Philosophy:Neuroenhancement

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Neuroenhancement or cognitive enhancement is the experimental use of pharmacological or non-pharmacological methods intended to improve cognitive and affective abilities in healthy people who don't have any mental illness.[1][2] Agents or methods of neuroenhancement are intended to affect cognitive, social, psychological, mood, or motor benefits beyond normal functioning.

Pharmacological neuroenhancement agents may include compounds thought to be nootropics, such as modafinil,[1][3] caffeine,[4][5] and other drugs used for treating people with neurological disorders.[6]

Non-pharmacological measures of cognitive enhancement may include behavioral methods (activities, techniques, and changes),[7] non-invasive brain stimulation, which has been used with the intent to improve cognitive and affective functions,[8] and brain-machine interfaces.[9]

Potential agents

There are many supposed nootropics, most having only small effect sizes in healthy individuals. Neuroenhancement's most common pharmacological agents include modafinil and methylphenidate (Ritalin). Stimulants in general and various dementia treatments[10] or other neurological therapies[11] may also affect cognition.

Neuroenhancement may also occur from:

Enhancers are multidimensional and can be clustered into biochemical, physical, and behavioral enhancement strategies.[17]

Modafinil

Main article: Chemistry:Modafinil

Approved for treating narcolepsy, obstructive sleep apnea, and shift work sleep disorder, modafinil is a wakefulness-promoting drug used to decrease fatigue, increase vigilance, and reduce daytime sleepiness.[1] Modafinil improves alertness, attention, long-term memory, and daily performance in people with sleep disorders.[1][18]

In sustained sleep deprivation, repeated use of modafinil helped individuals maintain higher levels of wakefulness than a placebo, but did not help attention and executive function.[1][19] Modafinil may impair one's self-monitoring ability; a common trend found in research studies indicated that participants rated their performances on cognitive tests higher than it was, suggesting an "overconfidence" effect.[1][19]

Methylphenidate

Main article: Chemistry:Methylphenidate

Methylphenidate (MPH), also known as Ritalin, is a stimulant that is used to treat attention-deficit hyperactivity disorder (ADHD). MPH is abused by a segment of the general population, especially college students.[19]

A comparison between the sales of MPH to the number of people for whom it was prescribed revealed a disproportionate ratio, indicating high abuse.[19] MPH may impair cognitive performance.[20]

Others

Studies are too preliminary to determine whether there are any cognitive-enhancing effects of agents such as memantine or acetylcholinesterase inhibitors (examples: donepezil, galantamine).[6]

Possible adverse effects

Common drugs intended for neuroehancement are typically well-tolerated by healthy people.[6][19] These drugs are already in mainstream use to treat people with different kinds of psychiatric disorders.

Assessment to determine potential adverse effects are drop-out rates and subjective rating.[6][19] The drop-out rates were minimal or non-existent for donepezil, memantine, MPH, and modafinil.[6][19] In the drug trials, participants reported the following adverse reactions to use of donepezil, memantine, MPH, modafinil or caffeine:[5] gastrointestinal complaints (nausea), headache, dizziness, nightmares, anxiety, drowsiness, nervousness, restlessness, sleep disturbances, and insomnia,[6] diuresis.[21] The side effects normally ceased in the course of treatment.[6] Various factors, such as dosage, timing and concurrent behavior, may influence the onset of adverse effects.[6][19]

Non-pharmacological

Neurostimulation

Neurostimulation methods are being researched and developed.[8] Results indicate that details of the stimulation procedures are crucial, with some applications impairing rather than enhancing cognition and questions are being raised about whether this approach can deliver any meaningful results for cognitive domains.[8] Stimulation methods include electrical stimulation, magnetic stimulation, optical stimulation with lasers, several forms of acoustic stimulation, and physical methods like forms of neurofeedback.[8][17]

Software and media

Applications of augmented reality technologies may affect general memory enhancement, extending perception and learning-assistance.[22][23][additional citation(s) needed] The Internet may be considered a tool for enabling or extending cognition.[24][25][26] However, it is not "a simple, uniform technology, [n]either in its composition, [n]or in its use" and, as "an informational resource, currently fails to enhance cognition", partly due to issues that include information overload, misinformation and persuasion.[27]

Quality and social issues

Validation and quality control

See also: Biology:Food safety and Health policy
Upper photo of modafinil tablets acquired via the Internet; below photo is a mail order pharmacy dispenser

Quality standards, validation and authentication, sampling and lab testing are commonly substandard or absent for products thought to be cognitive enhancers, including dietary supplements.[28][29][30][31]

Well-being and productivity

Neuroenhancement products or methods are used with the intent to:

Neuroenhancement products are mentioned in entertainment productions, such as Limitless (2011), which may to some degree probe and explore opportunities and threats of using such products.[35]

Prevalence

In general, people under the age of 25 feel that neuroenhancement agents are acceptable or that the decision to use them is to be made individually.[36] Healthcare officials and parents feel concerned due to safety factors, lack of complete information on these agents, and possible irreversible adverse effects; such concerns may reduce the willingness to take such agents.[37]

A 2024 study based on a representative sample of more than 20,000 adults in Germany showed that around 70% of those surveyed had taken substances with the aim of improving mental performance within a year, without a medical prescription.[38] The consumption of caffeinated drinks, such as coffee and energy drinks, was widespread (64% of users), expressly with the aim of improving performance, followed by dietary supplements and home remedies, such as ginkgo biloba (31%).[38] Around 4% stated that they had taken prescription drugs for cognitive enhancement (lifetime prevalence of 6%), corresponding to around 2.5 million users in Germany.[38]

A 2016 German study among 6,454 employees found a rather low life-time prevalence of cognitive enhancement prescription drug use (namely 3%), while the willingness to take such drugs was found in 10% of respondents.[39] A survey of some 5,000 German university students found a relatively low 30-day prevalence of 1%, while 2% of those sampled used such drugs within the last 6 months, 3% within the last 12 months, and 5% of others used the drugs over their lifetimes.[37] Of those students who used such substances during the last 6 months, 39% reported their use once in this period, 24% twice, 12% three times, and 24% more than three times.[37] Consumers of neuroenhancement drugs are more willing to use them again in the future due to positive experiences or a tendency towards addiction.[40]

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Battleday, Ruairidh; Brem, Anna-Katharine (28 July 2015). "Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: a systematic review". European Neuropsychopharmacology 25 (11): 1865–1881. doi:10.1016/j.euroneuro.2015.07.028. PMID 26381811. https://www.sciencedirect.com/science/article/abs/pii/S0924977X15002497. 
  2. ↑ Veit, Walter (2018). "Cognitive Enhancement and the Threat of Inequality". Journal of Cognitive Enhancement 2 (4): 404–410. doi:10.1007/s41465-018-0108-x. 
  3. ↑ Al-Shargie, Fares; Tariq, Usman; Mir, Hasan; Alawar, Hamad; Babiloni, Fabio; Al-Nashash, Hasan (August 2019). "Vigilance Decrement and Enhancement Techniques: A Review" (in en). Brain Sciences 9 (8): 178. doi:10.3390/brainsci9080178. ISSN 2076-3425. PMID 31357524. 
  4. ↑ "Psychostimulants and cognition: a continuum of behavioral and cognitive activation". Pharmacological Reviews 66 (1): 193–221. January 2014. doi:10.1124/pr.112.007054. PMID 24344115. 
  5. ↑ 5.0 5.1 Becker, Maxi; Repantis, Dimitris; Dresler, Martin; Kühn, Simone (October 2022). "Cognitive enhancement: Effects of methylphenidate, modafinil, and caffeine on latent memory and resting state functional connectivity in healthy adults" (in en). Human Brain Mapping 43 (14): 4225–4238. doi:10.1002/hbm.25949. ISSN 1065-9471. PMID 35670369. 
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 Repantis, Dimitris; Laisney, Oona; Heuser, Isabella (June 2010). "Acetylcholinesterase inhibitors and memantine for neuroenhancement in healthy individuals: A systematic review". Pharmacological Research 61 (6): 473–481. doi:10.1016/j.phrs.2010.02.009. PMID 20193764. 
  7. ↑ Jangwan, Nitish Singh; Ashraf, Ghulam Md; Ram, Veerma; Singh, Vinod; Alghamdi, Badrah S.; Abuzenadah, Adel Mohammad; Singh, Mamta F. (2022). "Brain augmentation and neuroscience technologies: current applications, challenges, ethics and future prospects". Frontiers in Systems Neuroscience 16. doi:10.3389/fnsys.2022.1000495. PMID 36211589. 
  8. ↑ 8.0 8.1 8.2 8.3 Antal, Andrea; Luber, Bruce; Brem, Anna-Katharine; Bikson, Marom; Brunoni, Andre R.; Cohen Kadosh, Roi; Dubljević, Veljko; Fecteau, Shirley et al. (2022). "Non-invasive brain stimulation and neuroenhancement". Clinical Neurophysiology Practice 7: 146–165. doi:10.1016/j.cnp.2022.05.002. ISSN 2467-981X. PMID 35734582. 
  9. ↑ Nair, Prashant (2013-11-12). "Brain–machine interface". Proceedings of the National Academy of Sciences 110 (46): 18343. doi:10.1073/pnas.1319310110. ISSN 0027-8424. PMID 24222678. Bibcode: 2013PNAS..11018343N. 
  10. ↑ Weiergräber, Marco; Ehninger, Dan; Broich, Karl (1 April 2017). "Neuroenhancement and mood enhancement – Physiological and pharmacodynamical background". Medizinische Monatsschrift für Pharmazeuten 40 (4): 154–164. ISSN 0342-9601. PMID 29952165. 
  11. ↑ 11.0 11.1 Marazziti, Donatella; Avella, Maria Teresa; Ivaldi, Tea; Palermo, Stefania; Massa, Lucia; Della Vecchia, Alessandra; Basile, Lucia; Mucci, Federico (June 2021). "Neuroenhancement: state of the art and future perspectives". Clinical Neuropsychiatry 18 (3): 137–169. doi:10.36131/cnfioritieditore20210303. PMID 34909030. 
  12. ↑ Daubner, Johanna; Arshaad, Muhammad Imran; Henseler, Christina; Hescheler, Jürgen; Ehninger, Dan; Broich, Karl; Rawashdeh, Oliver; Papazoglou, Anna et al. (13 January 2021). "Pharmacological Neuroenhancement: Current Aspects of Categorization, Epidemiology, Pharmacology, Drug Development, Ethics, and Future Perspectives" (in en). Neural Plasticity 2021: 1–27. doi:10.1155/2021/8823383. ISSN 1687-5443. PMID 33519929. 
  13. ↑ 13.0 13.1 13.2 Brühl, Annette B.; Sahakian, Barbara J. (2016). "Drugs, games, and devices for enhancing cognition: implications for work and society". Annals of the New York Academy of Sciences 1369 (1): 195–217. doi:10.1111/nyas.13040. PMID 27043232. Bibcode: 2016NYASA1369..195B. https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/nyas.13040. 
  14. ↑ Buckner, Julia D.; Morris, Paige E.; Abarno, Cristina N.; Glover, Nina I.; Lewis, Elizabeth M. (17 April 2021). "Biopsychosocial Model Social Anxiety and Substance Use Revised" (in en). Current Psychiatry Reports 23 (6): 35. doi:10.1007/s11920-021-01249-5. ISSN 1535-1645. PMID 33864136. 
  15. ↑ Tennison, Michael N.; Moreno, Jonathan D. (2017). "Neuroenhancement and Therapy in National Defense Contexts". The Routledge Handbook of Neuroethics. pp. 150–165. doi:10.4324/9781315708652-12. ISBN 978-1-315-70865-2. https://www.taylorfrancis.com/chapters/edit/10.4324/9781315708652-12/neuroenhancement-therapy-national-defense-contexts-michael-tennison-jonathan-moreno. 
  16. ↑ Budde, Henning; Wegner, Mirko (17 April 2018) (in en). The Exercise Effect on Mental Health: Neurobiological Mechanisms. CRC Press. ISBN 978-1-4987-3953-5. https://books.google.com/books?id=6SJWDwAAQBAJ. 
  17. ↑ 17.0 17.1 Dresler, Martin; Sandberg, Anders; Bublitz, Christoph; Ohla, Kathrin; Trenado, Carlos; Mroczko-Wąsowicz, Aleksandra; Kühn, Simone; Repantis, Dimitris (20 March 2019). "Hacking the Brain: Dimensions of Cognitive Enhancement" (in en). ACS Chemical Neuroscience 10 (3): 1137–1148. doi:10.1021/acschemneuro.8b00571. ISSN 1948-7193. PMID 30550256. 
  18. ↑ Okechukwu, Chidiebere Emmanuel; Okechukwu, Chidubem Ekpereamaka; Torre, Giuseppe La (2022-10-02). "Effectiveness of bright light exposure, modafinil and armodafinil for improving alertness during working time among nurses on the night shift: A systematic review" (in en). International Journal of Healthcare Management 15 (4): 336–346. doi:10.1080/20479700.2022.2054508. ISSN 2047-9700. https://www.tandfonline.com/doi/full/10.1080/20479700.2022.2054508. 
  19. ↑ 19.0 19.1 19.2 19.3 19.4 19.5 19.6 19.7 Repantis, Dimitris; Schlattmann, Peter (2010). "Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review". Pharmacological Research 62 (3): 187–206. doi:10.1016/j.phrs.2010.04.002. PMID 20416377. 
  20. ↑ Chien; Chien; Liu; Wu; Chang; Wu (2019-10-24). "Effects of Methylphenidate on Cognitive Function in Adults with Traumatic Brain Injury: A Meta-Analysis" (in en). Brain Sciences 9 (11): 291. doi:10.3390/brainsci9110291. ISSN 2076-3425. PMID 31653039. 
  21. ↑ Repantis, Dimitris; Bovy, Leonore; Ohla, Kathrin; Kühn, Simone; Dresler, Martin (February 2021). "Cognitive enhancement effects of stimulants: a randomized controlled trial testing methylphenidate, modafinil, and caffeine" (in en). Psychopharmacology 238 (2): 441–451. doi:10.1007/s00213-020-05691-w. ISSN 0033-3158. PMID 33201262. 
  22. ↑ Schneider, Felicitas; Horowitz, Alan; Lesch, Klaus-Peter; Dandekar, Thomas (21 January 2020). "Delaying memory decline: different options and emerging solutions" (in en). Translational Psychiatry 10 (1): 13. doi:10.1038/s41398-020-0697-x. ISSN 2158-3188. PMID 32066684. 
  23. ↑ Moreno, Jonathan; Gross, Michael L.; Becker, Jack; Hereth, Blake; Shortland, Neil D.; Evans, Nicholas G. (2022). "The ethics of AI-assisted warfighter enhancement research and experimentation: Historical perspectives and ethical challenges". Frontiers in Big Data 5. doi:10.3389/fdata.2022.978734. ISSN 2624-909X. PMID 36156934. 
  24. ↑ Smart, Paul (1 September 2017). "Extended Cognition and the Internet" (in en). Philosophy & Technology 30 (3): 357–390. doi:10.1007/s13347-016-0250-2. ISSN 2210-5441. PMID 32010552. 
  25. ↑ Smart, Paul R. (22 November 2013). "The Web-Extended Mind" (in en). Philosophical Engineering. John Wiley & Sons, Ltd. pp. 116–133. doi:10.1002/9781118700143.ch8. ISBN 978-1-118-70014-3. 
  26. ↑ Smart, Paul R. (2018). "Human-extended machine cognition" (in en). Cognitive Systems Research 49: 9–23. doi:10.1016/j.cogsys.2017.11.001. https://eprints.soton.ac.uk/415609/1/hemcv2.pdf. 
  27. ↑ Voinea, Cristina; Vică, Constantin; Mihailov, Emilian; Savulescu, Julian (1 August 2020). "The Internet as Cognitive Enhancement" (in en). Science and Engineering Ethics 26 (4): 2345–2362. doi:10.1007/s11948-020-00210-8. ISSN 1471-5546. PMID 32253711. 
  28. ↑ "Prohibited, unlisted, even dangerous ingredients turn up in dietary supplements". Washington Post. https://www.washingtonpost.com/health/contaminated-supplements-unexpected-ingredients/2021/06/25/5d2227ec-bd62-11eb-83e3-0ca705a96ba4_story.html. 
  29. ↑ Eisenstein, Michael. "Setting Standards for Supplements" (in en). https://www.scientificamerican.com/custom-media/setting-standards-for-supplements/. 
  30. ↑ Glisson, James K. (14 March 2011). "Dietary Supplements: Safety Issues and Quality Control". Archives of Internal Medicine 171 (5): 476–7; author reply 477. doi:10.1001/archinternmed.2011.53. PMID 21403052. 
  31. ↑ "Are Dietary Supplements Safe?" (in en). https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/complementary-and-integrative-medicine/dietary-supplements/safety.html. 
  32. ↑ Marois, Alexandre; Lafond, Daniel (1 November 2022). "Augmenting cognitive work: a review of cognitive enhancement methods and applications for operational domains" (in en). Cognition, Technology & Work 24 (4): 589–608. doi:10.1007/s10111-022-00715-1. ISSN 1435-5566. 
  33. ↑ Mohamed, Ahmed Dahir (September 2014). "Neuroethical issues in pharmacological cognitive enhancement" (in en). WIREs Cognitive Science 5 (5): 533–549. doi:10.1002/wcs.1306. ISSN 1939-5078. PMID 26308743. 
  34. ↑ Saritas, Ozcan (2019). "Emerging Technologies, Trends and Wild Cards in Human Enhancement" (in en). Emerging Technologies for Economic Development. Science, Technology and Innovation Studies. Springer International Publishing. pp. 243–259. doi:10.1007/978-3-030-04370-4_11. ISBN 978-3-030-04370-4. https://link.springer.com/chapter/10.1007/978-3-030-04370-4_11. 
  35. ↑ Zwart H. (2014). "Limitless as a neuro-pharmaceutical experiment and as a Daseinsanalyse: on the use of fiction in preparatory debates on cognitive enhancement". Medicine, Health Care and Philosophy 17 (1): 29–38. doi:10.1007/s11019-013-9481-5. PMID 23585022. http://www.filosofie.science.ru.nl/PDF%20library%20HZ/Limitless.pdf. Retrieved 2016-05-07. 
  36. ↑ "The Rationale for Consuming Cognitive Enhancement Drugs in University Students and Teachers". PLOS ONE 8 (7). 2013. doi:10.1371/journal.pone.0068821. PMID 23874778. Bibcode: 2013PLoSO...868821S. 
  37. ↑ 37.0 37.1 37.2 "Cognitive test anxiety and cognitive enhancement: the influence of students' worries on their use of performance-enhancing drugs". Substance Use and Misuse 48 (3): 220–32. 2013. doi:10.3109/10826084.2012.751426. PMID 23302063. 
  38. ↑ 38.0 38.1 38.2 "Prevalence of Legal, Prescription, and Illegal Drugs Aiming at Cognitive Enhancement across Sociodemographic Groups in Germany". Deviant Behavior: 1–35. 2024. doi:10.1080/01639625.2024.2334274. 
  39. ↑ "Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement". Frontiers in Psychology 6: 1971. 2016. doi:10.3389/fpsyg.2015.01971. PMID 26779083. 
  40. ↑ "Evaluating the drivers of and obstacles to the willingness to use cognitive enhancement drugs: the influence of drug characteristics, social environment, and personal characteristics". Substance Abuse Treatment, Prevention, and Policy 9: 8. 2014. doi:10.1186/1747-597X-9-8. PMID 24484640. 



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