Why Should Neuroenhancement Be Possible?

Connecting Fantasy to Fact

In my introductory post on transcranial ultrasound I laid out a vision for developing transcranial, low-intensity ultrasound as a fully general neuromodulation technique, potentially for human cognitive and psychological enhancement.

In other words, making people “better than well.”

Maybe superhumanly smart; maybe superhumanly happy; maybe superhumanly “sane” or “wise”, whatever that means.

Now, obviously that would be cool; but why do we have any reason to suspect it’s possible?

Well, the natural places to look are at already-existing examples of enhancement. Not necessarily ultrasound specifically, but cases in which healthy people have gained mental or psychological abilities through neurological interventions/changes. The range of possibility necessarily includes the actual.

Stimulant-Like Cognitive Enhancement Effects

There are, of course, well-replicated, widely-used methods for enhancing the cognitive ability of healthy humans.

They’re called caffeine, nicotine, amphetamine, methylphenidate, and modafinil.

It’s kind of a gotcha, but it’s true. Stimulants make healthy human subjects perform better on cognitive tests. More so in sleep-deprived than in rested subjects, but there are some positive results in rested subjects too.

And these well-known stimulants are basically the only drugs that have a well-replicated, nontrivial effect on healthy human cognitive performance.

(The exceptions — non-famous drugs with any experimental evidence of a strong cognitive-enhancing effect in humans — are ispronicline, a discontinued ADHD drug that targets the nicotinic receptors, and cerebrolysin, a mixture of pig-brain derived growth peptides.)

Stimulants typically increase wakefulness and reduce reaction times; they also improve accuracy on tests that measure focus, memory, executive function, pattern recognition, and so on. After hundreds of years of familiarity with coffee, tea, and tobacco, we have some cultural intuition for the scale and nature of the effects of the “classic” stimulants. Stimulants generally make people sharper, clearer, more productive, better at concentrating — perhaps at the cost of greater anxiety, irritability, or “tunnel vision.”

Similarly, there are some stimulant-like effects that can be produced with brain stimulation.

rTMS, or repetitive transcranial magnetic stimulation, to the prefrontal cortex has some cognitive-enhancing effects in healthy people — reducing reaction time, increased accuracy on working-memory tasks, and so on.

Once again, the scale of the effect is not plausibly enough to make anybody a “genius” or increase the absolute ceiling of human mental ability; but it is definitely possible to make healthy people perform noticeably cognitively better than they ordinarily would.

Savant-Like Cognitive Enhancement Effects

It is a curious fact that sometimes brain damage can increase, rather than decrease, human capabilities.

There have been dozens of reported cases of “acquired savant syndrome”, in which individuals acquired extraordinary abilities as a result of a brain injury or disorder.

• A child in 1923 developed musical talents after an attack of meningitis

• a man with a bullet wound to the left brain in 1980 became mute, deaf, and paralyzed on the left side, but also gained exceptional mechanical skills

• 12 patients with frontotemporal dementia, in the 1990s, experienced dramatic improvements in artistic ability and unprecedented motivation to create art, even as their other cognitive abilities declined

• Alonzo Clemons gained the ability to form realistic sculptures of anything he glanced at, after a childhood fall and brain injury that left him intellectually disabled and unable to read

• Tony Cicoria gained a sudden obsession with piano music after being struck by lightning, and became a pianist and composer

• Derek Amato, similarly, acquired musical synaesthesia and composing talent after a fall in a swimming pool caused brain damage.

• Orlando Serrell gained calendar-calculating savant abilities and a perfect memory after being struck on the left side of the head by a baseball.

• Jason Padgett acquired geometrical and artistic savant abilities, including mathematical synaesthesia, after a traumatic brain injury from being attacked in an alley; he is now an artist.

Some “acquired savant” abilities are simply dramatic improvements from that individual’s baseline, while others are exceptional in an absolute sense (perfect memory, instant calculating abilities, synaesthesia, etc.) Often, cases of acquired savant syndrome involve damage to a verbal region of the brain, and a corresponding enhancement of nonverbal (musical, artistic, mathematical, or spatial) skills.

Cases of acquired savant syndrome often also involve sudden enhancements of motivation as well as talent for creative pursuits — a person who previously had no interest in music, art, or mathematics would suddenly become obsessed after a brain injury.

These cases suggest the potential possibility of unlocking savant-like abilities in healthy humans.

In fact, independent Australian researcher Allan Snyder has claimed to be able to induce savant-like abilities with magnetic stimulation (rTMS) to the left temporal lobe. Treated, but not control, subjects temporarily increased their “numerosity”, or ability to rapidly estimate the number of items displayed on a screen. And some (ambiguous) changes occurred in drawing style in response to rTMS stimulation.

I don’t think the Snyder rTMS studies are especially strong evidence that savant talents can be induced, but those and the case histories are suggestive of the kinds of possibilities that are out there.

Pleasure and Positive Emotions

Another axis on which people can be “better than well” is affective — is it possible to make a person feel better than a typical “healthy” person does?

Obviously yes; recreational drugs exist. You can, of course, feel unusually good temporarily if you take one of the many psychoactive substances that induce pleasure.

Of course, there are reasons people aren’t high all the time; apart from cultural, ethical, and legal concerns, all known recreational drugs cause acute impairment in everyday functioning, and many have side effects and health risks. And even if you didn’t care about any of that, it’s not literally possible to sustain a euphoric feeling from recreational drugs for the rest of your life, because of tolerance effects.

So, is it even possible to be chronically, sustainably happier than a “normal” person?

Yes, it turns out. There are case studies of “persistent euphoric states” or “chronic mania” — patients who are unusually happy and high-energy, all the time, without crashing back into depression as bipolar people do. As I wrote in my earlier post:

The typical pattern, from case studies, seems to be of a person who may have had transient manic episodes in the past, “settling into” a chronic manic state where they are generally euphoric but out of touch with reality, engaging in reckless, inappropriate, or obnoxious behavior, until they come to the attention of psychiatrists when neighbors or relatives bring them to the hospital.

This doesn’t sound too desirable, but, of course, there’s a selection effect here — someone who is extraordinarily, atypically happy and doesn’t have any attendant dysfunctions probably won’t go to a psychiatrist about it.

As with acquired savant syndrome, the location for brain lesions most closely associated with chronic mania is in the temporal lobe.

It’s also possible to induce euphoria in humans through deep brain stimulation. Stimulation to the nucleus accumbens, a deep brain structure involved in pleasure, reward, and reinforcement learning, and the subthalamic nucleus, a deep brain structure involved in motor planning, can cause transient feelings of euphoria and sometimes manic episodes.

In the 1950s, studies of deep brain stimulation on schizophrenic patients, in the septal area at the base of the frontal lobes, found that the stimulation had little effect on schizophrenia symptoms but produced powerful pleasurable (and sexual) sensations.

Deep brain stimulation in the ventral (but not dorsal) amygdala causes feelings of euphoria and strong mental imagery:

there’s green pasture all around…oh my god I want to be there…I want to go there so bad…oh man so beautiful…I wish I was there man…I can feel the mist the green trees the fresh air oh my god man…god I wish I can be there.”

It seems highly plausible that, if electrode stimulation in certain deep brain regions can cause pleasure in humans, noninvasive stimulation like transcranial ultrasound that reaches those same regions may do so as well.

It’s also not impossible in principle that there’s a way to cause long-term mood elevation with brain stimulation (i.e. not a transient effect that fades or develops tolerance) though I’m not currently aware of direct evidence of this.

Stress Resilience and Emotional Regulation

Enhanced positive feelings aren’t the only emotional “superpower” we might investigate; we could also ask if it’s possible to make healthy humans more resilient to distress.

I’m inclined to think this is the most tractable angle on human neuroenhancement. We know that it’s possible for a person to be clearheaded, calm, un-panicked, un-stressed — after all, most of us are in that state some of the time. And obviously it should be physically possible to stay calm more of the time than any human ever has; whereas it’s not obvious that it’s possible for a human to be, say, better at math than the best mathematician who has ever lived.

I suspect that even “purely cognitive performance” may be easier to boost by changing people’s emotions (reducing panic, shame, insecurity, anger, etc so they can think more clearly and avoid motivated cognition) than by increasing some “raw” measure of mental horsepower.

There are weak but suggestive effects of noninvasive brain stimulation to the prefrontal cortex on reducing the stress response to verbal criticism, and other effects like making subjects better at reducing negative emotions when instructed to “reappraise” a negative social interaction in a more positive way.

We also know that deep brain structures, not normally stimulated in healthy subjects, can affect stress — the amygdala, for instance, is activated in stress and monkeys with their amygdalas removed show no fear of ordinarily frightening things. Would noninvasive stimulation of emotion-related deep brain structures affect stress response? We don’t yet know, but it seems like an obvious place to investigate.