Doctors say brain-zapping— transcranial Direct Brain Stimulation (tDBS) applied to the scalp, noninvasively— may work to treat depression, math trouble, language fluency; and, in healthy people, may enhance focus, a sniper's aim, drone-piloting, or even a dried-up libido. But not even the white coats know yet how the technology works— what exactly it does to the brain. Worse, we have no clue what side effects may come later. Hope is warranted, but so is caution, and a critical mind. Don't trade your brain for a boner, as so many technophilic journalists do, at your first glimpse of neuro-pornography.
Be skeptical: skeptical of the guy who wants to sell you his miracle invention, and of the doctors who say they'll fix your sadness with a zap or a pill. More noteworthy than any buzzy new gadget or drug is how little anyone yet understands the map between that electrified hunk of wet tissue in your skull and the feelings that are you and me.
The National Institutes of Mental Health (NIMH), one of the biggest funders of brain research, called the psychiatric community out on this last month: Saying "Patients deserve better," its director Tom Insell announced that the institute would be abandoning the DSM-5— the Diagnostic and Statistical Manual of Mental Disorders, 5th edition— because its categorization scheme has so poorly explained the neural underpinnings of the mind, healthy and ill.
Gadgets are great, but understanding is better: We should be demanding that knowledge from our scientists and neuro-tech pioneers— not cheap cheat-codes for the brain.
There's nothing new about brain-stimulating the mentally-ill: electroconvulsive therapy (ECT), invented in 1932 by Italian neuropsychiatrists, and made notorious by the novels One Flew Over The Cuckoo's Nest and A Clockword Orange in 1962, is still the gold-standard treatment for nonremittant depression and mania, more than eighty years after its invention. More effective than any antidepressant pill, than exercise or talk therapy, electrically-induced seizures often bring suicidal or catatonically depressed patients back. Yet no one knows how, almost a century after the procedure was invented. Nor can any shrink explain or predict electroshock's rare but catastrophic side effects, like memory loss and mania. Ernest Hemingway shot himself after undergoing ECT at Mayo Clinic in 1961. Before his suicide, he told his biographer "Well, what is the sense of ruining my head and erasing my memory? It was a brilliant cure, but we lost the patient."
There's also nothing new about cognitive enhancement— the dream of neural holy grails like Ritalin— or commercial hucksters out to part gullible healthy folks from their money.
The CEO of MIND Alive Inc. is neither a doctor nor a psychologist. Dave Siever has no degree beyond a B.A. in telecommunications from the North Alberta Institute of Technology. He got his start making "audio-visual entrainment" (AVE) devices for dentists, to help treat patients with jaw stiffness, or temporomandibular joint disorder (TMJ) (a condition related to psychological stress), and his DAVID devices to help performing arts students overcome stage fright. But the innovation that got the attention of Canada's National Post last week is his latest product: a brain-zapping device he says improves memory, concentration, relaxation and mood, and can be used to treat mental disorders from depression to ADHD.
The list on Siever's website of 18 publications "proving" the efficacy of the brain-stimulating devices produced and sold by his company includes five that are unpublished, presumably because their data lack the statistical sturdiness to withstand peer review. The entrepreneur himself is a co-author of four of the papers. The journals that have vouched for his gadget include one on hypnosis and one called The Journal of Neurotherapy, a young journal for neurofeedback enthusiasts, created in 2002, which does not yet have an impact factor (the usual measure of a scientific journal's influence and merit in the field), but has an h-index of only eleven- meaning only eleven papers published in the journal have been cited more than 11 times. By comparison, the h-index of the journal Nature Neuroscience is 241, and that of Neuron is 288. The top-tier scientific journals Science and Nature have h-indices of 711 and 731, respectively: 731, versus eleven. So, the scientific consensus backing Siever's bold salesman's claims is, well, pretty thin.
You wouldn't imagine so, though, from the shininess of the stuff he says. "tDCS produces immediate and lasting sharpness and reasoning of mind," Siever declared in the International Society of Neurofeedback and Research (ISNR) Newsletter, Spring 2013. In a section of his article oddly titled "Depression, Mood, and Brainwave," the professorial non-professor tells his readers that "Right-brain strokes spawn cheerful survivors while left-brain strokes leave the survivor with depression... This supports the 'happy-left' and 'depressed-right' scenario." Run this "happy-left-brain, depressed-right" theory by any PhD or MD, and you will get laughter. Nobody familiar with the hazy current state of knowledge on emotion in the brain would presume to say something so confident, simple and bold. Doctors and scientists with brain-pictures look just as dumb as Siever when they make brash claims about where emotions live in cortex, for the simple reason that this is not known.
Skeptical psychiatrists and cognitive neuroscientists have cautioned against patients using commercially available tDCS devices like these (Sold online by Neuro Conn (Germany; U.S. $10,500); HDCKit, distributed by Magstim (Italy, just under $10,000); StartStim (Spain, around $10,000); 1X1 tDCS by Soterix (USA, $4,500); and the Oasis Pro by MIND Alive, for around $450). They point out that tDCS makers don't have medical licenses, and users may not know where to put the electrodes or how much current to apply. Nevertheless, sound medical evidence from the University of Sao Paulo, published in JAMA-Psychiatry last February, showed brain-stimulation to be as effective as the antidepressant drug Zoloft in treating depression— and less risky than alternatives transcranial magnetic stimulation (TMS) and ECT, which can trigger seizures. In reporting their impressive results with restraint, the Brazilian doctors joined a chorus of responsible scientists.
"We strongly caution you not to try this at home," one Oxford cognitive neuroscientist told Science NOW in a report on her own finding that tDCS can promote math-learning ability. "No matter how tempted you may be to slap a battery on your kid's head."
Still, as Slate's Will Oremus points out in "Spark of Genius", the smartest post I've read yet on the slippery slope of brain-enhancement, we'd be foolish to reject the prospect offhand. As Duke bioethicist and philosophy professor Allen Buchanan told The Atlantic's Ross Andersen, quoted by Oremus:
"The list of design flaws in human beings is pretty long, as it is in other organisms, and so to think that somehow we're at the summit of perfection and that we're stable is to have the wrong idea of human nature. The misleading assumption is that if we don't interfere, we're going to continue the way we are, and of course that goes completely contrary to everything we know about evolution. In fact it might turn out that the only way to prevent us from going extinct, or to prevent some great worsening of our condition, is to enhance some of our capacities."
So humans are going to evolve— we've got no choice. Technology will change us. If the futurists from last week's "Singularity Conference" Global Future 2045 have their way, we'll soon be living forever, as computerized consciousnesses embodied in synthetic avatars like Japanese roboticist Hiroshi Ishiguro's self-copy Geminoid. We've got no choice but to face this new world bravely.
The key thing is to be a smart consumer: brain, not boner. Whether dealing with doctors or sellers of brain-zapping machines, let's demand evidence to go with the fancy tools.
"Brain-hacking," once a sci-fi fantasy, is now becoming real. Computers are decoding brains, while brains are teaching computers.
This tracker will follow how neuro-technology is changing the way computer scientists think. As scientists better understand the human brain, we are learning clever ways for machines to gather, store and process data. The brain— the most sophisticated computer on earth— is teaching technologists how to build the smartest machines. Our computers may soon be able to think. The question is: Once we've got these brilliant AI's—- computerized scientists and engineers, news aggregators, synthesizers and analysts— what will the rest of us do with our time?
All these invasive advances influence not just medicine, but the world where we live and the tech we use. Come here for the latest neuro news, to keep pace with how brains are changing tech.
[Image: Flickr user LeDonne Morris]