Neurotechnology

Short description: Technology that interfaces with the nervous system to monitor or modify neural function

Neurotechnology encompasses any method or electronic device which interfaces with the nervous system to monitor or modulate neural activity.[1][2]

Common design goals for neurotechnologies include using neural activity readings to control external devices such as neuroprosthetics, altering neural activity via neuromodulation to repair or normalize function affected by neurological disorders,[3] or augmenting cognitive abilities.[4] In addition to their therapeutic or commercial uses, neurotechnologies also constitute powerful research tools to advance fundamental neuroscience knowledge.[5][6][7][8]

Some examples of neurotechnologies include deep brain stimulation, photostimulation based on optogenetics and photopharmacology, transcranial magnetic stimulation, transcranial electric stimulation and brain–computer interfaces, such as cochlear implants and retinal implants.

## Contents

* 1 Background
* 2 Types
* 2.1 Deep brain stimulation
* 2.2 Transcranial ultrasound stimulation
* 2.3 Transcranial magnetic stimulation
* 2.4 Transcranial direct current stimulation
* 2.5 Electrophysiology
* 2.6 Pharmaceuticals
* 3 Ethical considerations
* 3.1 Identity
* 3.2 Agency
* 3.3 Privacy
* 3.4 Cognitive liberty
* 4 See also
* 5 References

## Background

The field of neurotechnology has been around for nearly half a century but has only reached maturity in the last twenty years. The advent of brain imaging revolutionized the field, allowing researchers to directly monitor the brain's activities during experiments. Practice in neurotechnology can be found in fields such as pharmaceutical practices, be it from drugs for depression, sleep, ADHD, or anti-neurotics to cancer scanning, stroke rehabilitation, etc.

Many in the field aim to control and harness more of what the brain does and how it influences lifestyles and personalities. Commonplace technologies already attempt to do this; games like BrainAge,[9] and programs like Fast ForWord[10] that aim to improve brain function, are neurotechnologies.

Currently, modern science can image nearly all aspects of the brain as well as control a degree of the function of the brain. It can help control depression, over-activation, sleep deprivation, and many other conditions. Therapeutically it can help improve stroke patients' motor coordination, improve brain function, reduce epileptic episodes (see epilepsy), improve patients with degenerative motor diseases (Parkinson's disease, Huntington's disease, ALS), and can even help alleviate phantom pain perception.[11] Advances in the field promise many new enhancements and rehabilitation methods for patients with neurological problems. The neurotechnology revolution has given rise to the Decade of the Mind initiative, which was started in 2007.[12] It also offers the possibility of revealing the mechanisms by which mind and consciousness emerge from the brain.

## Types

### Deep brain stimulation

Main article: Biology:Deep brain stimulation

Deep brain stimulation is currently used in patients with movement disorders to improve the quality of life in patients.[13]

### Transcranial ultrasound stimulation

Transcrancial ultrasound stimulation (TUS) is a technique using ultrasound to modulate neural activity in the brain. It is an emerging technique that has shown therapeutic promise in a variety of neurological diseases. [14]

### Transcranial magnetic stimulation

Main articles: Physics:Transcranial magnetic stimulation and Physics:Pulsed electromagnetic field therapy

Transcranial magnetic stimulation (TMS) is a technique for applying magnetic fields to the brain to manipulate electrical activity at specific loci in the brain.[15] This field of study is currently receiving a large amount of attention due to the potential benefits that could come out of better understanding this technology.[16] Transcranial magnetic movement of particles in the brain shows promise for drug targeting and delivery as studies have demonstrated this to be noninvasive on brain physiology.[17]

Transcranial magnetic stimulation is a relatively new method of studying how the brain functions and is used in many research labs focused on behavioral disorders, epilepsy, PTSD, migraine, hallucinations, and other disorders.[16] Currently, repetitive transcranial magnetic stimulation is being researched to see if positive behavioral effects of TMS can be made more permanent. Some techniques combine TMS and another scanning method such as EEG to get additional information about brain activity such as cortical response.[18]

### Transcranial direct current stimulation

Transcranial direct current stimulation (TDCS) is a form of neurostimulation which uses constant, low current delivered via electrodes placed on the scalp. The mechanisms underlying TDCS effects are still incompletely understood, but recent advances in neurotechnology allowing for in vivo assessment of brain electric activity during TDCS[19] promise to advance understanding of these mechanisms. Research into using TDCS on healthy adults have demonstrated that TDCS can increase cognitive performance on a variety of tasks, depending on the area of the brain being stimulated. TDCS has been used to enhance language and mathematical ability (though one form of TDCS was also found to inhibit math learning),[20] attention span, problem solving, memory,[21] coordination and relieve depression [22][23][24] and chronic fatigue.[25][26]

### Electrophysiology

Electroencephalography (EEG) is a method of measuring brainwave activity non-invasively. A number of electrodes are placed around the head and scalp and electrical signals are measured.[27] Clinically, EEGs are used to study epilepsy as well as stroke and tumor presence in the brain. Electrocorticography (ECoG) relies on similar principles but requires invasive implantation of electrodes on the brain's surface to measure local field potentials or action potentials more sensitively.

Magnetoencephalography (MEG) is another method of measuring activity in the brain by measuring the magnetic fields that arise from electrical currents in the brain.[28] The benefit to using MEG instead of EEG is that these fields are highly localized and give rise to better understanding of how specific loci react to stimulation or if these regions over-activate (as in epileptic seizures).

There are potential uses for EEG and MEG such as charting rehabilitation and improvement after trauma as well as testing neural conductivity in specific regions of epileptics or patients with personality disorders. EEG has been fundamental in understanding the resting brain during sleep.[27] Real-time EEG has been considered for use in lie detection.[29] Similarly, real-time fMRI is being researched as a method for pain therapy by altering how people perceive pain if they are made aware of how their brain is functioning while in pain. By providing direct and understandable feedback, researchers can help patients with chronic pain decrease their symptoms.Cite error: Closing `</ref>` missing for `<ref>` tag The most common neurodevices available for clinical use are deep brain stimulators implanted in the subthalamic nucleus for patients with Parkinson's disease.[13]

### Pharmaceuticals

Main article: Medicine:Neuropsychopharmacology

Pharmaceuticals play a vital role in maintaining stable brain chemistry, and are the most commonly used neurotechnology by the general public and medicine. Drugs like sertraline, methylphenidate, and zolpidem act as chemical modulators in the brain, and they allow for normal activity in many people whose brains cannot act normally under physiological conditions. While pharmaceuticals are usually not mentioned and have their own field, the role of pharmaceuticals is perhaps the most far-reaching and commonplace in modern society. Movement of magnetic particles to targeted brain regions for drug delivery is an emerging field of study and causes no detectable circuit damage.[17]

## Ethical considerations

Like other disruptive innovations, neurotechnologies have the potential for profound social and legal repercussions, and as such their development and introduction to society raise a series of ethical questions.[30][31][2]

Key concerns include the preservation of identity, agency, cognitive liberty and privacy. While experts agree that these core features of the human experience stand to benefit from the ethical use of neurotechnology, they also make a point of emphasizing the importance of preventively establishing specific regulatory frameworks and other mechanisms that protect against inappropriate or unauthorized uses.[1][30][32]

### Identity

Identity in this context refers to personal continuity, described as bodily and mental integrity and their persistence over time. In other words, it is the individual's self-narrative and concept of self.

While disruption of identity is not a common goal for neurotechnologies, some techniques can create unwanted shifts that range in severity. For instance, deep brain stimulation is commonly used as treatment for Parkinson's disease but can have side effects that touch on the concept of identity, such as loss of voice modulation, increased impulsivity or feelings of self-estrangement.[1][33][34][35] In the case of neural prostheses and brain-computer interfaces, the shift may take the form of an extension of one's sense of self, potentially incorporating the device as an integral part of oneself or expanding the range of sensory and cognitive channels available to the user beyond the traditional senses.[1][36]

Part of the difficulty in determining which changes constitute a threat to identity is rooted in its dynamic nature: since one's personality and concept of self is expected to change with time as a result of emotional development and lived experience, it is not easy to identify clear criteria and draw a line between acceptable shifts and problematic changes.[1][37] This becomes even harder when dealing with neurotechnologies aimed at influencing psychological processes—such as those designed to recude the symptoms of depression or post-traumatic stress disorder (PTSD) by modulating emotional states or saliency of memories to ease a patient's pain.[38][39] Even helping a patient remember, which would seemingly help preserve identity, can be a delicate question: "Forgetting is also important to how a person navigates the world, since it allows the opportunity for both losing track of embarrassing or difficult memories, and focusing on future-oriented activity. Efforts to enhance identity through memory preservation thus run the risk of inadvertently damaging a valuable, if less consciously-driven cognitive process."[1]

### Agency

Although the nuances of its definition are debated in philosophy and sociology,[40] agency is commonly understood as the individual's ability to consciously make and communicate a decision or choice. While identity and agency are distinct, an impairment in agency can in turn undermine personal identity: the subject may no longer be able to substantially modify their own self-narrative, and may therefore lose their ability to contribute to the dynamic process of identity formation.[37]

The interplay between agency and neurotechnology can have implications for moral responsibility and legal liability.[41][31] As with identity, devices aimed at treating some psychiatric conditions like depression or anorexia may work by modulating neural function linked with desire or motivation, potentially compromising the user's agency.[38][42] This can also be the case, paradoxically, for those neurotechnologies designed to restore agency to patients, such as neural prostheses and BCI-mediated assistive technology like wheelchairs or computer accessibility tools.[43][44] Because these devices often operate by interpreting sensory inputs or the user's neural data in order to estimate the individual's intention and respond according to it, estimation margins can lead to inaccurate or undesired responses that may threaten agency: "If the agent's intent and the device's output can come apart (think of how the auto-correct function in texting sometimes misinterprets the user's intent and sends problematic text messages), the user's sense of agency may be undermined."[1]

### Privacy

Finally, when these technologies are being developed society must understand that these neurotechnologies could reveal the one thing that people can always keep secret: what they are thinking. While there are large amounts of benefits associated with these technologies, it is necessary for scientists, citizens and policy makers alike to consider implications for privacy.[45] This term is important in many ethical circles concerned with the state and goals of progress in the field of neurotechnology (see neuroethics). Current improvements such as "brain fingerprinting" or lie detection using EEG or fMRI could give rise to a set fixture of loci/emotional relationships in the brain, although these technologies are still years away from full application.[45] It is important to consider how all these neurotechnologies might affect the future of society, and it is suggested that political, scientific, and civil debates are heard about the implementation of these newer technologies that potentially offer a new wealth of once-private information.[45] Some ethicists are also concerned with the use of TMS and fear that the technique could be used to alter patients in ways that are undesired by the patient.[16]

### Cognitive liberty

Cognitive liberty refers to a suggested right to self-determination of individuals to control their own mental processes, cognition, and consciousness including by the use of various neurotechnologies and psychoactive substances. This perceived right is relevant for reformation and development of associated laws.

## See also

* Biotechnology
* Neural engineering
* Neuroimaging
* Neuroscience

## References

1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 "Recommendations for Responsible Development and Application of Neurotechnologies". Neuroethics 14 (3): 365–386. April 2021. doi:10.1007/s12152-021-09468-6. PMID 33942016.
2. ↑ 2.0 2.1 "Neurotechnology: Current Developments and Ethical Issues". Frontiers in Systems Neuroscience 11: 93. 2017. doi:10.3389/fnsys.2017.00093. PMID 29326561.
3. ↑ "Prediction of seizure likelihood with a long-term, implanted seizure advisory system in patients with drug-resistant epilepsy: a first-in-man study". The Lancet. Neurology 12 (6): 563–71. June 2013. doi:10.1016/s1474-4422(13)70075-9. PMID 23642342.
4. ↑ "Neurotechnologies for Human Cognitive Augmentation: Current State of the Art and Future Prospects". Frontiers in Human Neuroscience 13: 13. 31 January 2019. doi:10.3389/fnhum.2019.00013. PMID 30766483.
5. ↑ "Brain-computer interfaces: a powerful tool for scientific inquiry". Current Opinion in Neurobiology 25: 70–5. April 2014. doi:10.1016/j.conb.2013.11.013. PMID 24709603.
6. ↑ "Brain-computer interfaces for dissecting cognitive processes underlying sensorimotor control". Current Opinion in Neurobiology 37: 53–58. April 2016. doi:10.1016/j.conb.2015.12.005. PMID 26796293.
7. ↑ "Integration of optogenetics with complementary methodologies in systems neuroscience". Nature Reviews. Neuroscience 18 (4): 222–235. March 2017. doi:10.1038/nrn.2017.15. PMID 28303019.
8. ↑ "On the Use of TMS to Investigate the Pathophysiology of Neurodegenerative Diseases". Frontiers in Neurology 11: 584664. 2020-11-03. doi:10.3389/fneur.2020.584664. PMID 33224098.
9. ↑ Nintendo Company of America. BrainAge (2006). Based on the work of Ryuta Kawashima, M.D.
10. ↑ The changing nervous system: neurobehavioral consequences of early brain disorders. Oxford University Press US. 1999. ISBN 978-0-19-512193-3. https://books.google.com/books?id=paxE8PFrsLEC.
11. ↑ The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science. Viking Adult. 2007. ISBN 978-0-670-03830-5.
12. ↑ "For an international decade of the mind". The Malaysian Journal of Medical Sciences 18 (2): 1–2. April 2011. PMID 22135580.
13. ↑ 13.0 13.1 "What happened to posteroventral pallidotomy for Parkinson's disease and dystonia?". Neurotherapeutics 5 (2): 281–93. April 2008. doi:10.1016/j.nurt.2008.02.001. PMID 18394570.
14. ↑ "TUS" (in en). https://www.biomedcentral.com/collections/transcranial-ultrasound-stimulation.
15. ↑ "Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996". Electroencephalography and Clinical Neurophysiology 108 (1): 1–16. January 1998. doi:10.1016/S0168-5597(97)00096-8. PMID 9474057. https://zenodo.org/record/1259909.
16. ↑ 16.0 16.1 16.2 "An ethics perspective on transcranial magnetic stimulation (TMS) and human neuromodulation". Behavioural Neurology 17 (3–4): 149–57. 2006. doi:10.1155/2006/791072. PMID 17148834.
17. ↑ 17.0 17.1 "Movement of magnetic nanoparticles in brain tissue: mechanisms and impact on normal neuronal function". Nanomedicine 11 (7): 1821–9. October 2015. doi:10.1016/j.nano.2015.06.003. PMID 26115639.
18. ↑ "TMS-EEG co-registration: on TMS-induced artifact". Clinical Neurophysiology 120 (7): 1392–9. July 2009. doi:10.1016/j.clinph.2009.04.023. PMID 19535291.
19. ↑ "In vivo assessment of human brain oscillations during application of transcranial electric currents". Nature Communications 4: 2032. 2013. doi:10.1038/ncomms3032. PMID 23787780. Bibcode: 2013NatCo...4.2032S.
20. ↑ "Transcranial direct current stimulation of the posterior parietal cortex modulates arithmetic learning". The European Journal of Neuroscience 42 (1): 1667–74. July 2015. doi:10.1111/ejn.12947. PMID 25970697. https://www.zora.uzh.ch/id/eprint/113360/1/Grabner_EJN_2015.pdf. "Cathodal tDCS (compared with sham) decreased learning rates during training and resulted in poorer performance which lasted over 24 h after stimulation. Anodal tDCS showed an operation-specific improvement for subtraction learning.".
21. ↑ "Electrically stimulating prefrontal cortex at retrieval improves recollection accuracy". Cortex; A Journal Devoted to the Study of the Nervous System and Behavior 73: 188–94. December 2015. doi:10.1016/j.cortex.2015.09.003. PMID 26457823. "We found that stimulation of dlPFC significantly increased recollection accuracy, relative to a no-stimulation sham condition and also relative to active stimulation of a comparison region in left parietal cortex.".
22. ↑ "Treatment of depression with transcranial direct current stimulation (tDCS): a review". Exp Neurol 219 (1): 14–19. 2009. doi:10.1016/j.expneurol.2009.03.038. PMID 19348793.
23. ↑ "Transcranial direct current stimulation for acute major depressive episodes: meta-analysis of individual patient data". Br J Psychiatry 208 (6): 522–531. 2016. doi:10.1192/bjp.bp.115.164715. PMID 27056623.
24. ↑ "Parietal dysfunctional connectivity in depression in multiple sclerosis". Mult Scler 27 (9): 1468–1469. 2020. doi:10.1177/1352458520964412. PMID 33084529.
25. ↑ "tDCS randomized controlled trials in no-structural diseases: a quantitative review". Scientific Reports 11 (1): 16311. 2021. doi:10.1038/s41598-021-95084-6. PMID 34381076. Bibcode: 2021NatSR..1116311G.
26. ↑ "Home treatment against fatigue in multiple sclerosis by a personalized, bilateral whole-body somatosensory cortex stimulation". Mult Scler Relat Disord 63: 103813. 2022. doi:10.1016/j.msard.2022.103813. PMID 35597081.
27. ↑ 27.0 27.1 Neuroscience, Fourth Edition. Sinauer Associates, Inc.. 2007. p. 715. ISBN 978-0-87893-697-7.
28. ↑ "Magnetoencephalography (MEG)". Athinoula A. Martinos Center for Biomedical Imaging. November 2007. http://www.nmr.mgh.harvard.edu/martinos/research/technologiesMEG.
29. ↑ "Using brain MERMER testing to detect knowledge despite efforts to conceal". Journal of Forensic Sciences 46 (1): 135–43. January 2001. doi:10.1520/JFS14925J. PMID 11210899.
30. ↑ 30.0 30.1 "The Rise of Neurotechnology Calls for a Parallel Focus on Neurorights". Scientific American. 27 May 2021. https://www.scientificamerican.com/article/the-rise-of-neurotechnology-calls-for-a-parallel-focus-on-neurorights/.
31. ↑ 31.0 31.1 "Legal liabilities of BCI-users: Responsibility gaps at the intersection of mind and machine?". International Journal of Law and Psychiatry. Neuroscience, Law, and Ethics 65: 101399. 2019-07-01. doi:10.1016/j.ijlp.2018.10.002. PMID 30449603. https://www.sciencedirect.com/science/article/pii/S0160252718300852.
32. ↑ "Four ethical priorities for neurotechnologies and AI". Nature 551 (7679): 159–163. November 2017. doi:10.1038/551159a. PMID 29120438. Bibcode: 2017Natur.551..159Y.
33. ↑ "Personality changes after deep brain stimulation in Parkinson's disease". Parkinson's Disease 2015: 490507. 2015-01-29. doi:10.1155/2015/490507. PMID 25705545.
34. ↑ "Deep Brain Stimulation, Authenticity and Value". Cambridge Quarterly of Healthcare Ethics 26 (4): 640–657. October 2017. doi:10.1017/S0963180117000147. PMID 28937346.
35. ↑ "I Miss Being Me: Phenomenological Effects of Deep Brain Stimulation". AJOB Neuroscience 8 (2): 96–109. 2017-04-03. doi:10.1080/21507740.2017.1320319. ISSN 2150-7740.
36. ↑ "Multi-Person Brain-To-Brain Interfaces: Ethical Issues". Frontiers in Neuroscience 13: 1177. 5 Nov 2019. doi:10.3389/fnins.2019.01177. PMID 31827418.
37. ↑ 37.0 37.1 ""I Am Who I Am": On the Perceived Threats to Personal Identity from Deep Brain Stimulation". Neuroethics 6 (3): 513–526. 2013-12-01. doi:10.1007/s12152-011-9137-1. PMID 24273621.
38. ↑ 38.0 38.1 "Wired Emotions: Ethical Issues of Affective Brain-Computer Interfaces". Science and Engineering Ethics 26 (1): 351–367. February 2020. doi:10.1007/s11948-019-00087-2. PMID 30868377.
39. ↑ "Biomarkers for PTSD Susceptibility and Resilience, Ethical Issues". AJOB Neuroscience 10 (3): 122–124. 2019-07-03. doi:10.1080/21507740.2019.1632964. PMID 31361197. https://cris.maastrichtuniversity.nl/en/publications/789df5c5-dfda-44be-b7cb-12fb371e4742.
40. ↑ "Action". The Stanford Encyclopedia of Philosophy (Winter 2016 ed.). Metaphysics Research Lab, Stanford University. 2016. https://plato.stanford.edu/archives/win2016/entries/action/.
41. ↑ "Did I Do That? Brain–Computer Interfacing and the Sense of Agency" (in en). Minds and Machines 23 (3): 405–418. 2013-08-01. doi:10.1007/s11023-012-9298-7. ISSN 1572-8641.
42. ↑ "Staying in the Loop: Relational Agency and Identity in Next-Generation DBS for Psychiatry". AJOB Neuroscience 8 (2): 59–70. 2017-04-03. doi:10.1080/21507740.2017.1320320. ISSN 2150-7740.
43. ↑ "A brain-computer interface for long-term independent home use". Amyotrophic Lateral Sclerosis 11 (5): 449–55. October 2010. doi:10.3109/17482961003777470. PMID 20583947.
44. ↑ "Restoration of reaching and grasping movements through brain-controlled muscle stimulation in a person with tetraplegia: a proof-of-concept demonstration". Lancet 389 (10081): 1821–1830. May 2017. doi:10.1016/s0140-6736(17)30601-3. PMID 28363483.
45. ↑ 45.0 45.1 45.2 "Emerging neurotechnologies for lie-detection: promises and perils". The American Journal of Bioethics 5 (2): 39–49. 2005. doi:10.1080/15265160590923367. PMID 16036700. https://repository.upenn.edu/cgi/viewcontent.cgi?article=1005&context=neuroethics_pubs.

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