Brain Makeover

A

Have you ever longed for a dose of medicine for your mind? Or some "gizmo" to fire an electric current through the prefrontal cortex to kick-start your brain into action, making you just that bit brighter? Well, you may not have to wait much longer. The over-the-counter eureka pill and the thinking cap may soon become reality, and whether and when we should be allowed to use them is the next big conundrum of medical ethics.

B

Huge advances in treating mental diseases mean that techniques for improving brain performance could soon be applied, on demand, to healthy brains in an entirely new branch of elective medicine. So-called "cosmetic neurology" could be used not merely to improve thought processes, but also to alter other aspects of brain function such as reflexes, attention and memory, to accelerate learning and sharpen reactions. Students could take a "cognitive enhancer" to ensure that they retain more information; police facing emergencies could speed up their reactions; and a novelist struggling with writer’s block could clear the blockage with a shot of artificial brainpower.

C

This may sound fanciful, but what plastic surgery can already achieve for the face and body, cosmetic neurology could one day do for the brain. Techniques for improving brain response are being developed for the most laudable medical reasons: to fight serious neurological diseases such as Parkinson’s or Alzheimer’s disease, in much the same way that plastic surgery was pioneered to treat the disfigured victims of warfare. But, as with plastic surgery, if people want cosmetic neurology enough, doctors will provide it, whatever the ethical qualms involved -- and at a price: Botox for the brain, ironing out the mind-wrinkles.

D

The science of mind improvement is developing at an incredible rate. Already, some 40 potential cognitive enhancers are in clinical development in the US. Dr Chatterjee of the University of Pennsylvania, writing in the journal Neurology, warned that cosmetic neurology is on the near horizon:

"This is coming, and we need to know it’s coming."

E

A recent study of pilots using flight simulators found that those given a dose of donepezil, a medication used for treating Alzheimer’s disease, performed markedly better in emergency situations. Another recent test by the US National Institute of Neurological Disorders and Stroke discovered that sending a small electrical impulse through a person’s forehead could boost verbal skills by up to 20 per cent.

Amphetamines used on stroke patients might theoretically be developed for healthy individuals who want to improve their learning of motor skills during, say, a piano lesson. Advances in brain imaging, molecular biology and genetics mean that scientists are developing their understanding of the way the brain works, thus increasing the potential to develop drugs that improve its performance.

No amount of drugs or electrical stimulation will turn you into Einstein; a pill cannot help you recall something you never knew in the first place. The danger, however, is that one might then recollect many things best left unremembered. There is a good reason why we forget some things.

F

The ethical implications of brain-sharpening drugs are, of course, enormous. If pilots are safer on certain drugs, should they be required to take them? If students can improve their examination performance with a dose of this or a zap of that, the test surely becomes unfair. Mind medication is certain to be expensive, so will the rich be able to buy better brains?

Medicine exists to improve the lives of those who are sick, but should medical knowledge also be used to enhance the lives of people who are perfectly healthy? Millions have seized the opportunity offered by cosmetic surgery to become more conventionally beautiful; how many more would leap at the opportunity to become a little brainier?

G

Many of us use a chemical brain enhancer every day. Coffee, after all, has been used as a pick-me-up for at least four centuries. Perhaps cosmetic neurology will be no more than this. Yet the imminent arrival of the "clever pill" must force the medical profession to address once again the distinction between curing the ill and improving the well, and between patient and consumer. It is one thing to change the outside of one’s head for the sake of vanity, but another to alter the inside for personal advantage.