Fregni, F., & Altimari, L. R. (2015). Improving cycling performance: Transcranial direct current stimulation increases time to exhaustion in cycling. PLoS ONE, 10(12), e0144916. https://doi.org/10.1371/journal.pone.0144916
Williams, P. S., Hoffman, R. L., & Clark, B. C. (2013). Preliminary evidence that anodal transcranial direct current stimulation enhances time to task failure of a sustained submaximal contraction. PLoS ONE, 8(12), e81418. https://doi.org/10.1371/journal.pone.0081418
Wolpe, P. R. (2002). Treatment, enhancement, and the ethics of neurotherapeutics. Brain and Cognition, 50(3), 387–395. https://doi.org/10.1016/S0278-2626(02)00534-1
Wood, T. (2006). Brain and body in sport and exercise. British Journal of Sports Medicine, 40, 880–881. https://doi.org/10.1136/bjsm.2006.026872
Zelinski, E. M., & Reyes, R. (2010). Cognitive benefits of computer games for older adults. Gerontechnology, 8(4), 220–235. https://doi.org/10.4017/gt.2009.08.04.004.00
Zhu, F. F., Yeung, A. Y., Poolton, J. M., Lee, T. M. C., Leung, G. K. K., & Masters, R. S. W. (2015). Cathodal transcranial direct current stimulation over left dorsolateral prefrontal cortex area promotes implicit motor learning in a golf putting task. Brain Stimulation, 8(4), 784–786. https://doi.org/10.1016/j.brs.2015.02.005
Zoefel, B., Huster, R. J., & Herrmann, C. S. (2011). Neurofeedback training of the upper alpha frequency band in EEG improves cognitive performance. NeuroImage, 54(2), 1427–1431. https://doi.org/10.1016/j.neuroimage.2010.08.078
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