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1.
Neuron ; 102(4): 728-731, 2019 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-31121124

RESUMO

The wearable neurotechnology market targets consumers with promises of cognitive benefit and personal wellness. Scientific evidence is essential to substantiate claims about utility, safety, and efficacy and for informed choice and public trust.


Assuntos
Triagem e Testes Direto ao Consumidor/ética , Eletroencefalografia/instrumentação , Estimulação Transcraniana por Corrente Contínua/instrumentação , Dispositivos Eletrônicos Vestíveis/ética , Eletroencefalografia/ética , Humanos , Invenções/ética , Estimulação Transcraniana por Corrente Contínua/ética
2.
Bioethics ; 33(1): 122-131, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30157289

RESUMO

Non-invasive brain stimulation is used to modulate brain excitation and inhibition and to improve cognitive functioning. The effectiveness of the enhancement due to transcranial direct current stimulation (tDCS) is still controversial, but the technique seems to have large potential for improvement and more specific applications. In particular, it has recently been used by athletes, both beginners and professionals. This paper analyses the ethical issues related to tDCS enhancement, which depend on its specific features: ease of use, immediate effect, non-detectability and great variability of effects. If tDCS were to become widespread, there could be some potential side effects, especially the rise of inequality in many selective competitive contexts. I discuss two possible scenarios to counter this effect: that of prohibition and that of compensation, each supported by reasons and arguments that seem plausible and worthy of consideration. In conclusion, I show why I think the scenario of compensation is the preferable one.


Assuntos
Desempenho Atlético/ética , Melhoramento Biomédico/ética , Encéfalo , Cognição , Justiça Social , Esportes/ética , Estimulação Transcraniana por Corrente Contínua/ética , Atletas , Compensação e Reparação , Comportamento Competitivo/ética , Humanos , Controle Social Formal , Fatores Socioeconômicos
3.
Ergonomics ; 61(11): 1454-1463, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30587084

RESUMO

We employed a simulated production task that mimics the real-world skill acquisition required of operators working in control rooms of power plants to assess short and long-term effects of transcranial random noise stimulation (tRNS). tRNS has shown potential for enhancing learning and performance of cognitive skills. Forty subjects (24 female) learned how to execute the simulated production task during the training phase and were required to perform a secondary task during the skill acquisition phase while they received active (12 min) or sham tRNS on DLPFC. After 2 weeks they had to recall the task again without any stimulation. The results demonstrate that tRNS promoted better multitasking as reflected by better performance in a secondary task during and immediately after tRNS. However, 2 weeks later, beneficial effect of tRNS on retention was moderated by general mental ability. Particularly, tRNS benefited those with lower general mental ability. Practitioner summary: By using a simulated production task, we assessed the effects of tRNS on learning and skill retention. The study indicates that neurostimulation can enhance the learning of multiple complex tasks. Moreover, it shows that retention of those tasks can be supported by neurostimulation, especially for those with lower general mental ability.


Assuntos
Aprendizagem , Rememoração Mental , Comportamento Multitarefa , Estimulação Transcraniana por Corrente Contínua , Adulto , Feminino , Humanos , Inteligência , Masculino , Estimulação Transcraniana por Corrente Contínua/ética , Adulto Jovem
5.
Trends psychiatry psychother. (Impr.) ; 39(4): 232-238, Oct.-Dec. 2017.
Artigo em Inglês | LILACS | ID: biblio-904590

RESUMO

Abstract Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates cortical excitability. It is devoid of serious adverse events and exerts variable effects on cognition, with several research findings suggesting that it can improve memory, verbal and mathematical skills. Because tDCS devices are low-cost, portable and relatively easy to assemble, they have become available outside of the medical setting and used for non-medical ("cosmetic") purposes by laypersons. In this sense, tDCS has become a popular technique aiming to improve cognition and the achievement of a better performance not only at work, but also in other fields such as sports, leisure activities (video games) and even the military. In spite of these unforeseen developments, there has been a general paralysis of the medical and regulatory agencies to develop guidelines for the use of tDCS for cosmetic purposes. Several challenges are present, most importantly, how to restrict tDCS use outside of the medical setting in face of variable and sometimes conflicting results from scientific research. This article aims to describe the popular use of tDCS, in light of the pillars of neuroethics, a branch of bioethics relative to brain research. Between two possible but extreme solutions - total release or total restriction of tDCS - it is paramount to develop a spectrum of alternatives, which may vary over time and in different cultural backgrounds.


Resumo A estimulação transcraniana por corrente contínua (ETCC) é uma técnica não invasiva de estimulação cerebral que modula a excitabilidade cortical. A ETCC é desprovida de efeitos adversos graves e exerce efeitos variáveis sobre a cognição, com vários achados de pesquisa sugerindo que a técnica pode promover melhora nas habilidades mnêmica, verbal e matemática. Devido ao seu baixo custo, portabilidade e facilidade de montagem, os aparelhos de ETCC tornaram-se disponíveis fora do contexto médico, sendo usados para fins não médicos ("cosméticos") por indivíduos leigos. Nesse sentido, a ETCC tornou-se um procedimento popular para aprimoramento da cognição e a realização de melhor desempenho não somente no ambiente de trabalho, mas também em campos tais como o esporte, atividades de lazer ( video games ) e até no meio militar. Apesar desses acontecimentos imprevisíveis, há uma certa morosidade das agências médicas e regulatórias em desenvolver diretrizes para o uso de ETCC para fins cosméticos. Há muitos desafios presentes, principalmente, como restringir o uso da ETCC fora do contexto médico em face de resultados variáveis, e muitas vezes conflitantes, da pesquisa científica sobre o tema. Este artigo tem como objetivo descrever o uso popular da ETCC sob a luz da neuroética, um ramo da bioética que se dedica ao estudo do cérebro. Entre duas situações possíveis, mas extremas - liberação ou restrição totais da ETCC -, é primordial o desenvolvimento de um espectro de alternativas, que podem variar ao longo do tempo e depender de diversos contextos culturais.


Assuntos
Humanos , Encéfalo/fisiologia , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Estimulação Transcraniana por Corrente Contínua/instrumentação , Estimulação Transcraniana por Corrente Contínua/métodos , Estimulação Transcraniana por Corrente Contínua/ética , Processos Mentais/fisiologia
6.
Trends Psychiatry Psychother ; 39(4): 232-238, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29160331

RESUMO

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that modulates cortical excitability. It is devoid of serious adverse events and exerts variable effects on cognition, with several research findings suggesting that it can improve memory, verbal and mathematical skills. Because tDCS devices are low-cost, portable and relatively easy to assemble, they have become available outside of the medical setting and used for non-medical ("cosmetic") purposes by laypersons. In this sense, tDCS has become a popular technique aiming to improve cognition and the achievement of a better performance not only at work, but also in other fields such as sports, leisure activities (video games) and even the military. In spite of these unforeseen developments, there has been a general paralysis of the medical and regulatory agencies to develop guidelines for the use of tDCS for cosmetic purposes. Several challenges are present, most importantly, how to restrict tDCS use outside of the medical setting in face of variable and sometimes conflicting results from scientific research. This article aims to describe the popular use of tDCS, in light of the pillars of neuroethics, a branch of bioethics relative to brain research. Between two possible but extreme solutions - total release or total restriction of tDCS - it is paramount to develop a spectrum of alternatives, which may vary over time and in different cultural backgrounds.


Assuntos
Encéfalo/fisiologia , Estimulação Transcraniana por Corrente Contínua , Humanos , Processos Mentais/fisiologia , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Estimulação Transcraniana por Corrente Contínua/ética , Estimulação Transcraniana por Corrente Contínua/instrumentação , Estimulação Transcraniana por Corrente Contínua/métodos
7.
Clin Neurophysiol ; 128(9): 1774-1809, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28709880

RESUMO

Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1-2mA and during tACS at higher peak-to-peak intensities above 2mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity 'conventional' TES defined as <4mA, up to 60min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3-13A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6-7, 2016 and were refined thereafter by email correspondence.


Assuntos
Encéfalo/fisiologia , Guias de Prática Clínica como Assunto/normas , Estimulação Transcraniana por Corrente Contínua/ética , Estimulação Transcraniana por Corrente Contínua/normas , Animais , Queimaduras por Corrente Elétrica/etiologia , Queimaduras por Corrente Elétrica/prevenção & controle , Humanos , Estimulação Transcraniana por Corrente Contínua/efeitos adversos
8.
J Bioeth Inq ; 13(1): 95-103, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26715046

RESUMO

In recent years, discussion around memory modification interventions has gained attention. However, discussion around the use of memory interventions in the criminal justice system has been mostly absent. In this paper we start by highlighting the importance memory has for human well-being and personal identity, as well as its role within the criminal forensic setting; in particular, for claiming and accepting legal responsibility, for moral learning, and for retribution. We provide examples of memory interventions that are currently available for medical purposes, but that in the future could be used in the forensic setting to modify criminal offenders' memories. In this section we contrast the cases of (1) dampening and (2) enhancing memories of criminal offenders. We then present from a pragmatic approach some pressing ethical issues associated with these types of memory interventions. The paper ends up highlighting how these pragmatic considerations can help establish ethically justified criteria regarding the possibility of interventions aimed at modifying criminal offenders' memories.


Assuntos
Comportamento de Escolha/ética , Consciência , Criminosos/psicologia , Psiquiatria Legal/ética , Memória Episódica , Competência Mental , Rememoração Mental , Punição , Identificação Social , Responsabilidade Social , Coerção , Direito Penal/ética , Direito Penal/legislação & jurisprudência , Direito Penal/tendências , Criminosos/legislação & jurisprudência , Tomada de Decisões/ética , Emoções , Etanol/farmacologia , Psiquiatria Legal/legislação & jurisprudência , Psiquiatria Legal/métodos , Psiquiatria Legal/tendências , Humanos , Consentimento Livre e Esclarecido/ética , Competência Mental/legislação & jurisprudência , Competência Mental/psicologia , Rememoração Mental/efeitos dos fármacos , Princípios Morais , Prisioneiros/psicologia , Propranolol/farmacologia , Punição/psicologia , Segurança , Tiopental/farmacologia , Tortura/ética , Tortura/psicologia , Estimulação Transcraniana por Corrente Contínua/ética , Estimulação Magnética Transcraniana/ética
9.
J Med Ethics ; 42(4): 211-5, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26324456

RESUMO

Scientists and neuroethicists have recently drawn attention to the ethical and regulatory issues surrounding the do-it-yourself (DIY) brain stimulation community, which comprises individuals stimulating their own brains with transcranial direct current stimulation (tDCS) for self-improvement. However, to date, existing regulatory proposals and ethical discussions have been put forth without engaging those involved in the DIY tDCS community or attempting to understand the nature of their practices. I argue that to better contend with the growing ethical and safety concerns surrounding DIY tDCS, we need to understand the practices of the community. This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers cope with the methodological limitations inherent in self-experimentation. I conclude by discussing how a deeper understanding of the practices of DIY tDCS has important regulatory and ethical implications.


Assuntos
Autoexperimentação , Cognição , Equipamentos e Provisões/ética , Legislação de Dispositivos Médicos/tendências , Memória de Curto Prazo , Transtornos Mentais/terapia , Testes Neuropsicológicos , Efeito Placebo , Prática Psicológica , Estimulação Transcraniana por Corrente Contínua , Fatores de Confusão Epidemiológicos , Transtorno Depressivo/terapia , Desenho de Equipamento , Humanos , Transtornos Mentais/psicologia , Reprodutibilidade dos Testes , Tamanho da Amostra , Esquizofrenia/terapia , Estimulação Transcraniana por Corrente Contínua/ética , Estimulação Transcraniana por Corrente Contínua/instrumentação , Estimulação Transcraniana por Corrente Contínua/métodos , Estimulação Transcraniana por Corrente Contínua/tendências
10.
Eur J Neurosci ; 38(7): 2973-7, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23869660

RESUMO

A range of techniques are now available for modulating the activity of the brain in healthy people and people with neurological conditions. These techniques, including transcranial magnetic stimulation (TMS) and transcranial current stimulation (tCS, which includes direct and alternating current), create magnetic or electrical fields that cross the intact skull and affect neural processing in brain areas near to the scalp location where the stimulation is delivered. TMS and tCS have proved to be valuable tools in behavioural neuroscience laboratories, where causal involvement of specific brain areas in specific tasks can be shown. In clinical neuroscience, the techniques offer the promise of correcting abnormal activity, such as when a stroke leaves a brain area underactive. As the use of brain stimulation becomes more commonplace in laboratories and clinics, we discuss the safety and ethical issues inherent in using the techniques with human participants, and we suggest how to balance scientific integrity with the safety of the participant.


Assuntos
Estimulação Transcraniana por Corrente Contínua/ética , Estimulação Transcraniana por Corrente Contínua/métodos , Estimulação Magnética Transcraniana/ética , Estimulação Magnética Transcraniana/métodos , Ensaios Clínicos como Assunto/efeitos adversos , Ensaios Clínicos como Assunto/ética , Ensaios Clínicos como Assunto/métodos , Humanos , Efeito Placebo , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Estimulação Magnética Transcraniana/efeitos adversos
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