Saskia K. Nagel

Critical Neuroscience: Linking Neuroscience and Society through Critical Practice

We outline the framework of the new project of Critical Neuroscience: a reflexive scientific practice that responds to the social, cultural and political challenges posed by the advances in the behavioural and brain sciences. Indeed, the new advances in neuroscience have given rise to growing projects of the sociology of neuroscience as well as neuroethics. In parallel, however, there is also a growing gulf between social studies of neuroscience and empirical neuroscience itself. This is where Critical Neuroscience finds its place. Here, we begin with a sketch of several forms of critique that can contribute to developing a model of critical scientific practice. We then describe a set of core activities that jointly make up the practice of Critical Neuroscience as it can be applied and practised both within and outside of neuroscience. We go on to propose three possible areas of application: (1) the problems related to new possibilities of neuropharmacological interventions; (2) the importance of culture, and the problems of reductionism, in psychiatry; (3) the use of imaging data from neuroscience in the law as alleged evidence about ‘human nature’.

Beyond sensory substitution?learning the sixth sense

Rapid advances in neuroscience have sparked numerous efforts to study the neural correlate of consciousness. Prominent subjects include higher sensory area, distributed assemblies bound by synchronization of neuronal activity and neurons in specific cortical laminae. In contrast, it has been suggested that the quality of sensory awareness is determined by systematic change of afferent signals resulting from behaviour and knowledge thereof. Support for such skill-based theories of perception is provided by experiments on sensory substitution. Here, we pursue this line of thought and create new sensorimotor contingencies and, hence, a new quality of perception. Adult subjects received orientation information, obtained by a magnetic compass, via vibrotactile stimulation around the waist. After six weeks of training we evaluated integration of the new input by a battery of tests. The results indicate that the sensory information provided by the belt (1) is processed and boosts performance, (2) if inconsistent with other sensory signals leads to variable performance, (3) does interact with the vestibular nystagmus and (4) in half of the experimental subjects leads to qualitative changes of sensory experience. These data support the hypothesis that new sensorimotor contingencies can be learned and integrated into behaviour and affect perceptual experience.

Sensory augmentation for the blind.

Common navigational aids used by blind travelers during large-scale navigation divert attention away from important cues of the immediate environment (i.e., approaching vehicles). Sensory augmentation devices, relying on principles similar to those at work in sensory substitution, can potentially bypass the bottleneck of attention through sub-cognitive implementation of a set of rules coupling motor actions with sensory stimulation. We provide a late blind subject with a vibrotactile belt that continually signals the direction of magnetic north. The subject completed a set of behavioral tests before and after an extended training period. The tests were complemented by questionnaires and interviews. This newly supplied information improved performance on different time scales. In a pointing task we demonstrate an instant improvement of performance based on the signal provided by the device. Furthermore, the signal was helpful in relevant daily tasks, often complicated for the blind, such as keeping a direction over longer distances or taking shortcuts in familiar environments. A homing task with an additional attentional load demonstrated a significant improvement after training. The subject found the directional information highly expedient for the adjustment of his inner maps of familiar environments and describes an increase in his feeling of security when exploring unfamiliar environments with the belt. The results give evidence for a firm integration of the newly supplied signals into the behavior of this late blind subject with better navigational performance and more courageous behavior in unfamiliar environments. Most importantly, the complementary information provided by the belt lead to a positive emotional impact with enhanced feeling of security. The present experimental approach demonstrates the positive potential of sensory augmentation devices for the help of handicapped people.

Pediatric neuroenhancement: Ethical, legal, social, and neurodevelopmental implications

The use of prescription medication to augment cognitive or affective function in healthy persons—or neuroenhancement—is increasing in adult and pediatric populations. In children and adolescents, neuroenhancement appears to be increasing in parallel to the rising rates of attention-deficit disorder diagnoses and stimulant medication prescriptions, and the opportunities for medication diversion. Pediatric neuroenhancement remains a particularly unsettled and value-laden practice, often without appropriate goals or justification. Pediatric neuroenhancement presents its own ethical, social, legal, and developmental issues, including the fiduciary responsibility of physicians caring for children, the special integrity of the doctor–child–parent relationship, the vulnerability of children to various forms of coercion, distributive justice in school settings, and the moral obligation of physicians to prevent misuse of medication. Neurodevelopmental issues include the importance of evolving personal authenticity during childhood and adolescence, the emergence of individual decision-making capacities, and the process of developing autonomy. This Ethics, Law, and Humanities Committee position paper, endorsed by the American Academy of Neurology, Child Neurology Society, and American Neurological Association, focuses on various implications of pediatric neuroenhancement and outlines discussion points in responding to neuroenhancement requests from parents or adolescents. Based on currently available data and the balance of ethics issues reviewed in this position paper, neuroenhancement in legally and developmentally nonautonomous children and adolescents without a diagnosis of a neurologic disorder is not justifiable. In nearly autonomous adolescents, the fiduciary obligation of the physician may be weaker, but the prescription of neuroenhancements is inadvisable because of numerous social, developmental, and professional integrity issues.

Learning New Sensorimotor Contingencies: Effects of Long-Term Use of Sensory Augmentation on the Brain and Conscious Perception

Theories of embodied cognition propose that perception is shaped by sensory stimuli and by the actions of the organism. Following sensorimotor contingency theory, the mastery of lawful relations between own behavior and resulting changes in sensory signals, called sensorimotor contingencies, is constitutive of conscious perception. Sensorimotor contingency theory predicts that, after training, knowledge relating to new sensorimotor contingencies develops, leading to changes in the activation of sensorimotor systems, and concomitant changes in perception. In the present study, we spell out this hypothesis in detail and investigate whether it is possible to learn new sensorimotor contingencies by sensory augmentation. Specifically, we designed an fMRI compatible sensory augmentation device, the feelSpace belt, which gives orientation information about the direction of magnetic north via vibrotactile stimulation on the waist of participants. In a longitudinal study, participants trained with this belt for seven weeks in natural environment. Our EEG results indicate that training with the belt leads to changes in sleep architecture early in the training phase, compatible with the consolidation of procedural learning as well as increased sensorimotor processing and motor programming. The fMRI results suggest that training entails activity in sensory as well as higher motor centers and brain areas known to be involved in navigation. These neural changes are accompanied with changes in how space and the belt signal are perceived, as well as with increased trust in navigational ability. Thus, our data on physiological processes and subjective experiences are compatible with the hypothesis that new sensorimotor contingencies can be acquired using sensory augmentation.

Enhancement for well-being is still ethically challenging

Enhancement is generally understood as being intended to improve well-being. The motivation to enhance is the desire to change a person for the better. However, even when increased well-being is the motivation, it is unclear how to morally evaluate any given intervention. Four examples illustrate why any enhancement intervention, including those motivated by the desire to increase well-being, still demands ethical reflection.

Predictions in the light of your own action repertoire as a general computational principle.

We argue that brains generate predictions only within the constraints of the action repertoire. This makes the computational complexity tractable and fosters a step-by-step parallel development of sensory and motor systems. Hence, it is more of a benefit than a literal constraint and may serve as a universal normative principle to understand sensorimotor coupling and interactions with the world.

Addressing the problem of ADHD medication as neuroenhancements

The prevalence of attention deficit hyperactivity disorder (ADHD) diagnoses is rising. ADHD is closely linked to its treatment with medications such as methylphenidate and amphetamines, which have popular appeal as neuroenhancement drugs by persons without a neurological disorder. The three main reasons for the increase in ADHD medication demand, production, and consumption are a) the inclusion of milder ADHD diagnoses; b) the vast marketing of ADHD medications by the pharmaceutical industry; and c) the illegal diversion of controlled ADHD medication to consumers seeking stimulants as neuroenhancements. Rapidly rising rates of any neurological disorder – especially a behaviorly-defined disorder closely linked to potent medications currently prescribed to more than 5% of the population – deserves ongoing scrutiny. Major social and ethical problems arise from vague-symptom medicalization, neurological disorder trivialization, medication overuse, and controlled substances diversion to healthy persons for nonmedical purposes. We argue against the ‘spectrumization’ of ADHD in an effort to curtail further diagnosis creep.

Self-Perception and Self-Determination in Surveillance Conditions

The current demographic trends require rethinking health care and home care solutions. Rapid development of information and communication technologies that can be applied to technically equip priva...

Enhancement in Children and Adolescents: Scrutinizing Effects Beyond Cognition

determined even in individuals with a sincere belief in equality (Terbeck et al. 2012). Consequently, Vrecko’s subjects might not have had sufficient self-reflecting ability to recognize the nature of their motivation. To take it further, the fact that the students were taking illegally prescribed drugs and accepting the side effects would indicate that they were very motivated, even more than others, to perform well. Clearly more research is needed, perhaps especially using unobtrusive measures of motivation rather than self-reports. In conclusion, the fact that the students are taking performance enhancing drugs strongly contradicts the findings that students are not motivated about their work or performance. Otherwise, why would they bother taking it?