Transcranial Electrical Stimulation to Enhance Cognitive Performance of Healthy Minors: A Complex Governance Challenge

Abstract

An increasing number of healthy adolescents are consuming products that can enhance their cognitive performance in educational settings. Currently, the use of pharmaceuticals is the most widely discussed enhancement method in the literature, but new evidence suggests that other methods based on Transcranial Electrical Stimulation (tES) also have potential as cognitive enhancer. Just like pharmaceutical enhancers, the availability and education-related use of tES-devices raise a broad range of ethical, legal, and societal issues that need to be addressed by policy-makers. Few studies, however, have specifically explored these issues in relation to child wellbeing. In this narrative review with systematic search, we describe the issues for child wellbeing that could arise from the availability and education-related use of tES-based enhancers by healthy minors. We demonstrate that the issues form a complex web of uncertainties and concerns, which are mainly incited by two factors. First is the high level of factual uncertainty due to gaps in empirical evidence about the exact working mechanisms and efficacy of tES. Moreover, a lack of insight into the technique’s (long-term) effects on healthy developing brains, and uncertainties about potential cognitive trade-offs have fueled concerns about the technique’s safety and impact. The second factor that contributes to the complexity of issues is the presence of moral diversity in our society. Different opinions exist on whether a certain enhancement effect would be desirable and whether potential risks would be acceptable. These opinions depend on one’s moral perspective, and the way one interprets and weights values such as the child’s autonomy and authenticity. The challenge for proper governance resides in the design of an appropriate framework that is capable of balancing the different moral perspectives in society, while recognizing the uncertainties that still exist. We therefore argue for a responsible innovation approach, which encourages an adaptive attitude toward emerging knowledge and dynamic societal values, to deal with the identified issues regarding tES-based enhancement appropriately.

Vigilance Enhancement Using Computerized Techniques

“…Interestingly, there has been an increasing amount of research in the use of tDCS on cognition and clinical studies [34][35][36]. Recent studies have examined the effects of tDCS on vigilance, attention and at alleviating problem at workplace [34,35,[37][38][39][40][41][42][43]. However, the effects of tDCS depends on the period of stimulation as well as the electrode placement on the brain areas.…”

“…Study in [46] applied tDCS to the parietal lobes of healthy adults during visual vigilant task with numerical characters, showed enhancement of numerical proficiency. Another studies stimulated the parietal lobes during training of a vigilance numerosity task showed improvements on discernable effects up to weeks [39][40][41]. The technique has reported positive impact on improving cognitive function of people with cognitive impairments by reducing symptoms of attention deficits [35,42,43] and alleviate vigilance problems at work [38].…”

Brain Data: Scanning, Scraping and Sculpting the Plastic Learning Brain Through Neurotechnology

“…Neurostimulation techniques such as transcranial electrical stimulation (tES) have been explored for their potential as cognitive enhancers with young people. According to a review of neurostimulation research in relation to education, the use of tES techniques has been linked to improvements in several cognitive domains, including memory, attention, language, mathematics and decision-making, some of which have been found to be long-lasting (Schuijer et al 2017). Although Schuijer et al (2017: 6-7) note that 'tES is associated with a range of promising cognitive benefits, which could potentially boost children's educational performances', they also caution that 'no certainty exists yet with regard to the benefits of tES-based enhancement for cognitive wellbeing, and incorrect application settings could even result in impairment of cognitive function'.…”

“…(Nuffield Council on Bioethics 2013: 174) The report cautions about the coercive use of neurostimulation and neurofeedback with children, adding that 'the effects of these interventions on the developing brain are, as yet, unclear, and children and young people may be less well equipped to resist pressures from educators or parents who wish them to use neurotechnologies to enhance their capacities for learning and educational performance' (Nuffield Council on Bioethics 2013: 233). Schuijer et al (2017) set out similar ethical concerns in relation to neuroenhancement technologies such as transcranial neurostimulation devices and their potential to be used as 'child management tools'.…”

Neuroenhancing Substances Use, Exam Anxiety and Academic Performance in Bosnian-Herzegovinian Firstyear University Students

“…The topic of neuroenhancement, defined as the use of the substances by healthy subjects in order to enhance their mood or cognitive function, has become increasingly popular (1,2). These substances are frequently used among students in their academic en-vironment to improve their academic performance (1,3). The most commonly used neuroenhancing substances are known as soft enhancers [i.e.…”