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Fukushi T. East Asian perspective of responsible research and innovation in neurotechnology. IBRO Neurosci Rep 2024; 16:582-597. [PMID: 38774060 PMCID: PMC11107355 DOI: 10.1016/j.ibneur.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/10/2024] [Accepted: 04/30/2024] [Indexed: 05/24/2024] Open
Abstract
After more than half a century of research and development (R&D), Brain-computer interface (BCI)-based Neurotechnology continues to progress as one of the leading technologies of the 2020 s worldwide. Various reports and academic literature in Europe and the United States (U.S.) have outlined the trends in the R&D of neurotechnology and the consideration of ethical issues, and the importance of the formulation of ethical principles, guidance and industrial standards as well as the development of relevant human resources has been discussed. However, limited number studies have focused on neurotechnology R&D, the dissemination of neuroethics related to the academic foundation advancing the discussion on ethical principles, guidance and standards or human resource development in the Asian region. This study fills in this gap in understanding of Eastern Asian (China, Korea and Japan) situation based on the participation in activities to develop ethical principles, guidance, and industrial standards for appropriate use of neurotechnology, in addition to literature survey and clinical registries' search investigation reflecting the trends in neurotechnology R&D as well as its social implication in Asian region. The current study compared the results with the situation in Europa and the U.S. and discussed issues that need to be addressed in the future and discussed the significance and potential of corporate consortium initiatives in Japan and examples of ethics and governance activities in Asian Countries.
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Affiliation(s)
- Tamami Fukushi
- Faculty of Human Welfare, Tokyo Online University, Nishi-Shinjuku Shinjuku-ku, Tokyo 160-0023, Japan
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2
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Rainey S. An Anticipatory Approach to Ethico-Legal Implications of Future Neurotechnology. Sci Eng Ethics 2024; 30:18. [PMID: 38748291 PMCID: PMC11096192 DOI: 10.1007/s11948-024-00482-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/20/2024] [Indexed: 05/18/2024]
Abstract
This paper provides a justificatory rationale for recommending the inclusion of imagined future use cases in neurotechnology development processes, specifically for legal and policy ends. Including detailed imaginative engagement with future applications of neurotechnology can serve to connect ethical, legal, and policy issues potentially arising from the translation of brain stimulation research to the public consumer domain. Futurist scholars have for some time recommended approaches that merge creative arts with scientific development in order to theorise possible futures toward which current trends in technology development might be steered. Taking a creative, imaginative approach like this in the neurotechnology context can help move development processes beyond considerations of device functioning, safety, and compliance with existing regulation, and into an active engagement with potential future dynamics brought about by the emergence of the neurotechnology itself. Imagined scenarios can engage with potential consumer uses of devices that might come to challenge legal or policy contexts. An anticipatory, creative approach can imagine what such uses might consist in, and what they might imply. Justifying this approach also prompts a co-responsibility perspective for policymaking in technology contexts. Overall, this furnishes a mode of neurotechnology's emergence that can avoid crises of confidence in terms of ethico-legal issues, and promote policy responses balanced between knowledge, values, protected innovation potential, and regulatory safeguards.
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Affiliation(s)
- Stephen Rainey
- Department of Values, Technology and Innovation (VTI), Delft University of Technology, Delft, The Netherlands.
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3
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Waisberg E, Ong J, Lee AG. Ethical Considerations of Neuralink and Brain-Computer Interfaces. Ann Biomed Eng 2024:10.1007/s10439-024-03511-2. [PMID: 38602573 DOI: 10.1007/s10439-024-03511-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
Neuralink is a neurotechnology company founded by Elon Musk in 2016, which has been quietly developing revolutionary technology allowing for ultra-high precision bidirectional communication between external devices and the brain. In this paper, we explore the multifaceted ethical considerations surrounding neural interfaces, analyzing potential societal impacts, risks, and call for a need for responsible innovation. Despite the technological, medical, medicolegal, and ethical challenges ahead, neural interface technology remains extremely promising and has the potential to create a new era of medicine.
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Affiliation(s)
- Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge, UK.
| | - Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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4
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Finn S, Aliyianis T, Beattie B, Boissé Lomax L, Shukla G, Scott SH, Winston GP. Robotic assessment of sensorimotor and cognitive deficits in patients with temporal lobe epilepsy. Epilepsy Behav 2024; 151:109613. [PMID: 38183928 DOI: 10.1016/j.yebeh.2023.109613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Individuals with temporal lobe epilepsy (TLE) frequently demonstrate impairments in executive function, working memory, and/or declarative memory. It is recommended that screening for cognitive impairment is undertaken in all people newly diagnosed with epilepsy. However, standard neuropsychological assessments are a limited resource and thus not available to all. Our study investigated the use of robotic technology (the Kinarm robot) for cognitive screening. METHODS 27 participants with TLE (17 left) underwent both a brief neuropsychological screening and a robotic (Kinarm) assessment. The degree of impairments and correlations between standardized scores from both approaches to assessments were analysed across different neurocognitive domains. Performance was compared between people with left and right TLE to look for laterality effects. Finally, the association between the duration of epilepsy and performance was assessed. RESULTS Across the 6 neurocognitive domains (attention, executive function, language, memory, motor and visuospatial) assessed by our neuropsychological screening, all showed scores that significantly correlated with Kinarm tasks assessing the same cognitive domains except language and memory that were not adequately assessed with Kinarm. Participants with right TLE performed worse on most tasks than those with left TLE, including both visuospatial (typically considered right hemisphere), and verbal memory and language tasks (typically considered left hemisphere). No correlations were found between the duration of epilepsy and either the neuropsychological screening or Kinarm assessment. SIGNIFICANCE Our findings suggest that Kinarm may be a useful tool in screening for neurocognitive impairment in people with TLE. Further development may facilitate an easier and more rapid screening of cognition in people with epilepsy and distinguishing patterns of cognitive impairment.
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Affiliation(s)
- Spencer Finn
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | | | - Brooke Beattie
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | - Lysa Boissé Lomax
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
| | - Garima Shukla
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | - Gavin P Winston
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
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5
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Alipour J, Pourrashidi H. A Critical Study on the Researches about the Application of Neurotechnology in Education. Int J Neurosci 2024:1-12. [PMID: 38270558 DOI: 10.1080/00207454.2024.2311231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/23/2024] [Indexed: 01/26/2024]
Abstract
The education and pedagogy have been adopted with the growth of technology in order to achieve efficient consequences by the usage of innovational and up-to-date technologies. The new methods in neuroscience and neurotechnology have influenced the educational systems and the classrooms. A considerable number of researches have been projected in this field that all try to demonstrate the advantages and desirable effects of neurotechnology in education and the classrooms. In fact, most researchers have connived its harms and disadvantages on the students and the educational systems and the sphere of the classrooms. This paper tries to survey the fourteen recent researches in the framework of critical theory to discuss the adverse effects of neurotechnology as well as their neglected aspects in education and the classrooms. The findings illuminate that crucial disadvantages of neurotechnology are neglected in education and on the participants in the process of learning.
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Affiliation(s)
- Javad Alipour
- Department of Political Science, Faculty of Law and Social Science, The University of Tabriz, Tabriz, Iran
| | - Hatef Pourrashidi
- Research Center for Religion and Denominations, The University of Religions and Denominations, Qom, Iran
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6
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Stranahan AM, Tabet A, Anikeeva P. Region-specific targeting of microglia in vivo using direct delivery of tamoxifen metabolites via microfluidic polymer fibers. Brain Behav Immun 2024; 115:131-142. [PMID: 37820974 PMCID: PMC10842189 DOI: 10.1016/j.bbi.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/07/2023] [Accepted: 09/30/2023] [Indexed: 10/13/2023] Open
Abstract
Region-specific genetic manipulation of glial cells remains challenging due to the lack of anatomically selective transgenic models. Although local transduction is achievable with viral vectors, uniform recombination can be challenging in larger brain regions. We investigated the efficacy of intraparenchymal delivery of the tamoxifen metabolite endoxifen using inducible cre reporter mice. After observing localized reporter induction following stereotaxic injections of endoxifen in CX3CR1creERT2 mice, we carried out chronic delivery via osmotic pumps attached to bilateral cannulas made of stainless steel or microfluidic polymer fibers. Analysis of reporter expression in sections or iDISCO-cleared brains from TMEM119creERT2 mice revealed widespread induction following chronic infusion. Neuronal damage and gliosis were more prevalent around steel cannulas than polymer fibers, and glial reactivity was further attenuated when devices were implanted two months before drug delivery. In summary, region-specific recombination is achievable in glia with minimal tissue damage after endoxifen delivery via microfluidic polymer implants.
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Affiliation(s)
- Alexis M Stranahan
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Augusta University, 1120 15th St, Augusta, GA 30912, USA.
| | - Anthony Tabet
- Research Laboratory of Electronics and McGovern Institute for Brain Research, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139-4307, USA
| | - Polina Anikeeva
- Research Laboratory of Electronics and McGovern Institute for Brain Research, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139-4307, USA; Departments of Materials Science & Engineering and Brain & Cognitive Sciences, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139-4307, USA
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7
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Huyghe T, Calleja-González J, Bird SP, Alcaraz PE. Pupillometry as a new window to player fatigue? A glimpse inside the eyes of a Euro Cup Women's Basketball team. Biol Sport 2024; 41:3-15. [PMID: 38188113 PMCID: PMC10765450 DOI: 10.5114/biolsport.2024.125590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 07/18/2022] [Accepted: 02/14/2023] [Indexed: 01/09/2024] Open
Abstract
A rapidly emerging area of interest in high-pressure environments is that of pupillometry, where handheld quantitative infrared pupillometers (HQIPs) are able to track psycho-physiological fatigue in a fast, objective, valid, reliable, and non-invasive manner. However, the application of HQIPs in the context of athlete monitoring is yet to be determined. Therefore, the main aim of this pilot study was to examine the potential usefulness of a HQIP to monitor game-induced fatigue inside a professional female basketball setting by determining its (1) test-retest repeatability, (2) relationship with other biomarkers of game-induced fatigue, and (3) time-course from rested to fatigued states. A non-ophthalmologic practitioner performed a standardized Pupil Light Reflex (PLR) test using a medically graded HQIP among 9 professional female basketball players (2020-2021 Euro Cup) at baseline, 24-h pre-game (GD-1), 24-h post-game (GD+1) and 48-h post-game (GD+2). This was repeated over four subsequent games, equalling a total of 351 observations per eye. Two out of seven pupillometrics displayed good ICCs (0.95-0.99) (MinD and MaxD). Strong significant relationships were found between MaxD, MinD, and all registered biomarkers of game-induced fatigue (r = 0.69-0.82, p < 0.05), as well as between CV, MCV, and cognitive, lower-extremity muscle, and physiological fatigue markers (r = 0.74-0.76, p < 0.05). Three pupillometrics were able to detect a significant difference between rested and fatigued states. In particular, PC (right) (F = 5.173, η2 = 0.115 p = 0.028) and MCV (right) (F = 3.976, η2 = 0.090 p = 0.049) significantly decreased from baseline to GD+2, and LAT (left) (F = 4.023, η2 = 0.109 p = 0.009) significantly increased from GD-1 to GD+2. HQIPs have opened a new window of opportunity for monitoring game-induced fatigue in professional female basketball players. However, future research initiatives across larger and heterogenous samples, and longer investigation periods, are required to expand upon these preliminary findings.
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Affiliation(s)
- Thomas Huyghe
- Research Center for High Performance Sport, Universidad Católica de Murcia, Murcia, Spain
| | - Julio Calleja-González
- Department of Physical Education and Sports, Faculty of Education and Sport, University of the Basque Country, (UPV/EHU), Vitoria-Gasteiz, Spain
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Stephen P Bird
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich QLD, Australia
| | - Pedro E Alcaraz
- Research Center for High Performance Sport, Universidad Católica de Murcia, Murcia, Spain
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8
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Cantillo-Negrete J, Carino-Escobar RI, Ortega-Robles E, Arias-Carrión O. A comprehensive guide to BCI-based stroke neurorehabilitation interventions. MethodsX 2023; 11:102452. [PMID: 38023311 PMCID: PMC10630643 DOI: 10.1016/j.mex.2023.102452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Brain-Computer Interfaces (BCIs) offer the potential to facilitate neurorehabilitation in stroke patients by decoding user intentions from the central nervous system, thereby enabling control over external devices. Despite their promise, the diverse range of intervention parameters and technical challenges in clinical settings have hindered the accumulation of substantial evidence supporting the efficacy and effectiveness of BCIs in stroke rehabilitation. This article introduces a practical guide designed to navigate through these challenges in conducting BCI interventions for stroke rehabilitation. Applicable regardless of infrastructure and study design limitations, this guide acts as a comprehensive reference for executing BCI-based stroke interventions. Furthermore, it encapsulates insights gleaned from administering hundreds of BCI rehabilitation sessions to stroke patients.•Presents a comprehensive methodology for implementing BCI-based upper extremity therapy in stroke patients.•Provides detailed guidance on the number of sessions, trials, as well as the necessary hardware and software for effective intervention.
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Affiliation(s)
- Jessica Cantillo-Negrete
- División de Investigación en Neurociencias Clínica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra, Mexico City, NM 14389, Mexico
| | - Ruben I. Carino-Escobar
- División de Investigación en Neurociencias Clínica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra, Mexico City, NM 14389, Mexico
| | - Emmanuel Ortega-Robles
- Unidad de Trastornos del Movimiento y Sueño, Hospital General Dr. Manuel Gea González, Mexico City 14080, Mexico
| | - Oscar Arias-Carrión
- Unidad de Trastornos del Movimiento y Sueño, Hospital General Dr. Manuel Gea González, Mexico City 14080, Mexico
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Chang EH, Gabalski AH, Huerta TS, Datta-Chaudhuri T, Zanos TP, Zanos S, Grill WM, Tracey KJ, Al-Abed Y. The Fifth Bioelectronic Medicine Summit: today's tools, tomorrow's therapies. Bioelectron Med 2023; 9:21. [PMID: 37794457 PMCID: PMC10552422 DOI: 10.1186/s42234-023-00123-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
The emerging field of bioelectronic medicine (BEM) is poised to make a significant impact on the treatment of several neurological and inflammatory disorders. With several BEM therapies being recently approved for clinical use and others in late-phase clinical trials, the 2022 BEM summit was a timely scientific meeting convening a wide range of experts to discuss the latest developments in the field. The BEM Summit was held over two days in New York with more than thirty-five invited speakers and panelists comprised of researchers and experts from both academia and industry. The goal of the meeting was to bring international leaders together to discuss advances and cultivate collaborations in this emerging field that incorporates aspects of neuroscience, physiology, molecular medicine, engineering, and technology. This Meeting Report recaps the latest findings discussed at the Meeting and summarizes the main developments in this rapidly advancing interdisciplinary field. Our hope is that this Meeting Report will encourage researchers from academia and industry to push the field forward and generate new multidisciplinary collaborations that will form the basis of new discoveries that we can discuss at the next BEM Summit.
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Affiliation(s)
- Eric H Chang
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA.
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA.
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA.
| | - Arielle H Gabalski
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
| | - Tomas S Huerta
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Timir Datta-Chaudhuri
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Theodoros P Zanos
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Stavros Zanos
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Warren M Grill
- Department of Biomedical Engineering, Fitzpatrick CIEMAS, Duke University, Room 1427, 101 Science Drive, Box 90281, Durham, NC, 27708, USA
| | - Kevin J Tracey
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
| | - Yousef Al-Abed
- Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Blvd, Hempstead, NY, 11549, USA
- The Elmezzi Graduate School of Molecular Medicine, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA
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10
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Zohny H, Lyreskog DM, Singh I, Savulescu J. The Mystery of Mental Integrity: Clarifying Its Relevance to Neurotechnologies. NEUROETHICS-NETH 2023; 16:20. [PMID: 37614938 PMCID: PMC10442279 DOI: 10.1007/s12152-023-09525-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/06/2023] [Indexed: 08/25/2023]
Abstract
The concept of mental integrity is currently a significant topic in discussions concerning the regulation of neurotechnologies. Technologies such as deep brain stimulation and brain-computer interfaces are believed to pose a unique threat to mental integrity, and some authors have advocated for a legal right to protect it. Despite this, there remains uncertainty about what mental integrity entails and why it is important. Various interpretations of the concept have been proposed, but the literature on the subject is inconclusive. Here we consider a number of possible interpretations and argue that the most plausible one concerns neurotechnologies that bypass one's reasoning capacities, and do so specifically in ways that reliably lead to alienation from one's mental states. This narrows the scope of what constitutes a threat to mental integrity and offers a more precise role for the concept to play in the ethical evaluation of neurotechnologies.
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Affiliation(s)
- Hazem Zohny
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - David M. Lyreskog
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Ilina Singh
- Department of Psychiatry, University of Oxford, Oxford, UK
- Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Julian Savulescu
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Murdoch Children’s Research Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
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11
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Merner AR, Kostick-Quenet K, Campbell TA, Pham MT, Sanchez CE, Torgerson L, Robinson J, Pereira S, Outram S, Koenig BA, Starr PA, Gunduz A, Foote KD, Okun MS, Goodman W, McGuire AL, Zuk P, Lázaro-Muñoz G. Participant perceptions of changes in psychosocial domains following participation in an adaptive deep brain stimulation trial. Brain Stimul 2023; 16:990-998. [PMID: 37330169 PMCID: PMC10529988 DOI: 10.1016/j.brs.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/19/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND There has been substantial controversy in the neuroethics literature regarding the extent to which deep brain stimulation (DBS) impacts dimensions of personality, mood, and behavior. OBJECTIVE/HYPOTHESIS Despite extensive debate in the theoretical literature, there remains a paucity of empirical data available to support or refute claims related to the psychosocial changes following DBS. METHODS A mixed-methods approach was used to examine the perspectives of patients who underwent DBS regarding changes to their personality, authenticity, autonomy, risk-taking, and overall quality of life. RESULTS Patients (n = 21) who were enrolled in adaptive DBS trials for Parkinson's disease, essential tremor, obsessive-compulsive disorder, Tourette's syndrome, or dystonia participated. Qualitative data revealed that participants, in general, reported positive experiences with alterations in what was described as 'personality, mood, and behavior changes.' The majority of participants reported increases in quality of life. No participants reported 'regretting the decision to undergo DBS.' CONCLUSION(S) The findings from this patient sample do not support the narrative that DBS results in substantial adverse changes to dimensions of personality, mood, and behavior. Changes reported as "negative" or "undesired" were few in number, and transient in nature.
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Affiliation(s)
- Amanda R Merner
- Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States
| | - Kristin Kostick-Quenet
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Tiffany A Campbell
- Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States
| | - Michelle T Pham
- Center for Bioethics and Social Justice, Michigan State University, East Fee Hall, 965 Wilson Road Rm A-126, East Lansing, MI, 48824, United States
| | - Clarissa E Sanchez
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Laura Torgerson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Jill Robinson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Stacey Pereira
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Simon Outram
- Program in Bioethics, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, United States
| | - Barbara A Koenig
- Program in Bioethics, University of California, San Francisco, 490 Illinois Street, San Francisco, CA, 94143, United States
| | - Philip A Starr
- Department of Neurological Surgery, University of California, San Francisco, 400 Parnassus Avenue, San Francisco, CA, 94143, United States
| | - Aysegul Gunduz
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, 3009 SW Williston Road, Gainesville, FL, 32608, United States; Department of Biomedical Engineering, University of Florida, 1275 Center Drive, Biomedical Science Building, JG283, Gainesville, FL, 32611, United States
| | - Kelly D Foote
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, 3009 SW Williston Road, Gainesville, FL, 32608, United States
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, 3009 SW Williston Road, Gainesville, FL, 32608, United States
| | - Wayne Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd Suite E4.100, Houston, TX, 77030, United States
| | - Amy L McGuire
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Peter Zuk
- Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States
| | - Gabriel Lázaro-Muñoz
- Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, United States.
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12
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Yoo SH, Choi K, Nam S, Yoon EK, Sohn JW, Oh BM, Shim J, Choi MY. Development of Korea Neuroethics Guidelines. J Korean Med Sci 2023; 38:e193. [PMID: 37365727 DOI: 10.3346/jkms.2023.38.e193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/07/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Advances in neuroscience and neurotechnology provide great benefits to humans though unknown challenges may arise. We should address these challenges using new standards as well as existing ones. Novel standards should include ethical, legal, and social aspects which would be appropriate for advancing neuroscience and technology. Therefore, the Korea Neuroethics Guidelines were developed by stakeholders related to neuroscience and neurotechnology, including experts, policy makers, and the public in the Republic of Korea. METHOD The guidelines were drafted by neuroethics experts, were disclosed at a public hearing, and were subsequently revised by opinions of various stakeholders. RESULTS The guidelines are composed of twelve issues; humanity or human dignity, individual personality and identity, social justice, safety, sociocultural prejudice and public communication, misuse of technology, responsibility for the use of neuroscience and technology, specificity according to the purpose of using neurotechnology, autonomy, privacy and personal information, research, and enhancement. CONCLUSION Although the guidelines may require a more detailed discussion after future advances in neuroscience and technology or changes in socio-cultural milieu, the development of the Korea Neuroethics Guidelines is a milestone for the scientific community and society in general for the ongoing development in neuroscience and neurotechnology.
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Affiliation(s)
- Sang-Ho Yoo
- Department of Medical Humanities and Ethics, Hanyang University College of Medicine, Seoul, Korea
| | - Kyungsuk Choi
- School of Law/Bioethics Policy Studies, Ewha Womans University, Seoul, Korea
| | - Seungmin Nam
- Department of Pre-Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Ei-Kyung Yoon
- Department of Criminal Justice Policy Research, Korean Institute of Criminology and Justice, Seoul, Korea
| | - Jeong-Woo Sohn
- Department of Medical Science, College of Medicine, Catholic Kwandong University, Gangneung, Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jiwon Shim
- Department of Philosophy, Dongguk University, Seoul, Korea
| | - Min-Young Choi
- Department of Criminal Justice Policy Research, Korean Institute of Criminology and Justice, Seoul, Korea.
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13
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Mollica A, Greben R, Cyr M, Olson JA, Burke MJ. Placebo Effects and Neuromodulation: Ethical Considerations and Recommendations. Can J Neurol Sci 2023; 50:s34-s41. [PMID: 37160673 DOI: 10.1017/cjn.2023.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Placebo-controlled trials are the gold standard of evaluating treatment efficacy in clinical research. Neuromodulation is emerging as an important treatment pathway for many neuropsychiatric conditions, and placebo control arms of these trials require careful design with unique considerations (e.g., sham devices that mimic active stimulation, blinding effectiveness). Inherent to placebo-controlled trials are ethical concerns, such as deception, and potential harm of not receiving the active treatment. In this article, we outline important ethical considerations of placebo-controlled trials across neuromodulation approaches and provide recommendations on how ethical principles can be adhered to going forward. We specifically address issues of autonomy and respect for persons, beneficence, and justice. Within the context of this ethical framework, we also discuss factors influencing placebo effects in neuromodulation, the importance of adequate blinding, and alternative trial designs that could be considered.
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Affiliation(s)
- Adriano Mollica
- Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Harquail Centre for Neuromodulation and Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Rachel Greben
- Harquail Centre for Neuromodulation and Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Marieve Cyr
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Jay A Olson
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Matthew J Burke
- Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
- Harquail Centre for Neuromodulation and Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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14
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Nadler R. Antitrust as a Guardrail for Socially Responsible Neurotechnology Design. Can J Neurol Sci 2023; 50:s42-s45. [PMID: 37160674 DOI: 10.1017/cjn.2022.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The neurotechnology sector is likely to develop under pressure towards commercialized, nonmedical products and may also undergo market consolidation. This possibility raises ethical, social, and policy concerns about the future responsibility of neurotechnology innovators and companies for high-consequence design decisions. Present-day internet technology firms furnish an instructive example of the problems that arise when providers of communicative technologies become too big for accountability. As a guardrail against the emergence of similar problems, concerned neurotechnologists may wish to draw inspiration from antitrust law and direct efforts, where appropriate, against undue consolidation in the commercial neurotechnology market.
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Affiliation(s)
- Roland Nadler
- Peter A. Allard School of Law, University of British Columbia, Vancouver, British Columbia, Canada
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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15
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Giacobbe P, Burhan AM, Waxman R, Ng E. Interventional Psychiatry and Neurotechnologies: Education and Ethics Training. Can J Neurol Sci 2023; 50:s10-s16. [PMID: 37160678 DOI: 10.1017/cjn.2023.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The last two decades have seen dramatic growth in the application of procedurally based interventions for treating refractory psychiatric conditions, leading to interest in developing the foundations for the subspecialty of "Interventional Psychiatry." However, there is cause for concern that the rate of expansion of clinical advances in this field may be outpacing the ability of postgraduate curricula to provide sufficient exposure to and teaching and supervision of these treatments. The paucity of adequately trained practitioners in Interventional Psychiatry further exacerbates inequities in the ability of eligible patients to access and benefit from these approaches. This paper explores the rates of utilization of Interventional Psychiatry treatments, the current state of education in these treatments, and the role that training can play in translating scientific advances in this area to ensure equitable access and maximum impact at a population level. The majority of the discussion is centered on electroconvulsive therapy (ECT), the most established and available of these treatments, highlighting how enhancing education and training in ECT can reduce barriers to its utilization. It is argued that innovations in pedagogical approaches for disseminating the learning of these procedures are needed to increase the current low rates of competency in these treatments and can facilitate the more rapid dissemination of other Interventional Psychiatry approaches and neurotechnologies, such as repetitive transcranial magnetic stimulation, ketamine, deep brain stimulation, and focused ultrasound.
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Affiliation(s)
- Peter Giacobbe
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Amer M Burhan
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
| | - Robyn Waxman
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Ontario Shores Centre for Mental Health Sciences, Whitby, Canada
| | - Enoch Ng
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, Canada
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16
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Harding L, McFarlane J, Honey CR, McDonald PJ, Illes J. Mapping the Landscape of Equitable Access to Advanced Neurotechnologies in Canada. Can J Neurol Sci 2023; 50:s17-s25. [PMID: 37160675 PMCID: PMC10172973 DOI: 10.1017/cjn.2023.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Geographic, social, political, and economic factors shape access to advanced neurotechnologies, yet little previous research has explored the barriers, enablers, and areas of opportunity for equitable and meaningful access for diverse patient communities across Canada. We applied a mixed-mode approach involving semi-structured interviews and rating scale questions to consult with 24 medical experts who are involved in the care of patients who undergo functional neurosurgery targeting the brain. Seven major themes emerged from the qualitative analysis: Health care system, Neurotechnology features, Patient demographics, Target condition features, Ethics, Upstream barriers and enablers, and Areas of opportunity. Descriptive statistics of the Likert-scale responses suggest that interviewees perceive a disparity between the imperative of access to advanced neurotechnologies for people living in rural and remote areas and the likelihood of achieving such access. The results depict a complex picture of access to functional neurosurgery in Canada with pockets of excellence and a motivation to improve the availability of care for vulnerable populations through the expansion of distributed care models, improved health care system efficiencies, increasing funding and support for patient travel, and increasing awareness about and advocacy for advanced neurotechnologies.
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Affiliation(s)
- Louise Harding
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacob McFarlane
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher R. Honey
- Faculty of Medicine, Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick J. McDonald
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Faculty of Medicine, Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
- Section of Neurosurgery, Departments of Surgery and Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Marcos-Martínez D, Santamaría-Vázquez E, Martínez-Cagigal V, Pérez-Velasco S, Rodríguez-González V, Martín-Fernández A, Moreno-Calderón S, Hornero R. ITACA: An open-source framework for Neurofeedback based on Brain-Computer Interfaces. Comput Biol Med 2023; 160:107011. [PMID: 37201274 DOI: 10.1016/j.compbiomed.2023.107011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/28/2023] [Accepted: 05/03/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND OBJECTIVE Neurofeedback (NF) is a paradigm that allows users to self-modulate patterns of brain activity. It is implemented with a closed-loop brain-computer interface (BCI) system that analyzes the user's brain activity in real-time and provides continuous feedback. This paradigm is of great interest due to its potential as a non-pharmacological and non-invasive alternative to treat non-degenerative brain disorders. Nevertheless, currently available NF frameworks have several limitations, such as the lack of a wide variety of real-time analysis metrics or overly simple training scenarios that may negatively affect user performance. To overcome these limitations, this work proposes ITACA: a novel open-source framework for the design, implementation and evaluation of NF training paradigms. METHODS ITACA is designed to be easy-to-use, flexible and attractive. Specifically, ITACA includes three different gamified training scenarios with a choice of five brain activity metrics as real-time feedback. Among them, novel metrics based on functional connectivity and network theory stand out. It is complemented with five different computerized versions of widespread cognitive assessment tests. To validate the proposed framework, a computational efficiency analysis and an NF training protocol focused on frontal-medial theta modulation were conducted. RESULTS Efficiency analysis proved that all implemented metrics allow an optimal feedback update rate for conducting NF sessions. Furthermore, conducted NF protocol yielded results that support the use of ITACA in NF research studies. CONCLUSIONS ITACA implements a wide variety of features for designing, conducting and evaluating NF studies with the goal of helping researchers expand the current state-of-the-art in NF training.
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Affiliation(s)
- Diego Marcos-Martínez
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Eduardo Santamaría-Vázquez
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Víctor Martínez-Cagigal
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Sergio Pérez-Velasco
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Víctor Rodríguez-González
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
| | - Ana Martín-Fernández
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain.
| | - Selene Moreno-Calderón
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain.
| | - Roberto Hornero
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, 47011, Valladolid, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Spain.
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18
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Reyes-Sanchez M, Amaducci R, Sanchez-Martin P, Elices I, Rodriguez FB, Varona P. Automatized offline and online exploration to achieve a target dynamics in biohybrid neural circuits built with living and model neurons. Neural Netw 2023; 164:464-475. [PMID: 37196436 DOI: 10.1016/j.neunet.2023.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/01/2023] [Accepted: 04/18/2023] [Indexed: 05/19/2023]
Abstract
Biohybrid circuits of interacting living and model neurons are an advantageous means to study neural dynamics and to assess the role of specific neuron and network properties in the nervous system. Hybrid networks are also a necessary step to build effective artificial intelligence and brain hybridization. In this work, we deal with the automatized online and offline adaptation, exploration and parameter mapping to achieve a target dynamics in hybrid circuits and, in particular, those that yield dynamical invariants between living and model neurons. We address dynamical invariants that form robust cycle-by-cycle relationships between the intervals that build neural sequences from such interaction. Our methodology first attains automated adaptation of model neurons to work in the same amplitude regime and time scale of living neurons. Then, we address the automatized exploration and mapping of the synapse parameter space that lead to a specific dynamical invariant target. Our approach uses multiple configurations and parallel computing from electrophysiological recordings of living neurons to build full mappings, and genetic algorithms to achieve an instance of the target dynamics for the hybrid circuit in a short time. We illustrate and validate such strategy in the context of the study of functional sequences in neural rhythms, which can be easily generalized for any variety of hybrid circuit configuration. This approach facilitates both the building of hybrid circuits and the accomplishment of their scientific goal.
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Affiliation(s)
- Manuel Reyes-Sanchez
- Grupo de Neurocomputación Biológica, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain.
| | - Rodrigo Amaducci
- Grupo de Neurocomputación Biológica, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Pablo Sanchez-Martin
- Grupo de Neurocomputación Biológica, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Irene Elices
- Grupo de Neurocomputación Biológica, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain; Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Francisco B Rodriguez
- Grupo de Neurocomputación Biológica, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Pablo Varona
- Grupo de Neurocomputación Biológica, Departamento de Ingeniería Informática, Escuela Politécnica Superior, Universidad Autónoma de Madrid, 28049 Madrid, Spain.
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19
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Santamaría-Vázquez E, Martínez-Cagigal V, Marcos-Martínez D, Rodríguez-González V, Pérez-Velasco S, Moreno-Calderón S, Hornero R. MEDUSA©: A novel Python-based software ecosystem to accelerate brain-computer interface and cognitive neuroscience research. Comput Methods Programs Biomed 2023; 230:107357. [PMID: 36693292 DOI: 10.1016/j.cmpb.2023.107357] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/14/2022] [Accepted: 01/15/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Neurotechnologies have great potential to transform our society in ways that are yet to be uncovered. The rate of development in this field has increased significantly in recent years, but there are still barriers that need to be overcome before bringing neurotechnologies to the general public. One of these barriers is the difficulty of performing experiments that require complex software, such as brain-computer interfaces (BCI) or cognitive neuroscience experiments. Current platforms have limitations in terms of functionality and flexibility to meet the needs of researchers, who often need to implement new experimentation settings. This work was aimed to propose a novel software ecosystem, called MEDUSA©, to overcome these limitations. METHODS We followed strict development practices to optimize MEDUSA© for research in BCI and cognitive neuroscience, making special emphasis in the modularity, flexibility and scalability of our solution. Moreover, it was implemented in Python, an open-source programming language that reduces the development cost by taking advantage from its high-level syntax and large number of community packages. RESULTS MEDUSA© provides a complete suite of signal processing functions, including several deep learning architectures or connectivity analysis, and ready-to-use BCI and neuroscience experiments, making it one of the most complete solutions nowadays. We also put special effort in providing tools to facilitate the development of custom experiments, which can be easily shared with the community through an app market available in our website to promote reproducibility. CONCLUSIONS MEDUSA© is a novel software ecosystem for modern BCI and neurotechnology experimentation that provides state-of-the-art tools and encourages the participation of the community to make a difference for the progress of these fields. Visit the official website at https://www.medusabci.com/ to know more about this project.
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Affiliation(s)
- Eduardo Santamaría-Vázquez
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, (CIBER-BBN), Spain.
| | - Víctor Martínez-Cagigal
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, (CIBER-BBN), Spain.
| | - Diego Marcos-Martínez
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain.
| | - Víctor Rodríguez-González
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, (CIBER-BBN), Spain.
| | - Sergio Pérez-Velasco
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain.
| | - Selene Moreno-Calderón
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain.
| | - Roberto Hornero
- Biomedical Engineering Group (GIB), E.T.S Ingenieros de Telecomunicación, University of Valladolid, Paseo de Belén 15, Valladolid, 47011, Spain; Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina, (CIBER-BBN), Spain.
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20
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Kempes M. Added value of neurotechnology for forensic psychiatric and psychological assessment. Handb Clin Neurol 2023; 197:217-232. [PMID: 37633712 DOI: 10.1016/b978-0-12-821375-9.00015-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
The attention for neuroscience in relation to criminal behavior is growing rapidly, and research shows that neurobiological factors have added value to the understanding of psychological and social factors in explaining delinquency. There is evidence that neurotechnology can be used in criminal justice and may be of relevance for forensic psychiatric and psychological assessment. However, the question is whether scientific knowledge of neurobiological factors is applicable in daily practice of forensic assessment. Incorporation of basic technologies, e.g., psychophysiology (heart rate, skin conductance, wearables), hormonal measures (cortisol, testosterone), and neuropsychological testing might be evident, since they can be applied relatively easy. Moreover, a body of research shows the additive value of these technologies in this field. In addition, first steps are taken to apply these technologies in individual diagnostics, treatment, and risk assessment. Complex neurotechnologies like functional MRI (e.g., brain reading) and EEG show potential to be applicable in criminal justice, once it is known what additional information these indices offer for individual cases.
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Affiliation(s)
- Maaike Kempes
- Department of Science and Education, Netherlands Institute for Forensic Psychiatry and Psychology, Utrecht, The Netherlands; Faculty of Social and Behavioral Sciences, Institute of Education and Child Studies, Leiden University, Leiden, The Netherlands.
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21
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Meynen G, Van de Pol N, Tesink V, Ligthart S. Neurotechnology to reduce recidivism: Ethical and legal challenges. Handb Clin Neurol 2023; 197:265-276. [PMID: 37633715 DOI: 10.1016/b978-0-12-821375-9.00006-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/28/2023]
Abstract
Crime comes with enormous costs, not only financial but also in terms of loss of mental and physical health and, in some cases, even loss of life. Recidivism is responsible for a considerable percentage of the crimes, and therefore, society deems reducing recidivism a priority. To reduce recidivism, several types of interventions can be used, such as education and employment-focused rehabilitation programs which are intended to improve psychological and social factors. Another way to prevent reoffending is to influence the offender's brain functions. For example, medication can be offered to treat delusions or to diminish sexual drive. In the near future, innovative neurotechnologies are expected to improve prediction and prevention of reoffending. Potential positive effects of such neurotechniques include a safer society and earlier release of prisoners who are no longer "at high risk" to relapse into criminal behavior. Meanwhile, employing these neurotechniques in the criminal justice system raises fundamental concerns, for example, about autonomy, privacy and mental integrity. This chapter aims to identify some of the ethical and legal challenges of using neurotechnologies to reduce recidivism.
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Affiliation(s)
- Gerben Meynen
- Willem Pompe Institute for Criminal Law and Criminology, Faculty of Law, Economics and Governance, Utrecht University, Utrecht, The Netherlands; Department of Philosophy, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - Naomi Van de Pol
- Willem Pompe Institute for Criminal Law and Criminology, Faculty of Law, Economics and Governance, Utrecht University, Utrecht, The Netherlands
| | - Vera Tesink
- Department of Philosophy, Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sjors Ligthart
- Willem Pompe Institute for Criminal Law and Criminology, Faculty of Law, Economics and Governance, Utrecht University, Utrecht, The Netherlands; Department of Criminal Law, Tilburg Law School, Tilburg University, Tilburg, The Netherlands
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22
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Olson JA, Cyr M, Artenie DZ, Strandberg T, Hall L, Tompkins ML, Raz A, Johansson P. Emulating future neurotechnology using magic. Conscious Cogn 2023; 107:103450. [PMID: 36566673 DOI: 10.1016/j.concog.2022.103450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/24/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
Recent developments in neuroscience and artificial intelligence have allowed machines to decode mental processes with growing accuracy. Neuroethicists have speculated that perfecting these technologies may result in reactions ranging from an invasion of privacy to an increase in self-understanding. Yet, evaluating these predictions is difficult given that people are poor at forecasting their reactions. To address this, we developed a paradigm using elements of performance magic to emulate future neurotechnologies. We led 59 participants to believe that a (sham) neurotechnological machine could infer their preferences, detect their errors, and reveal their deep-seated attitudes. The machine gave participants randomly assigned positive or negative feedback about their brain's supposed attitudes towards charity. Around 80% of participants in both groups provided rationalisations for this feedback, which shifted their attitudes in the manipulated direction but did not influence donation behaviour. Our paradigm reveals how people may respond to prospective neurotechnologies, which may inform neuroethical frameworks.
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Affiliation(s)
- Jay A Olson
- Department of Psychology, McGill University, 2001 McGill College Ave., Montreal, QC H3A 1G1, Canada.
| | - Mariève Cyr
- Faculty of Medicine and Health Sciences, McGill University, 3605 De la Montagne St., Montreal, QC H3G 2M1, Canada
| | - Despina Z Artenie
- Department of Psychology, Université du Québec à Montréal, 100 Sherbrooke St. W., Montreal, QC H2X 3P2, Canada
| | - Thomas Strandberg
- Lund University Cognitive Science, Lund University, Box 192, S-221 00, Lund, Sweden
| | - Lars Hall
- Lund University Cognitive Science, Lund University, Box 192, S-221 00, Lund, Sweden
| | - Matthew L Tompkins
- Lund University Cognitive Science, Lund University, Box 192, S-221 00, Lund, Sweden
| | - Amir Raz
- Institute for Interdisciplinary Behavioral and Brain Sciences, Chapman University, 9401 Jeronimo Road, Irvine, CA 92618, USA
| | - Petter Johansson
- Lund University Cognitive Science, Lund University, Box 192, S-221 00, Lund, Sweden.
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Latheef S. Brain to Brain Interfaces (BBIs) in future military operations; blurring the boundaries of individual responsibility. New Bioeth 2022:10.1007/s40592-022-00171-7. [PMID: 36550229 DOI: 10.1007/s40592-022-00171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Developments in neurotechnology took a leap forward with the demonstration of the first Brain to Brain Interface (BBI). BBIs enable direct communication between two brains via a Brain Computer Interface (BCI) and bypasses the peripheral nervous system. This discovery promises new possibilities for future battlefield technology. As battlefield technology evolves, it is more likely to place greater demands on future soldiers. Future soldiers are more likely to process large amounts of data derived from an extensive networks of humans and machines. This raises several ethical and philosophical concerns. This paper will look at BBI technology in current stages of research, future BBI applications in the military and how the potential use of BBIs in military operations challenges the way we understand the concept of responsibility. In this paper, I propose that an individual connected to a BBI ought not to be held fully responsible for her actions. The justification for this proposition is based on three key points such as an individual connected to a BBI does not have the ability to act freely, has a diminished sense of self-agency and may not be able to demonstrate authenticity of the thoughts and memories generated when connected to the interface.
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Affiliation(s)
- Sahar Latheef
- College of Asia and the Pacific, Australian National University, Canberra, ACT, Australia.
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Privitera AJ, Du H. Educational neurotechnology: Where do we go from here? Trends Neurosci Educ 2022; 29:100195. [PMID: 36470622 DOI: 10.1016/j.tine.2022.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Recent educational trends point to an interest in educational neurotechnology. While these tools have the potential to change education, little is known about whether their use improves educational outcomes. Additionally, their adoption may be negatively impacted by teachers' lack of knowledge about the brain. In this paper we outline the potential of educational neurotechnology including what we know, what we do not yet know, and additional considerations for the ethical, successful adoption of these tools in classrooms around the world. Special consideration is given to the training needs of pre- and in-service educators whose support will be essential to the successful adoption of educational neurotechnology.
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Hsu WY, Goverover Y, Bove RM. Capturing cognitive changes in multiple sclerosis by performance-based functional and virtual reality assessments. Ann Phys Rehabil Med 2022; 66:101677. [PMID: 35667625 DOI: 10.1016/j.rehab.2022.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 04/25/2022] [Accepted: 05/07/2022] [Indexed: 12/03/2022]
Abstract
Cognitive impairment (CI) has been recognized as one of the core multiple sclerosis (MS) symptoms that profoundly impact lives of people with MS (PwMS). Clinical trials have begun to focus on cognition as a primary or secondary outcome, but translating improvements in cognitive testing scores to functioning in the real world is difficult. Performance-based functional assessments and virtual reality (VR) assessments, which incorporate real-world challenges, have been proposed as a way to better assess functional cognition (i.e., cognitive performance and its impact on real-life cognitive functioning of PwMS) and could address the difficulty in evaluating the impact of a treatment on real-world functioning. In this narrative review, we identify and summarize some of the promising recent research applications of performance-based functional assessments and VR tools to assess functional cognition in MS. Overall, most of the studies suggest that functional and VR assessments can detect cognitive differences between people with and without MS and between PwMS with and without CI. Furthermore, performance on some of the functional and VR assessments was associated with performance on standard cognitive assessments. However, developing any guidelines on how to implement these assessments in clinical practice is difficult because of the relatively small sample size across these studies. Performance-based functional and VR assessments represent an innovative approach to increasing sensitivity of how cognitive impairments/abilities present in the daily life of PwMS. More studies, with a larger sample size, robust research methods, and pre- and post-treatment assessments, are warranted to validate relevant, accessible functional and VR assessments before implementing these assessment approaches in clinical practice.
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Lázaro-Muñoz G, Pham MT, Muñoz KA, Kostick-Quenet K, Sanchez CE, Torgerson L, Robinson J, Pereira S, Outram S, Koenig BA, Starr PA, Gunduz A, Foote KD, Okun MS, Goodman W, McGuire AL, Zuk P. Post-trial access in implanted neural device research: Device maintenance, abandonment, and cost. Brain Stimul 2022; 15:1029-1036. [PMID: 35926784 PMCID: PMC9588741 DOI: 10.1016/j.brs.2022.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/16/2022] [Accepted: 07/26/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Clinical trial participants who benefit from experimental neural devices for the treatment of debilitating and otherwise treatment-resistant conditions are generally not ensured continued access to effective therapy or maintenance of devices at the conclusion of trials. OBJECTIVE/HYPOTHESIS Post-trial obligations have been extensively examined in the context of drug trials, but there has been little empirical examination of stakeholder perspectives regarding these obligations in the rapidly growing field of neural device research. METHODS This study examined the perspectives of 44 stakeholders (i.e., 23 researchers and 21 patient-participants) involved in implantable neural device trials. RESULTS Researchers were concerned about current post-trial management, identified barriers like cost, and suggested ways to improve the system. Many patient-participants were unaware of whether they would have post-trial access, but most thought they should keep devices if beneficial, and agreed with researchers that more should be done to help them keep and maintain these neural devices. CONCLUSION To our knowledge, this is the first in-depth examination of researcher perspectives regarding continued access to experimental neural devices and only the second such examination of patient-participant perspectives. These data can help inform future ethical and policy decisions about post-trial access to implantable neurotechnology.
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Affiliation(s)
- Gabriel Lázaro-Muñoz
- Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, United States.
| | - Michelle T Pham
- Center for Bioethcis and Social Justice, College of Human Medicine, Michigan State University, East Fee Hall 965 Wilson Road Rm A-126, East Lansing, MI, 48824, United States
| | - Katrina A Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Kristin Kostick-Quenet
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Clarissa E Sanchez
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Laura Torgerson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Jill Robinson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Stacey Pereira
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Simon Outram
- Program in Bioethics, University of California, 490 Illinois Street, San Francisco, CA, 94143, United States
| | - Barbara A Koenig
- Program in Bioethics, University of California, 490 Illinois Street, San Francisco, CA, 94143, United States
| | - Philip A Starr
- Department of Neurological Surgery, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, United States
| | - Aysegul Gunduz
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, 3009 SW Williston Road, Gainesville, FL, 32608, United States; Department of Biomedical Engineering, University of Florida, 1275 Center Drive, Biomedical Science Building, JG56, Gainesville, FL, 32611, United States
| | - Kelly D Foote
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, 3009 SW Williston Road, Gainesville, FL, 32608, United States
| | - Michael S Okun
- Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, 3009 SW Williston Road, Gainesville, FL, 32608, United States
| | - Wayne Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd Suite E4.100, Houston, TX, 77030, United States
| | - Amy L McGuire
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, One Baylor Plaza, Suite 326D, Houston, TX, 77030, United States
| | - Peter Zuk
- Center for Bioethics, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, United States
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Doya K, Ema A, Kitano H, Sakagami M, Russell S. Social impact and governance of AI and neurotechnologies. Neural Netw 2022; 152:542-54. [PMID: 35671575 DOI: 10.1016/j.neunet.2022.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 02/28/2022] [Accepted: 05/13/2022] [Indexed: 01/04/2023]
Abstract
Advances in artificial intelligence (AI) and brain science are going to have a huge impact on society. While technologies based on those advances can provide enormous social benefits, adoption of new technologies poses various risks. This article first reviews the co-evolution of AI and brain science and the benefits of brain-inspired AI in sustainability, healthcare, and scientific discoveries. We then consider possible risks from those technologies, including intentional abuse, autonomous weapons, cognitive enhancement by brain-computer interfaces, insidious effects of social media, inequity, and enfeeblement. We also discuss practical ways to bring ethical principles into practice. One proposal is to stop giving explicit goals to AI agents and to enable them to keep learning human preferences. Another is to learn from democratic mechanisms that evolved in human society to avoid over-consolidation of power. Finally, we emphasize the importance of open discussions not only by experts, but also including a diverse array of lay opinions.
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28
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Martini M, Kemper C. [Cybersecurity of brain-computer interfaces]. Int Cybersecur Law Rev 2022; 3:191-243. [PMID: 37521509 PMCID: PMC8929247 DOI: 10.1365/s43439-022-00046-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/29/2022] [Indexed: 11/27/2022]
Abstract
Brain-computer interfaces inspire visions of superhuman powers, enabling users to control protheses and other devices solely with their thoughts. But the rapid development and commercialization of this technology also brings security risks. Attacks on brain-computer interfaces may cause harrowing consequences for users, from eavesdropping on neurological data to manipulating brain activity. At present, data protection law, the regulation of medical devices, and the new rules on the sale of goods with digital elements all govern aspects of cybersecurity. There are, nevertheless, significant gaps. The article analyzes how the legal system currently addresses the risks of cyberattacks on brain-computer interfaces-and how policymakers could address such risks in the future.
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Affiliation(s)
- Mario Martini
- Deutsche Universität für Verwaltungswissenschaften (DUV), Speyer, Deutschland
- Deutsches Forschungsinstitut für öffentliche Verwaltung (FÖV), Speyer, Deutschland
| | - Carolin Kemper
- Deutsches Forschungsinstitut für öffentliche Verwaltung (FÖV), Speyer, Deutschland
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Illes J, Lipsman N, McDonald PJ, Hrincu V, Chandler J, Fasano A, Giacobbe P, Hamani C, Ibrahim GM, Kiss Z, Meng Y, Sankar T, Weise L. From vision to action: Canadian leadership in ethics and neurotechnology. Int Rev Neurobiol 2021; 159:241-273. [PMID: 34446249 DOI: 10.1016/bs.irn.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This chapter explores the complex neuroethical aspects of neurosurgery and neuromodulation in the context of Canadian healthcare and innovation, as seen through the lens of the Pan Canadian Neurotechnology Ethics Consortium (PCNEC). Highlighted are key areas of ethical focus, each with its own unique challenges: technical advances, readiness and risk, vulnerable populations, medico-legal issues, training, and research. Through an exploration of Canadian neurotechnological practice from these various clusters, we provide a critical review of progress, describe opportunities to address areas of debate, and seek to foster ethical innovation. Underpinning this comprehensive review are the fundamental principles of solution-oriented, practical neuroethics, with beneficence and justice at the core. In our view, it is a moral imperative that neurotechnological advancements include a delineation of ethical priorities for future guidelines, oversight, and interactions.
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Affiliation(s)
- Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Nir Lipsman
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Patrick J McDonald
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Division of Neurosurgery, Department of Surgery, BC Children's Hospital, Vancouver, BC, Canada
| | - Viorica Hrincu
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Chandler
- University of Ottawa, Centre for Health Law, Policy and Ethics, Ottawa, ON, Canada
| | - Alfonso Fasano
- Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON, Canada; Division of Neurology, University of Toronto, Toronto, ON, Canada; Krembil Brain Institute, Toronto, ON, Canada; Center for Advancing Neurotechnological Innovation to Application (CRANIA), Toronto, ON, Canada
| | - Peter Giacobbe
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Clement Hamani
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - George M Ibrahim
- Division of Neurosurgery, Hospital for Sick Children and Toronto Western Hospital, Toronto, ON, Canada
| | - Zelma Kiss
- Hotchkiss Brain Institute, Departments of Psychiatry and Clinical Neuroscience, University of Calgary, Calgary, AB, Canada
| | - Ying Meng
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Tejas Sankar
- Division of Neurosurgery, University of Alberta, Edmonton, AB, Canada
| | - Lutz Weise
- Department of Neurosurgery, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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Butorac I, Lentzos F, Aicardi C. Gray Matters: Exploring Technologists' Perceptions of Dual-Use Potentiality in Emerging Neurotechnology Applications. Health Secur 2021; 19:424-430. [PMID: 34264762 DOI: 10.1089/hs.2020.0147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In this article, we report on a pilot study examining perceptions of dual use among neurotechnologists and neuroethicists. We carried out 10 semistructured interviews with participants from established universities in the United States, the United Kingdom, and Australia about the risks they saw with the new technology and who has responsibility for safely developing it. We used a grounded theory approach to code and develop themes from the data and establish a foundation for analysis. Our findings showed that dual use was not considered binary, but rather multifaceted and fluid, with the commercialization and globalization of the emerging science shifting participants' understandings of what neurotechnologies are considered beneficial and harmful, rendering future uses unknowable.
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Affiliation(s)
- Isobel Butorac
- Isobel Butorac, MSc, is a PhD Candidate, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia. Filippa Lentzos, PhD, is a Senior Research Fellow, Department of War Studies, and Christine Aicardi, PhD, MSc, MEng, is a Senior Research Fellow; both in the Department of Global Health and Social Medicine, King's College London, London, UK
| | - Filippa Lentzos
- Isobel Butorac, MSc, is a PhD Candidate, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia. Filippa Lentzos, PhD, is a Senior Research Fellow, Department of War Studies, and Christine Aicardi, PhD, MSc, MEng, is a Senior Research Fellow; both in the Department of Global Health and Social Medicine, King's College London, London, UK
| | - Christine Aicardi
- Isobel Butorac, MSc, is a PhD Candidate, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia. Filippa Lentzos, PhD, is a Senior Research Fellow, Department of War Studies, and Christine Aicardi, PhD, MSc, MEng, is a Senior Research Fellow; both in the Department of Global Health and Social Medicine, King's College London, London, UK
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31
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DiLorenzo DJ. Societal return on investment may greatly exceed financial return on investment in neurotechnology-based therapies: A case study in epilepsy therapy development. Surg Neurol Int 2021; 12:180. [PMID: 34084608 PMCID: PMC8168695 DOI: 10.25259/sni_230_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/07/2020] [Indexed: 11/21/2022] Open
Abstract
Background: This research study is an economic analysis of a neurotechnology-based translational research and development venture focused on the development of a therapy for patients with epilepsy. In the conceptualization, planning, financing, and execution of neurotechnology ventures, many factors come into play in determining value and ability to secure financing at each stage of the venture. Conventionally, these have included factors that determine the return on investment for the stakeholders of the venture, most notably the investors and the team members, the former investing hard earned capital, and the latter investing significant portions of their professional careers. For a variety of reasons, the positive impact on society is often not quantified and taken into consideration. Methods: To address this, a new term is defined and assessed at a first approximation level using an index technology. The metric is termed the societal return on investment (sROI). Results: Among chronic conditions, neurological disease is virtually unique in the magnitude of economic devastation that it can inflict on a person and a family. Because the device costs do not reflect this value that is lost and subject to restoration, these are missing from this important calculation. The index project is the development of a seizure advisory system, which cost $71.2 million to develop and conduct a First-In-Man (FIM) study (NCT01043406) and which was estimated to require $50 million to complete a pivotal study. Conclusion: Despite the immense costs required to develop, test, and commercialize such a system, the direct and indirect economic costs imposed by uncontrolled seizures are sufficiently staggering that a sROI becomes positive after only 400 patients have been successfully treated and returned to work.
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Affiliation(s)
- Daniel John DiLorenzo
- Department of Neurosurgery, Loma Linda University, Loma Linda, California, United States
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Chen K, Wellman SM, Yaxiaer Y, Eles JR, Kozai TD. In vivo spatiotemporal patterns of oligodendrocyte and myelin damage at the neural electrode interface. Biomaterials 2020; 268:120526. [PMID: 33302121 DOI: 10.1016/j.biomaterials.2020.120526] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 12/26/2022]
Abstract
Intracortical microelectrodes with the ability to detect intrinsic electrical signals and/or deliver electrical stimulation into local brain regions have been a powerful tool to understand brain circuitry and for therapeutic applications to neurological disorders. However, the chronic stability and sensitivity of these intracortical microelectrodes are challenged by overwhelming biological responses, including severe neuronal loss and thick glial encapsulation. Unlike microglia and astrocytes whose activity have been extensively examined, oligodendrocytes and their myelin processes remain poorly studied within the neural interface field. Oligodendrocytes have been widely recognized to modulate electrical signal conductance along axons through insulating myelin segments. Emerging evidence offers an alternative perspective on neuron-oligodendrocyte coupling where oligodendrocytes provide metabolic and neurotrophic support to neurons through cytoplasmic myelin channels and monocarboxylate transporters. This study uses in vivo multi-photon microscopy to gain insights into the dynamics of oligodendrocyte soma and myelin processes in response to chronic device implantation injury over 4 weeks. We observe that implantation induces acute oligodendrocyte injury including initial deformation and substantial myelinosome formation, an early sign of myelin injury. Over chronic implantation periods, myelin and oligodendrocyte soma suffer severe degeneration proximal to the interface. Interestingly, wound healing attempts such as oligodendrogenesis are initiated over time, however they are hampered by continued degeneration near the implant. Nevertheless, this detailed characterization of oligodendrocyte spatiotemporal dynamics during microelectrode-induced inflammation may provide insights for novel intervention targets to facilitate oligodendrogenesis, enhance the integration of neural-electrode interfaces, and improve long-term functional performance.
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Affiliation(s)
- Keying Chen
- Department of Bioengineering, University of Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, USA
| | - Steven M Wellman
- Department of Bioengineering, University of Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, USA
| | - Yalikun Yaxiaer
- Eberly College of Science, Pennsylvania State University, University Park, USA
| | - James R Eles
- Department of Bioengineering, University of Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, USA
| | - Takashi Dy Kozai
- Department of Bioengineering, University of Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, USA; Center for Neuroscience, University of Pittsburgh, USA; McGowan Institute of Regenerative Medicine, University of Pittsburgh, USA; NeuroTech Center, University of Pittsburgh Brain Institute, USA.
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Chari A, Budhdeo S, Sparks R, Barone DG, Marcus HJ, Pereira EAC, Tisdall MM. Brain-Machine Interfaces: The Role of the Neurosurgeon. World Neurosurg 2020; 146:140-147. [PMID: 33197630 DOI: 10.1016/j.wneu.2020.11.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 11/04/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022]
Abstract
Neurotechnology is set to expand rapidly in the coming years as technological innovations in hardware and software are translated to the clinical setting. Given our unique access to patients with neurologic disorders, expertise with which to guide appropriate treatments, and technical skills to implant brain-machine interfaces (BMIs), neurosurgeons have a key role to play in the progress of this field. We outline the current state and key challenges in this rapidly advancing field, including implant technology, implant recipients, implantation methodology, implant function, and ethical, regulatory, and economic considerations. Our key message is to encourage the neurosurgical community to proactively engage in collaborating with other health care professionals, engineers, scientists, ethicists, and regulators in tackling these issues. By doing so, we will equip ourselves with the skills and expertise to drive the field forward and avoid being mere technicians in an industry driven by those around us.
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Affiliation(s)
- Aswin Chari
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom.
| | - Sanjay Budhdeo
- Department for Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, United Kingdom; Department of Neurology, National Hospital for Neurology and Neurosurgery, London, United Kingdom; OwkinInc, New York, New York, USA
| | - Rachel Sparks
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Damiano G Barone
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Hani J Marcus
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom; Wellcome EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - Erlick A C Pereira
- Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's, University of London, United Kingdom
| | - Martin M Tisdall
- Developmental Neurosciences, Great Ormond Street Institute of Child Health, University College London, London, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital, London, United Kingdom
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Munjal V, Arakelyan M, McDonald PJ, Illes J. Epilepsy through the eyes of the media: A paradox of positive reporting and challenges of access to advanced neurotechnology. Epilepsy Behav 2020; 111:107200. [PMID: 32544701 DOI: 10.1016/j.yebeh.2020.107200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Media coverage of disorders and medical advancements can impact public perception regarding the riskiness, effectiveness, and accessibility of treatment options. We studied that coverage for epilepsy with a focus on surgical interventions and emerging neurotechnologies. METHODS Epilepsy-related English language articles published through 2019 were retrieved from online International news media with a circulation of 80,000 or above. We used directed content analysis of news articles to code content into a priori categories both to identify salient themes and to characterize their valence. RESULTS One hundred forty-six unique articles matched our search terms. Overall, there was a steady increase in epilepsy reporting over time, with a majority of articles published with a positive tone. Neuromodulation was the focus of over 50% of all the articles in the time points analyzed. Vagus nerve stimulation (VNS) and deep-brain stimulation (DBS) were discussed more prominently than other types of neurotechnological interventions; VNS was the neurotechnological focus in 39% of the pediatric articles; resective surgery was the focus in 34% of adult articles. Access, support, and epilepsy literacy were the central themes in the context of ethical, legal, and social issues. SIGNIFICANCE News media can influence the trust that the public places in science and medicine, and by extension, influences health policy. As innovations in neurotechnology for epilepsy emerge, understanding of individual and societal values is essential to their beneficial evolution and translation to care.
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Abstract
The incorporation of neural-based technologies into psychiatry offers novel means to use neural data in patient assessment and clinical diagnosis. However, an over-optimistic technologisation of neuroscientifically-informed psychiatry risks the conflation of technological and psychological norms. Neurotechnologies promise fast, efficient, broad psychiatric insights not readily available through conventional observation of patients. Recording and processing brain signals provides information from 'beneath the skull' that can be interpreted as an account of neural processing and that can provide a basis to evaluate general behaviour and functioning. But it ought not to be forgotten that the use of such technologies is part of a human practice of neuroscience informed psychiatry. This paper notes some challenges in the integration of neural technologies into psychiatry and suggests vigilance particularly in respect to normative challenges. In this way, psychiatry can avoid a drift toward reductive technological approaches, while nonetheless benefitting from promising advances in neuroscience and technology.
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Affiliation(s)
- Stephen Rainey
- Oxford Uehiro Centre for Practical Ethics, Suite 8, Littlegate House, St Ebbes Street, Oxford, OX1 1PT, UK.
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Abstract
This article provides a conceptual and normative framework through which we may understand the potentially ethically significant roles that information generated by neurotechnologies about our brains and minds may play in our construction of our identities. Neuroethics debates currently focus disproportionately on the ways that third parties may (ab)use these kinds of information. These debates occlude interests we may have in whether and how we ourselves encounter information about our own brains and minds. This gap is not yet adequately addressed by most allusions in the literature to potential identity impacts. These lack the requisite conceptual or normative foundations to explain why we should be concerned about such effects or how they might be addressed. This article seeks to fill this gap by presenting a normative account of identity as constituted by embodied self-narratives. It proposes that information generated by neurotechnologies can play significant content-supplying and interpretive roles in our construction of our self-narratives. It argues, to the extent that these roles support and detract from the coherence and inhabitability of these narratives, access to information about our brains and minds engages non-trivial identity-related interests. These claims are illustrated using examples drawn from empirical literature reporting reactions to information generated by implantable predictive BCIs and psychiatric neuroimaging. The article concludes by highlighting ways in which information generated by neurotechnologies might be governed so as to protect information subjects' interests in developing and inhabiting their own identities.
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Affiliation(s)
- Emily Postan
- The University of Edinburgh School of Law, Edinburgh, UK
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Mitchell KAS, Anderson W, Shay T, Huang J, Luciano M, Suarez JI, Manson P, Brem H, Gordon CR. First-In-Human Experience With Integration of Wireless Intracranial Pressure Monitoring Device Within a Customized Cranial Implant. Oper Neurosurg (Hagerstown) 2020; 19:341-350. [PMID: 31993644 PMCID: PMC7594174 DOI: 10.1093/ons/opz431] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/01/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Decompressive craniectomy is a lifesaving treatment for intractable intracranial hypertension. For patients who survive, a second surgery for cranial reconstruction (cranioplasty) is required. The effect of cranioplasty on intracranial pressure (ICP) is unknown. OBJECTIVE To integrate the recently Food and Drug Administration-approved, fully implantable, noninvasive ICP sensor within a customized cranial implant (CCI) for postoperative monitoring in patients at high risk for intracranial hypertension. METHODS A 16-yr-old female presented for cranioplasty 4-mo after decompressive hemicraniectomy for craniocerebral gunshot wound. Given the persistent transcranial herniation with concomitant subdural hygroma, there was concern for intracranial hypertension following cranioplasty. Thus, cranial reconstruction was performed utilizing a CCI with an integrated wireless ICP sensor, and noninvasive postoperative monitoring was performed. RESULTS Intermittent ICP measurements were obtained twice daily using a wireless, handheld monitor. The ICP ranged from 2 to 10 mmHg in the supine position and from -5 to 4 mmHg in the sitting position. Interestingly, an average of 7 mmHg difference was consistently noted between the sitting and supine measurements. CONCLUSION This first-in-human experience demonstrates several notable findings, including (1) newfound safety and efficacy of integrating a wireless ICP sensor within a CCI for perioperative neuromonitoring; (2) proven restoration of normal ICP postcranioplasty despite severe preoperative transcranial herniation; and (3) proven restoration of postural ICP adaptations following cranioplasty. To the best of our knowledge, this is the first case demonstrating these intriguing findings with the potential to fundamentally alter the paradigm of cranial reconstruction.
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Affiliation(s)
- Kerry-Ann S Mitchell
- Section of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - William Anderson
- Section of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tamir Shay
- Section of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Judy Huang
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mark Luciano
- Section of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jose I Suarez
- Division of Neurocritical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Paul Manson
- Section of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Henry Brem
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Chad R Gordon
- Section of Neuroplastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Rainey S, Martin S, Christen A, Mégevand P, Fourneret E. Brain Recording, Mind-Reading, and Neurotechnology: Ethical Issues from Consumer Devices to Brain-Based Speech Decoding. Sci Eng Ethics 2020; 26:2295-2311. [PMID: 32356091 PMCID: PMC7417394 DOI: 10.1007/s11948-020-00218-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 04/16/2020] [Indexed: 05/19/2023]
Abstract
Brain reading technologies are rapidly being developed in a number of neuroscience fields. These technologies can record, process, and decode neural signals. This has been described as 'mind reading technology' in some instances, especially in popular media. Should the public at large, be concerned about this kind of technology? Can it really read minds? Concerns about mind-reading might include the thought that, in having one's mind open to view, the possibility for free deliberation, and for self-conception, are eroded where one isn't at liberty to privately mull things over. Themes including privacy, cognitive liberty, and self-conception and expression appear to be areas of vital ethical concern. Overall, this article explores whether brain reading technologies are really mind reading technologies. If they are, ethical ways to deal with them must be developed. If they are not, researchers and technology developers need to find ways to describe them more accurately, in order to dispel unwarranted concerns and address appropriately those that are warranted.
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Affiliation(s)
- Stephen Rainey
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - Stéphanie Martin
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Andy Christen
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pierre Mégevand
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Eric Fourneret
- Braintech Lab (U 1205), Université Grenoble Alpes, Grenoble, France
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Abstract
In recent years, both fields of physics and psychology have made important scientific advances. The emergence of new instruments gave rise to a data-driven neuroscience allowing us to learn about the state of the brain supporting known mental functions and conversely. In parallel, the appearance of new mathematics allowed the development of computational models describing fundamental brain functions and implementing them in technological applications. While emphasizing the methodology of physics, the special issue aims to bring together these trends in both the experimental and theoretical sciences in order to explain some of the most basic mental processes such as perception, cognition, emotion, consciousness, and learning. In this editorial, we define unsolved problems for brain and psychological sciences, discuss possible means toward their respective solutions, and outline some collaborative initiatives aiming toward these goals. The following problems are defined in gradual order of difficulty: what are the universal properties of human behavior across conditions and cultures? What have each culture learned over historical times and why should specific elements of knowledge be accumulated over cultural evolution? Can computational psychiatry help predict, understand, and cure mental disorders? What is the function of art and cultural artifacts such as music, fiction, or poetry for the cognitive system? How to explain the relation between first-person subjective experience and third-person objective physiological data? What neural mechanisms operate on which mental content at the highest levels of organization of the hierarchical brain? How do abstract ideas emerge from sensory-motor contingencies and what are the conditions for the birth of a new concept? Could symmetry play a role in psychogenesis and support the emergence of new hierarchical layers in cognition? How can we start addressing the question of meaning scientifically, and what does it entail for the physical sciences?
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Affiliation(s)
- Felix Schoeller
- Fluid Interfaces Group, Media Lab, Massachusetts Institute of Technology, Cambridge, USA; Centre de Recherches Interdisciplinaires, Paris, France.
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Charkhkar H, Christie BP, Pinault GJ, Tyler DJ, Triolo RJ. A translational framework for peripheral nerve stimulating electrodes: Reviewing the journey from concept to clinic. J Neurosci Methods 2019; 328:108414. [PMID: 31472187 DOI: 10.1016/j.jneumeth.2019.108414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/31/2019] [Accepted: 08/26/2019] [Indexed: 12/22/2022]
Abstract
The purpose of this review article is to describe the underlying methodology for successfully translating novel interfaces for electrical modulation of the peripheral nervous system (PNS) from basic design concepts to clinical applications and chronic human use. Despite advances in technologies to communicate directly with the nervous system, the pathway to clinical translation for most neural interfaces is not clear. FDA guidelines provide information on necessary evidence which should be generated and submitted to allow the agency evaluate safety and efficacy of a new medical device. However, a knowledge gap exists on translating neural interfaces from pre-clinical studies into the clinical domain. Our article is intended to inform the field on some of the key considerations for such a transition process specific to neural interfaces that may not be already covered by FDA guidances. This framework focuses on non-penetrating peripheral nerve stimulating electrodes that have been proven effective for motor and sensory neural prostheses and successfully transitioned from pre-clinical through first-in-human and chronic clinical deployment. We discuss the challenges of moving these neural interfaces along the translational continuum and ultimately through FDA approval for human feasibility studies. Specifically, we describe a translational process involving: quantitative human anatomy, neural modeling and simulation, acute intraoperative testing and verification, clinical demonstration with temporary percutaneous access, and finally chronic clinical deployment and functional performance. To clarify and demonstrate the importance of each step of this translational framework, we present case studies from electrodes developed at Case Western Reserve University (CWRU), specifically the spiral cuff, the Flat Interface Nerve Electrode (FINE), and the Composite FINE (C-FINE). In addition, we demonstrate that success along this translational pathway can be further expedited by: appropriate selection of well-characterized materials, validation of fabrication and sterilization protocols, well-implemented quality control measures, and quantification of impact on neural structure, health, and function. The issues and approaches identified in this review for the peripheral nervous system may also serve to accelerate the dissemination of any new neural interface into clinical practice, and consequently advance the performance, utility, and clinical value of new neural prostheses or neuromodulation systems.
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Affiliation(s)
- Hamid Charkhkar
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
| | - Breanne P Christie
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Gilles J Pinault
- Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Dustin J Tyler
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
| | - Ronald J Triolo
- Department of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, USA; Louis Stokes Cleveland Veteran Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA
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Black BJ, Atmaramani R, Plagens S, Campbell ZT, Dussor G, Price TJ, Pancrazio JJ. Emerging neurotechnology for antinoceptive mechanisms and therapeutics discovery. Biosens Bioelectron 2018; 126:679-689. [PMID: 30544081 DOI: 10.1016/j.bios.2018.11.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 11/01/2018] [Accepted: 11/10/2018] [Indexed: 12/20/2022]
Abstract
The tolerance, abuse, and potential exacerbation associated with classical chronic pain medications such as opioids creates a need for alternative therapeutics. Phenotypic screening provides a complementary approach to traditional target-based drug discovery. Profiling cellular phenotypes enables quantification of physiologically relevant traits central to a disease pathology without prior identification of a specific drug target. For complex disorders such as chronic pain, which likely involves many molecular targets, this approach may identify novel treatments. Sensory neurons, termed nociceptors, are derived from dorsal root ganglia (DRG) and can undergo changes in membrane excitability during chronic pain. In this review, we describe phenotypic screening paradigms that make use of nociceptor electrophysiology. The purpose of this paper is to review the bioelectrical behavior of DRG neurons, signaling complexity in sensory neurons, various sensory neuron models, assays for bioelectrical behavior, and emerging efforts to leverage microfabrication and microfluidics for assay development. We discuss limitations and advantages of these various approaches and offer perspectives on opportunities for future development.
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Affiliation(s)
- Bryan J Black
- Department of Bioengineering, University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA.
| | - Rahul Atmaramani
- Department of Bioengineering, University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA
| | - Sarah Plagens
- Department of Bioengineering, University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA
| | - Zachary T Campbell
- Department of Biological Sciences, The University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA
| | - Gregory Dussor
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA
| | - Theodore J Price
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA
| | - Joseph J Pancrazio
- Department of Bioengineering, University of Texas at Dallas, 800 W. Campbell Road, Richardson, TX 75080, USA
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Abstract
This article reviews neuroethics issues that arise with the development, translation, and use of technologies for neuromodulation. Three electronic databases (PubMed, Embase, and PhilPapers) were searched for relevant articles published between 1/1/16 - 6/26/18. We focus on pressing ethical issues related to the use of deep brain stimulation (DBS), adaptive DBS (aDBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and associated technologies. The neuroethics issues we address include privacy, continued access to devices, device removal, do-it-yourself neurostimulation, neuroenhancement, media coverage, changes in personal identity and agency, informed consent, and neuromodulation in minors. This review should be of assistance to a variety of stakeholders, including neurotechnology developers, as they make important decisions that will drive these neurotechnologies.
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Affiliation(s)
- Peter Zuk
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA.,Department of Philosophy, Rice University, Houston, Texas, USA
| | - Laura Torgerson
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
| | - Demetrio Sierra-Mercado
- Department of Anatomy & Neurobiology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
| | - Gabriel Lázaro-Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
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Sokolov AA, Grivaz P, Bove R. Cognitive Deficits in Multiple Sclerosis: Recent Advances in Treatment and Neurorehabilitation. Curr Treat Options Neurol 2018; 20:53. [PMID: 30345468 DOI: 10.1007/s11940-018-0538-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE OF REVIEW This article highlights recent progress in research on treatment and neurorehabilitation of cognitive impairment in multiple sclerosis (MS) including pharmacological interventions, physical exercise, and neuropsychological rehabilitation, both in conventional and technology-assisted settings. RECENT FINDINGS The most consistent evidence in terms of improvement or preservation of circumscribed cognitive scores in MS patients comes from moderately sampled randomized clinical trials on multimodal approaches that combine conventional or computerized neuropsychological training with psychoeducation or cognitive behavioral therapy. Disease-modifying treatments also appear to have beneficial effects in preventing or attenuating cognitive decline, whereas there is little evidence for agents such as donepezil or stimulants. Finally, physical exercise may yield some cognitive improvement in MS patients. Despite substantial and often promising research efforts, there is a lack of validated and widely accepted clinical procedures for cognitive neurorehabilitation in MS. Development of such approaches will require collaborative efforts towards the design of interventions that are fundamentally inspired by cognitive neuroscience, potentially guided by neuroimaging, and composed of conventional neuropsychological training and cognitive behavioral therapy as well as physical exercise and therapeutic video games. Subsequently, large-scale validation will be needed with meaningful outcome measures reflecting transfer to everyday cognitive function and maintenance of training effects.
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Ienca M, Wangmo T, Jotterand F, Kressig RW, Elger B. Ethical Design of Intelligent Assistive Technologies for Dementia: A Descriptive Review. Sci Eng Ethics 2018; 24:1035-1055. [PMID: 28940133 DOI: 10.1007/s11948-017-9976-1] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/05/2017] [Indexed: 05/16/2023]
Abstract
The use of Intelligent Assistive Technology (IAT) in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products.
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Affiliation(s)
- Marcello Ienca
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
- Health Ethics and Policy Lab, Department of Health Sciences and Technology, ETH, Zurich, Switzerland.
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Fabrice Jotterand
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
- Center for Bioethics and Medical Humanities, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Reto W Kressig
- Felix Platter Hospital, University Center for Medicine of Aging, Basel, Switzerland
- Chair of Geriatrics, University of Basel, Basel, Switzerland
| | - Bernice Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
- Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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Tegeler CL, Gerdes L, Shaltout HA, Cook JF, Simpson SL, Lee SW, Tegeler CH. Successful use of closed-loop allostatic neurotechnology for post-traumatic stress symptoms in military personnel: self-reported and autonomic improvements. Mil Med Res 2017; 4:38. [PMID: 29502530 PMCID: PMC5740870 DOI: 10.1186/s40779-017-0147-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 12/04/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Military-related post-traumatic stress (PTS) is associated with numerous symptom clusters and diminished autonomic cardiovascular regulation. High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®) is a noninvasive, closed-loop, allostatic, acoustic stimulation neurotechnology that produces real-time translation of dominant brain frequencies into audible tones of variable pitch and timing to support the auto-calibration of neural oscillations. We report clinical, autonomic, and functional effects after the use of HIRREM® for symptoms of military-related PTS. METHODS Eighteen service members or recent veterans (15 active-duty, 3 veterans, most from special operations, 1 female), with a mean age of 40.9 (SD = 6.9) years and symptoms of PTS lasting from 1 to 25 years, undertook 19.5 (SD = 1.1) sessions over 12 days. Inventories for symptoms of PTS (Posttraumatic Stress Disorder Checklist - Military version, PCL-M), insomnia (Insomnia Severity Index, ISI), depression (Center for Epidemiologic Studies Depression Scale, CES-D), and anxiety (Generalized Anxiety Disorder 7-item scale, GAD-7) were collected before (Visit 1, V1), immediately after (Visit 2, V2), and at 1 month (Visit 3, V3), 3 (Visit 4, V4), and 6 (Visit 5, V5) months after intervention completion. Other measures only taken at V1 and V2 included blood pressure and heart rate recordings to analyze heart rate variability (HRV) and baroreflex sensitivity (BRS), functional performance (reaction and grip strength) testing, blood and saliva for biomarkers of stress and inflammation, and blood for epigenetic testing. Paired t-tests, Wilcoxon signed-rank tests, and a repeated-measures ANOVA were performed. RESULTS Clinically relevant, significant reductions in all symptom scores were observed at V2, with durability through V5. There were significant improvements in multiple measures of HRV and BRS [Standard deviation of the normal beat to normal beat interval (SDNN), root mean square of the successive differences (rMSSD), high frequency (HF), low frequency (LF), and total power, HF alpha, sequence all, and systolic, diastolic and mean arterial pressure] as well as reaction testing. Trends were seen for improved grip strength and a reduction in C-Reactive Protein (CRP), Angiotensin II to Angiotensin 1-7 ratio and Interleukin-10, with no change in DNA n-methylation. There were no dropouts or adverse events reported. CONCLUSIONS Service members or veterans showed reductions in symptomatology of PTS, insomnia, depressive mood, and anxiety that were durable through 6 months after the use of a closed-loop allostatic neurotechnology for the auto-calibration of neural oscillations. This study is the first to report increased HRV or BRS after the use of an intervention for service members or veterans with PTS. Ongoing investigations are strongly warranted. TRIAL REGISTRATION NCT03230890 , retrospectively registered July 25, 2017.
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Affiliation(s)
- Catherine L Tegeler
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Lee Gerdes
- Brain State Technologies, LLC, 15150 North Hayden Road, Scottsdale, AZ, 85260, USA
| | - Hossam A Shaltout
- Hypertension and Vascular Research Center, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Jared F Cook
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Sean L Simpson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Sung W Lee
- Brain State Technologies, LLC, 15150 North Hayden Road, Scottsdale, AZ, 85260, USA
| | - Charles H Tegeler
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
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Tegeler CH, Cook JF, Tegeler CL, Hirsch JR, Shaltout HA, Simpson SL, Fidali BC, Gerdes L, Lee SW. Clinical, hemispheric, and autonomic changes associated with use of closed-loop, allostatic neurotechnology by a case series of individuals with self-reported symptoms of post-traumatic stress. BMC Psychiatry 2017; 17:141. [PMID: 28420362 PMCID: PMC5395741 DOI: 10.1186/s12888-017-1299-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 04/01/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The objective of this pilot study was to explore the use of a closed-loop, allostatic, acoustic stimulation neurotechnology for individuals with self-reported symptoms of post-traumatic stress, as a potential means to impact symptomatology, temporal lobe high frequency asymmetry, heart rate variability (HRV), and baroreflex sensitivity (BRS). METHODS From a cohort of individuals participating in a naturalistic study to evaluate use of allostatic neurotechnology for diverse clinical conditions, a subset was identified who reported high scores on the Posttraumatic Stress Disorder Checklist (PCL). The intervention entailed a series of sessions wherein brain electrical activity was monitored noninvasively at high spectral resolutions, with software algorithms translating selected brain frequencies into acoustic stimuli (audible tones) that were delivered back to the user in real time, to support auto-calibration of neural oscillations. Participants completed symptom inventories before and after the intervention, and a subset underwent short-term blood pressure recordings for HRV and BRS. Changes in temporal lobe high frequency asymmetry were analyzed from baseline assessment through the first four sessions, and for the last four sessions. RESULTS Nineteen individuals (mean age 47, 11 women) were enrolled, and the majority also reported symptom scores that exceeded inventory thresholds for depression. They undertook a median of 16 sessions over 16.5 days, and 18 completed the number of sessions recommended. After the intervention, 89% of the completers reported clinically significant decreases in post-traumatic stress symptoms, indicated by a change of at least 10 points on the PCL. At a group level, individuals with either rightward (n = 7) or leftward (n = 7) dominant baseline asymmetry in temporal lobe high frequency (23-36 Hz) activity demonstrated statistically significant reductions in their asymmetry scores over the course of their first four sessions. For 12 individuals who underwent short-term blood pressure recordings, there were statistically significant increases in HRV in the time domain and BRS (Sequence Up). There were no adverse events. CONCLUSION Closed-loop, allostatic neurotechnology for auto-calibration of neural oscillations appears promising as an innovative therapeutic strategy for individuals with symptoms of post-traumatic stress. TRIALS REGISTRATION ClinicalTrials.gov #NCT02709369 , retrospectively registered on March 4, 2016.
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Affiliation(s)
- Charles H. Tegeler
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Jared F. Cook
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Catherine L. Tegeler
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Joshua R. Hirsch
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Hossam A. Shaltout
- Hypertension and Vascular Research Center, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Sean L. Simpson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Brian C. Fidali
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 USA
| | - Lee Gerdes
- Brain State Technologies, 15150 North Hayden Road, Suite 106, Scottsdale, Arizona 85260 USA
| | - Sung W. Lee
- Brain State Technologies, 15150 North Hayden Road, Suite 106, Scottsdale, Arizona 85260 USA
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Tegeler CH, Tegeler CL, Cook JF, Lee SW, Gerdes L, Shaltout HA, Miles CM, Simpson SL. A Preliminary Study of the Effectiveness of an Allostatic, Closed-Loop, Acoustic Stimulation Neurotechnology in the Treatment of Athletes with Persisting Post-concussion Symptoms. Sports Med Open 2016; 2:39. [PMID: 27747793 PMCID: PMC5023638 DOI: 10.1186/s40798-016-0063-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 09/06/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Effective interventions are needed for individuals with persisting post-concussion symptoms. High-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®) is an allostatic, closed-loop, acoustic stimulation neurotechnology, designed to facilitate relaxation and self-optimization of neural oscillations. METHODS Fifteen athletes (seven females, mean age 18.1 years, SD 2.6) with persisting post-concussion symptoms received 18.7 (SD 6.0) HIRREM sessions over a mean of 29.6 (SD 23.2) days, including 11.3 (SD 4.6) in office days. Pre- and post-HIRREM measures included the Rivermead Post-Concussion Symptoms Questionnaire (RPQ, n = 12), the Insomnia Severity Index (ISI, n = 15), the Center for Epidemiologic Studies Depression Scale (CES-D, n = 10), short-term blood pressure and heart rate recordings for measures of autonomic cardiovascular regulation (n = 15), and reaction time by the drop-stick method (n = 7). All participants were asked about their physical activity level and sports participation status at their post-HIRREM data collection visit and 1 to 3 months afterward. RESULTS At the post-HIRREM visit, subjects reported improvements in all three inventories (RPQ mean change 19.7, SD 11.4, Wilcoxon p = 0.001; ISI mean change -4.1, SD 4.1, Wilcoxon p = 0.003; CES-D mean change -12.0, SD 10.0, Wilcoxon p = 0.004), including statistically significant reductions in 14 of the 16 individual items of the RPQ. There were also statistically significant improvements in baroreflex sensitivity, heart rate variability in the time domain (SDNN), and drop-stick reaction testing (baseline mean distance of 23.8 cm, SD 5.6, decreased to 19.8 cm, SD 4.6, Wilcoxon p = 0.016). Within 3 months of the post-HIRREM data collection, all 15 had returned to full exercise and workouts, and ten had returned to full participation in their athletic activity. CONCLUSIONS The use of HIRREM by a series of athletes with persisting post-concussion symptoms was associated with a range of improvements including, for the majority, return to full participation in their sport. The findings do not appear to be consistent with constituents of the placebo effect. A larger controlled trial is warranted.
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Affiliation(s)
- Charles H. Tegeler
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1078 USA
| | - Catherine L. Tegeler
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1078 USA
| | - Jared F. Cook
- Department of Neurology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1078 USA
| | - Sung W. Lee
- Brain State Technologies, LLC, Scottsdale, AZ USA
| | - Lee Gerdes
- Brain State Technologies, LLC, Scottsdale, AZ USA
| | - Hossam A. Shaltout
- Department of Obstetrics and Gynecology, Hypertension and Vascular Research Center, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Christopher M. Miles
- Sports Medicine, Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Sean L. Simpson
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC USA
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Martin A, Becker K, Darragh M, Giordano J. A four-part working bibliography of neuroethics: part 3 - "second tradition neuroethics" - ethical issues in neuroscience. Philos Ethics Humanit Med 2016; 11:7. [PMID: 27646569 PMCID: PMC5028939 DOI: 10.1186/s13010-016-0037-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Neuroethics describes several interdisciplinary topics exploring the application and implications of engaging neuroscience in societal contexts. To explore this topic, we present Part 3 of a four-part bibliography of neuroethics' literature focusing on the "ethics of neuroscience." METHODS To complete a systematic survey of the neuroethics literature, 19 databases and 4 individual open-access journals were employed. Searches were conducted using the indexing language of the U.S. National Library of Medicine (NLM). A Python code was used to eliminate duplications in the final bibliography. RESULTS This bibliography consists of 1137 papers, 56 books, and 134 book chapters published from 2002 through 2014, covering ethical issues in neuroimaging, neurogenetics, neurobiomarkers, neuro-psychopharmacology, brain stimulation, neural stem cells, neural tissue transplants, pediatric-specific issues, dual-use, and general neuroscience research issues. These works contain explanations of recent research regarding neurotechnology, while exploring ethical issues in future discoveries and use.
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Affiliation(s)
- Amanda Martin
- Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Bldg D, Rm 238, 4000 Reservoir Road, Washington, DC, 20057, USA
| | - Kira Becker
- Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Bldg D, Rm 238, 4000 Reservoir Road, Washington, DC, 20057, USA
- Department of Neuroscience, Amherst College, Amherst, MA, USA
| | - Martina Darragh
- Bioethics Research Library, Kennedy Institute of Ethics, Georgetown University, Washington, DC, USA
| | - James Giordano
- Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Bldg D, Rm 238, 4000 Reservoir Road, Washington, DC, 20057, USA.
- Departments of Neurology and Biochemistry, Georgetown University Medical Center, Washington, DC, USA.
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Fortunato JE, Tegeler CL, Gerdes L, Lee SW, Pajewski NM, Franco ME, Cook JF, Shaltout HA, Tegeler CH. Use of an allostatic neurotechnology by adolescents with postural orthostatic tachycardia syndrome (POTS) is associated with improvements in heart rate variability and changes in temporal lobe electrical activity. Exp Brain Res 2015; 234:791-8. [PMID: 26645307 PMCID: PMC4751215 DOI: 10.1007/s00221-015-4499-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 11/09/2015] [Indexed: 12/11/2022]
Abstract
Autonomic dysregulation and heterogeneous symptoms characterize postural orthostatic tachycardia syndrome (POTS). This study evaluated the effect of high-resolution, relational, resonance-based, electroencephalic mirroring (HIRREM®), a noninvasive, allostatic neurotechnology for relaxation and auto-calibration of neural oscillations, on heart rate variability, brain asymmetry, and autonomic symptoms, in adolescents with POTS. Seven subjects with POTS (three males, ages 15–18) underwent a median of 14 (10–16) HIRREM sessions over 13 (8–17) days. Autonomic function was assessed from 10-min continuous heart rate and blood pressure recordings, pre- and post-HIRREM. One-minute epochs of temporal high-frequency (23–36 Hz) brain electrical activity data (T3 and T4, eyes closed) were analyzed from baseline HIRREM assessment and subsequent sessions. Subjects rated autonomic symptoms before and after HIRREM. Four of seven were on fludrocortisone, which was stopped before or during their sessions. Heart rate variability in the time domain (standard deviation of the beat-to-beat interval) increased post-HIRREM (mean increase 51 %, range 10–143, p = 0.03), as did baroreflex sensitivity (mean increase in high-frequency alpha 65 %, range −6 to 180, p = 0.05). Baseline temporal electrical asymmetry negatively correlated with change in asymmetry from assessment to the final HIRREM session (p = 0.01). Summed high-frequency amplitudes at left and right temporal lobes decreased a median of 3.8 μV (p = 0.02). There was a trend for improvements in self-reported symptoms related to the autonomic nervous system. Use of HIRREM was associated with reduced sympathetic bias in autonomic cardiovascular regulation, greater symmetry and reduced amplitudes in temporal lobe high-frequency electrical activity, and a trend for reduced autonomic symptoms. Data suggest the potential for allostatic neurotechnology to facilitate increased flexibility in autonomic cardiovascular regulation, possibly through more balanced activity at regions of the neocortex responsible for autonomic management. Clinical trial registry “Tilt Table with Suspected postural orthostatic tachycardia syndrome (POTS) Subjects,” Protocol Record: WFUBAHA01.
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Affiliation(s)
- John E Fortunato
- Virginia Commonwealth University, Richmond, VA, USA. .,Hypertension and Vascular Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA.
| | - Catherine L Tegeler
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Lee Gerdes
- Brain State Technologies LLC, Scottsdale, AZ, 85260, USA
| | - Sung W Lee
- Brain State Technologies LLC, Scottsdale, AZ, 85260, USA
| | - Nicholas M Pajewski
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Meghan E Franco
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jared F Cook
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hossam A Shaltout
- Hypertension and Vascular Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Departments of Obstetrics and Gynecology and General Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Charles H Tegeler
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Akwei-Sekyere S. Powerline noise elimination in biomedical signals via blind source separation and wavelet analysis. PeerJ 2015; 3:e1086. [PMID: 26157639 PMCID: PMC4493666 DOI: 10.7717/peerj.1086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 06/16/2015] [Indexed: 11/29/2022] Open
Abstract
The distortion of biomedical signals by powerline noise from recording biomedical devices has the potential to reduce the quality and convolute the interpretations of the data. Usually, powerline noise in biomedical recordings are extinguished via band-stop filters. However, due to the instability of biomedical signals, the distribution of signals filtered out may not be centered at 50/60 Hz. As a result, self-correction methods are needed to optimize the performance of these filters. Since powerline noise is additive in nature, it is intuitive to model powerline noise in a raw recording and subtract it from the raw data in order to obtain a relatively clean signal. This paper proposes a method that utilizes this approach by decomposing the recorded signal and extracting powerline noise via blind source separation and wavelet analysis. The performance of this algorithm was compared with that of a 4th order band-stop Butterworth filter, empirical mode decomposition, independent component analysis and, a combination of empirical mode decomposition with independent component analysis. The proposed method was able to expel sinusoidal signals within powerline noise frequency range with higher fidelity in comparison with the mentioned techniques, especially at low signal-to-noise ratio.
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