Taking Psychology with You

Cosmetic Neurology: Tinkering with the Brain

Should healthy people be permitted, even encouraged, to take “brain boosters” or “neuroenhancers,” drugs that will sharpen concentration and memory? What about a pill that could erase a traumatic memory? If having cosmetic surgery can change parts of your body that you don't like, what's wrong with allowing “cosmetic neurology” to tinker with parts of your brain that you don't like?

For centuries, people have been seeking ways to stimulate their brains to work more efficiently, with caffeine being an especially popular drug of choice. But people who dislike coffee don't talk about the unfair advantage that coffee drinkers have. Likewise, no one objects to the finding that omega-3s, found in some kinds of fish, may help protect university students against the sudden increases in blood pressure that mental stress causes (Ginty & Conklin, 2012). But when it comes to prescription medications that increase alertness or appear to enhance memory and other cognitive functions, it's another kettle of fish oil, so to speak. What questions should you ask and what kind of evidence would you need to make wise decisions about using these medications? A new interdisciplinary specialty, neuroethics, has been formed to address the many legal, ethical, and scientific questions raised by brain research, including those raised by the development of neuroenhancing drugs (Gazzaniga, 2005).

Much of the buzz has focused on Provigil (modafinil), a drug approved for treating narcolepsy and other sleep disorders, and the amphetamines Ritalin and Adderall, approved for attention-deficit disorders. Some students, pilots, business executives, and jetlagged travelers are taking one or another of these drugs, either obtaining them illegally from friends or the Internet, or getting their own prescriptions. Most of these users claim the drugs help them learn better and stay alert. And one review of the literature concluded that Provigil can indeed improve memory for studied material (Smith & Farah, 2011), although the boost the medications deliver is less than what people expect (Repantis et al., 2010).

But the downside to these drugs rarely makes the news. Adderall, like all amphetamines, can cause nervousness, headaches, sleeplessness, allergic rashes, and loss of appetite, and, as the label says, it has “a high potential for abuse.” Provigil, too, is habit-forming. Another memory-enhancing drug being studied targets a type of glutamate receptor in the brain. The drug apparently improves short-term memory, but at the price of impairing long-term memory (Talbot, 2009).

Even when a drug is benign for most of its users, there may be surprising and unexpected consequences. For example, the better able that people are to focus and concentrate on a task—the reason for taking stimulants in the first place—the less creative they often are. Creativity, after all, comes from being able to let our minds roam freely, at leisure. One neurologist therefore worries that the routine use of mind-enhancing drugs among students could create “a generation of very focused accountants” (quoted in Talbot, 2009).

Some bioethicists and neuroscientists think that the desire for cosmetic neurology is just part of human nature, a way for people to adapt to their environments and achieve goals that they could not achieve without the drugs (Müller & Schumann, 2011). After all, we use eyeglasses to improve vision and hearing aids to improve hearing; why not use pills to improve our memories and other mental skills? One team of scientists has argued that improving brain function with pills is no more objectionable than eating right or getting a good night's sleep. “In a world in which human work spans and life spans are increasing,” they wrote, cognitive enhancement tools “will be increasingly useful for improved quality of life and extended work productivity, as well as to stave off normal and pathological age-related cognitive declines” (Greely et al., 2008).

Other scientists and social critics, however, consider cosmetic neurology to be a form of cheating that will give those who can afford the drugs an unfair advantage and increase socioeconomic inequalities. They think the issue is no different from the (prohibited) use of performance-enhancing steroids in athletics. And yes, they say, people wear glasses and hearing aids, but glasses and hearing aids do not have side effects or interact negatively with other treatments. Many neuroethicists also worry that ambitious parents will start giving these medications to their children to try to boost the child's academic performance, despite possible hazards for the child's developing brain. One reporter covering the pros and cons of neuroenhancers concluded that she's not sure she wants to live in a world where we are all worked so hard that we have to take drugs simply to keep up (Talbot, 2009).

And what if cognitive enhancement involved not pills but electrical stimulation of your brain? In 2012, neuroscientists at the University of Oxford reported that transcranial direct current stimulation (tDCS) might soon be used with healthy people to improve their math skills, memory, problem solving, and other mental abilities. One said, “I can see a time when people plug a simple device into an iPad so that their brain is stimulated when they are doing their homework, learning French, or taking up the piano.” And, he added, tDCS would be a great educational aid for children.

Should you get in line to buy your own tDCS machine? Best to wait. As a critical thinker, you would want to ask how much research on tDCS has been done. (Answer: Most is preliminary laboratory work that has been done only on a small scale.) Has research determined whether there are better or worse ways of using tDCS for different mental abilities? (Not yet.) Has the method been tested on children, whose brains are still developing? (Not yet.) Is it known whether boosting ability in one area might affect abilities in other areas? (Not yet.) Has research determined whether the use of tDCS in the lab can improve people's abilities in everyday life? (Not yet.) Finally, critical thinkers should be wary of the entrepreneurs who won't want to wait for the answers to these questions before they start trying to market tDCS to parents, patients, and students.