Neuroenhancement Basics

Neuroenhancement refers to the targeted improvement and extension of cognitive and affective abilities based on an understanding of their underlying neurobiology in healthy individuals who do not have mental illness. As such, it can be considered as a generic term that encompasses pharmacological and nonpharmacological methods of improving cognitive, emotional and motor functionality. As well as the general ethical-legal discourse that accompanies these objectives. Critically, for any agent to qualify as a neuroenvironment, it must generate significant cognitive, emotional or motor benefits beyond normal functioning in healthy individuals, with little side-effect: At most at the level of commonly used comparable legal substances or activities, such as caffeine, alcohol and sleep deprivation.

Pharmaceutical neuroenvironmental agents include well-validated nootropics, such as racetam, vinpocetine and phosphatidylserine, as well as other drugs used to treat patients with neurological disorders. Non-pharmacological measures include non-invasive brain stimulation, which has been used to improve various cognitive and affective functions, and brain-machine interfaces, which have great potential to expand the repertoire of motor and cognitive actions available to humans.

Although consideration of individual neuroenvironmental agents is usually triggered by clinical and technological success, they have also been used to assist individuals with a lack of normal cognitive, motor and emotional abilities: for example, , Social skills and empathy. In this case, neurodevelopment drugs try to increase oxytocin and reduce cortisol levels by helping people to improve their communication and social interaction skills.

Pharmacological

Modafinil

Modafinil is a revitalizing drug that reduces fatigue, increases alertness, reduces daytime sleepiness and improves mood.  Modafinil is currently licensed to treat patients with disorders such as narcolepsy, sleep apnea and sleep shift work by shifts. This drug also appears promising in the treatment of depression and bipolar disorder.  Modefinil is currently used by US Air Force personnel for long-term missions to reduce fatigue among crews. It has become more popular among the general public. In an online poll conducted by Nature magazine, 8.8% of the 1,400 readers admitted the use of modafinil for non-medical reasons. Their reasoning behind their use was increasing concentration and focusing on a specific task or counteracting sleep deprivation and jet lag.  A comparison between modafinil sales and the number of patients revealed a disproportionate ratio, indicating high abuse. [2]

Modafinil has been reported to improve executive function in healthy and sleepless individuals, while improving attention, learning and memory. The effects on sleep deprived persons are even more striking: a single dose has resulted in improved awakening, executive functions and memory. In the case of prolonged sleep deprivation, repeated intake of modafinil helped individuals maintain higher levels of arousal than placebo, but did not help attention and executive function. Since most of these trials have been conducted on military personnel, further research is needed on the effects of modafinil on the general population. Modafinil can impair its self-monitoring capability. A common trend in research studies indicated that participants rated their performance on cognitive tests higher than they actually were, suggesting an “overconfidence” effect.

Modafinil is becoming more popular among the general population. In addition to the desire of a consumer to increase his neurological performance, there are also financial incentives for manufacturers. Modafinil has a market share of more than $ 700 million per year, indicating a high degree of off-label use. [4] Modafinil is also one of the most readily available neuro-enhancement drugs on the market today. Modafinil can be purchased from many websites – mainly from Asian countries – as well as from darknet markets. Modafinil came into focus when world champion Kelli White was tested positive for the illegal use of modafinil in the World Athletics Championship in 2003, resulting in the loss of his Two gold medals.

Methylphenidate

Methylphenidate (MPH) is a stimulant that is used to treat Attention Deficit Hyperactivity Disorder (ADHD). The MPH is known to be very ill-treated by the general population, especially students.In an online survey conducted by Nature magazine, 12.4% of the 1,400 readers admitted using MPH for non-medical reasons. Their reasoning behind their use was to increase concentration, sleep deficit and jet lag.

A comparison between MPH sales and the number of patients revealed a disproportionate ratio, indicating high levels of abuse. The MPH is supposed to have a positive effect on memory consolidation, but the studies have not been able to conclusively verify this assertion. The popular opinion that MPH increases attention can not be verified.  MPH studies reported an improvement in problem solving skills. However, when these studies were repeated to reproduce the results, the placebo group obtained a higher score, indicating that MPH may even impair performance.

Methylphenidate

Methylphenidate (MPH) is a stimulant that is used to treat Attention Deficit Hyperactivity Disorder (ADHD). The MPH is known to be very ill-treated by the general population, especially students. [2] [4] In an online survey conducted by Nature magazine, 12.4% of the 1,400 readers admitted using MPH for non-medical reasons. Their reasoning behind their use was to increase concentration, sleep deficit and jet lag.

A comparison between MPH sales and the number of patients revealed a disproportionate ratio, indicating high levels of abuse.  The MPH is supposed to have a positive effect on memory consolidation, but the studies have not been able to conclusively verify this assertion. The popular opinion that MPH increases attention can not be verified.  MPH studies reported an improvement in problem solving skills. However, when these studies were repeated to reproduce the results, the placebo group obtained a higher score, indicating that MPH may even impair performance.

These inconclusive and generally negative results for memory improvement are insufficient to explain the use of MPH for non – medical reasons. Users may have motives other than the actual neurodevelopment that propels its illegal use, such as subjective and recreational effects. [2] Lack of result, positive or negative, indicated that the dosage of 10-20 mg may be too low for the drug. [2] Further studies have to be conducted, looking at different doses of MPH.

Memantine

Memantine is an NMDA receptor antagonist and is used to treat patients with moderate to severe Alzheimer’s disease, but is also used as a neuro-enhancement medication. [3] Memantine studies were unable to verify definitively the drug’s neuro-enhancement capacity. Since most of these studies were single dose tests for memantine, these drugs may only have a positive or negative effect after a continuous intake. Until then, single dose studies of memantine are not sufficient to reveal the actual potential of the drug. [3]

Donepezil

10mg of donepezil pill

Donepezil is an acetylcholinesterase inhibitor (AChEI) used to treat patients with mild to moderate Alzheimer’s disease. Although many HPAIs may be potentially neurodegenerative substances, donepezil is the ACHII most commonly used by the general population because of its widespread use in the treatment of Alzheimer’s disease. [3]

Most studies on donepezil do not provide a definitive check of the neuro-improvement capacity of the drug. [3] In such studies, it was seen that participants who took dopepezil obtained a higher score than those who took placebo. Donepezil helps individuals maintain training tasks, verbal memory and episodic memory.  In sleep deprivation studies, while donepezil had no effect on well-rested patients, it had a positive effect on patients suffering from 24-hour sleep deprivation. Such patients have benefited from an increase in memory and attention that would otherwise be deficient in such deprived sleep conditions.  However, this effect was observed only in people whose performance decreased significantly due to sleep deprivation.

Non pharmacologique

Stimulation of the transcranial direct current

While neuro-enhancement drugs are a potential method for improving cognitive performance, transcutaneous DC (DCS) stimulation on the motor cortex (MC) is considered to be another potential method. [13] Although it was initially intended to help patients with brain damage such as stroke, recent years have also sparked a lot of interest in the capabilities of TDCS for healthy individuals. Recent studies have already shown improved neuroplasticity from TDCS to facilitate motor learning in young humans, and it is possible to apply this method to the older segment of the workforce. [13]

The stimulation of superior cognitive functions of the brain, such as the function of language, with TDCS in a study has improved the search for words. TDCS works by improving connectivity in a given stimulated network, providing neural efficiency in highly specific brain areas critical for task performance. [14] During this period, MRI images also showed reduced activity in semantic search processes, suggesting more effective treatment in critical areas of the brain.  Reduced activity in the areas related to the circumscribed task was attributed to the consolidation of motor learning and superior memory performance. A new search in tDCS tries to locate the stimulation to affect the desired subset of very specific task-specific neurons.

Deep brain stimulation

Deep brain stimulation (DBS) is another form of neuro-improvement. Unlike TDCS, DBS involves the implantation of a medical device and is reserved for use for only a few serious diseases such as Parkinson’s disease and dystonia. [15] In one study, DBS improved movement by 39%, reduced disability by 38% and improved quality of life by 30% in patients with dystonia for 3 months. [15] Patients had a 50% reduction in symptoms of dystonia. [15] Improvement was noted in the hours or days after the DBS application. The benefits of DBS to date are well above those of high doses of trihexyphenidyl, a potent drug used in the treatment of dystonia.

Side Effects

Neuroenhancements medications are well tolerated by healthy humans. These drugs are already used to treat patients with different types of psychiatric disorders. Since most of the information on neuro-improvements and its abilities comes from research experiments, the best way to determine the adverse effects is dropout rates and subjective ratings. Dropout rates were minimal or non-existent for donepezil, memantine, MPH, and modafinil. In drug trials, participants reported the following adverse reactions to donepezil, memantine, MPH or modafinil: gastrointestinal complaints (nausea), headache, dizziness, Nightmares, anxiety, drowsiness, nervousness, restlessness, sleep disorders and insomnia. Side effects usually resolve during treatment. [3] Although there were no reported side effects from DBS, 18% of patients suffered from complications related to the device, such as infections caused by duplication or lead fracture.  18% of patients had complications related to the device, such as infections due to take-off or lead breakage.  18% of patients had complications related to the device, such as infections due to take-off or lead breakage.