Monday, May 3, 2010

Should students get "dope-tested" for cognitive enhancers?

Student use of “smart drugs” to increase academic performance is quite a common practice these days. According to a recent article in the Guardian and a publication in Nature, up to 25% of students at some universities are using drugs such as ritalin and modafinil as cognitive enhancers. These agents are relatively easy to acquire, and proponents of their use claim that they cause few adverse side effects.

Those who are for the use of neuroenhancers also argue that taking a pill is no different than having a cup of coffee. Both caffeine and modafinil are drugs (although they have different mechanisms of action) that help students stay up and do last-minute studying, but one substance is legal while the other isn’t.

If this argument is taken into consideration, however, an important follow-up question is: where do you draw the line between “fair” and unfair cognitive enhancement? Would a student who supports modafinil use to improve academic performance also support, say, special brain surgeries for students to help them increase cognition and exam scores?

While this might seem like a ridiculous situation on the surface, we could be facing related questions in the future, especially if no measures to prevent smart drug use are soon taken on students. In a 2008 case study of a single patient, Andres Lozano and colleagues at the University of Toronto found that deep brain stimulation (applying highly localized electric current to neurons) in a specific brain area dramatically enhanced certain cognitive abilities. After the patient was stimulated in the fornix, a major output of the hippocampus, he demonstrated significantly increased scores on measures of verbal memory and spatial learning, and his IQ increased by 9 points. Lozano is currently testing deep brain stimulation in Alzheimer’s patients to see if their cognitive deficits can be reversed or alleviated by the technique.

The potential of deep brain stimulation to positively affect cognition is promising for a few reasons. Lozano wasn’t trying to enhance his patient’s cognitive ability when he stumbled upon this effect; his patient was stimulated near the fornix in an attempt to suppress the patient’s appetite in a case of treatment-resistant obesity. Thus, even though the increased cognitive abilities observed were so drastic, the fornix might not necessarily even be the best place to stimulate in order to enhance cognitive function. Additionally, studies of Parkinson’s patients as well as animal models have revealed supportive effects of deep brain stimulation on cognition.

Now imagine a future in which a cognitive-enhancing electrodes can be inserted into the brain using a relatively non-invasive method, and this treatment is commonly used in the management of cognitive decline and Alzheimer’s disease. Just as students now desire drugs that are meant for treating ADHD and insomnia, would students of the future also jump at the opportunity to try this cognitive therapy meant for Alzheimer’s? Is this still the same thing as drinking a cup of coffee, or does everything change when the treatment involved extends beyond the realm of drug therapy?

In a environment so competitive that students longing for straight A’s are willing to sacrifice sleep and neglect basic self-care, it would be reasonable to assume that some students are willing to do literally whatever it takes to achieve their goals. In the absence of defined limits and regulations, cognitive enhancement to increase academic performance can and will become the rule rather than the exception.

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