“I know what you’re thinking….”

It’s a common saying and one that belies any functional capacity to predict another’s thoughts. Yet our drive to uncover arguably the most secretive and private form of information – thoughts – has led to major advances in the science of “reading one’s mind.”

Current technologies are able to perform generally accurate predictions about robust neurologic phenomena such as distinguishing if an individual is looking at (or imagining) a face or a home (Haynes and Rees, 2006). However, as technologies advance it may well soon be possible to detect and identify more complex and covert thoughts – lies (Langleben et al., 2005) and even subconscious thought (Dehaene et al., 1998). With this ability, we must question the ethics surrounding the pursuit of this knowledge.

Figure 3 from Haynes and Rees, 2006

With advances in neuroimaging the ability to decode mental states in humans by recording brain activity has become a reality. In a review for Nature Neuroscience that is now six years old, John-Dylan Haynes and Geraint Rees detail how fMRI can be used to accurately predict visual perception. They explain that with advanced statistical pattern recognition, not only can the perception of broadly different visual inputs be differentiated, such as faces versus landscapes, but even the perception of subtly distinct objects, such shoes versus a chair, can be recognized. Further, fine details can also be distinguished, including image orientation, direction of motion, and perceived color. Indeed, the orientation of masked images can even be discriminated by activity in the primary visual cortex despite the subject being unable to consciously distinguish the orientation of the image.

Decoding unconscious processing (from Haynes and Rees, 2006)

This year, Emory’s First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course.

These posts will be delivered in 4 weekly installments, each week featuring a commentary on a different neuroethics piece. This is the third of four installments.

This week, we feature the final installment of student blogs covering the following article:

Decoding mental states from brain activity in humans Nature Reviews Neuroscience 7, 523-534 (July 2006) 

At what point can be say without a shout of a doubt that no one is left inside that lifeless corpse laying there motionless in that hospital bed? The first major problem we encounter when discussing “disorders of consciousness¹” is that we still don’t have a definitive definition of what consciousness even is. Is it a tangible mass in the brain? Does it light up in response to stimuli during a brain scan? We are still fighting these issues about people’s mental states and their level of consciousness yet we have no idea what that even is. It seems to be a losing battle that will only end in debate. Some are trying to go a step farther and implement modern technology into the better accessing a patient’s mental abilities and whether or not it is safe to define that as being in a vegetative state.

Premotor cortex activity in a vegetative state (Source)

Functional brain imaging techniques have become a versatile tool for peering into brain and how its activity can manifest as behavior. Nervous system injuries can leave people with varying degrees of functionality and capability. Disabilities can be of the mind such as the inability to perform cognitive tasks like math or impair memory recall or formation. Other injuries can be of the body such as in paralysis or quadriplegia. Unfortunately when it comes to brain injuries, the resulting symptoms are never easily quantifiable. Diagnosis of such patients is complicated by the fact that “There is as yet no universally agreed definition of consciousness and, to an even greater extent, no definition of ‘self-consciousness’ or ‘sense of self/being’“ (Owen and Coleman, 2008). It is thus no surprise that misdiagnosis resulting from brain imaging techniques are as high as 43% (Andrews et al. 1996, Childs et al. 1993). The progression of neuroimaging techniques being used clinically to diagnose consciousness and the vegetative state requires neuroscientists themselves to step up and provide education to clinicians and patients about not only how neuroimaging works but also what it means.

Can fMRI determine consciousness? (Source)

So, you’re on a first date and you’ve just finished discussing your favorite movies, how many siblings you have et cetera. The next natural topic of discussion will be “how do you feel about functional neuroimaging of the vegetative state?” Don’t be intimidated. Here are three guidelines to follow so that your discussion is intellectually stimulating and does not get stuck in a mire of cognitive biases and gaps in logic.

fMRI Communication? (Source)

This year, Emory’s First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course.

These posts will be delivered in 4 weekly installments, each week featuring a commentary on a different neuroethics piece. This is the third of four installments.

This week, we feature blogs covering the following article:

Functional neuroimaging of the vegetative state Nature Reviews Neuroscience 9, 235-243 (March 2008).

Attention-deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders in the world. Its main symptoms consist of inattention (be easily distracted, miss details, and frequently switch from one activity to another or have difficulty organizing and completing a task or learning something new or trouble completing homework assignments), hyperactivity and impulsiveness (fidget and squirm in their seats or talk nonstop or be very impatient)¹. These symptoms emerge mainly before seven-year old and approximately 75% of those children are male^2,3.

Two criteria are currently used to diagnose ADHD, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) and International Classification of Diseases, 10th edition (ICD-10). American psychiatrists follow the DSM-IV, which describes two primary categories of behavioral symptoms: inattention and impulsivity-hyperactivity; and three subtypes of ADHD: inattentive type, hyperactive-impulsive type, and combined type. ICD-10, however, calls the condition Hyperkinetic Disorder (HKD or HD) and requires all three symptoms to be present for a diagnosis^4,5. Despite the complexity of ADHD diagnosis, there are effective treatments for children. In the US and in Europe, psychostimulants are first-line treatments for the disorder. These drugs have been shown to be more effective on ADHD symptoms than behavioral therapy alone⁶. In the past decade rates of diagnosis have increased dramatically in most countries around the world. ADHD and its diagnosis and treatment have been considered controversial. The controversies involve teachers, parents, clinicians, social scientists, ethicists, regulator and children themselves.

Prevalence of ADD in the US as of 2007 (Source)

Over the past decade or so, there has been an alarming growth in the number of ADHD diagnoses, and, which is more disturbing, the prescription of stimulants for children with this condition. Concurrent with these increases has been a growing concern in the general public about the legitimacy of ADHD as a real disease and the repercussions and ethical issues of giving kids psychotropic drugs.

A hundred years back, this was not a problem. Kids would come to class, be disruptive, not listen, misbehave… and get a whopping smack in the hand or bum with some kind of discipline ruler or other blunt object. The teacher found this behavior to be typical of kids, the parents shook their heads wondering “where did we go wrong?” and life went on. Today, however, there have been striking advances in science that have given us some insight into the factors that contribute to ADHD, tools for recognizing the symptoms of this disease, and yet others for treating it. Or so it seems. Do we indeed have a robust and trustworthy method of detecting ADHD? Can we prove, beyond a doubt that this disease it truly real and not just a series of troublesome personality traits that society has to deal with? Unfortunately, the answer to these questions is not a definite “no”, but it is most certainly not a “yes”.

ADHD or normal behavior? (Source)

There are many ethical concerns that are raised by the treatment of children with psychotropic drugs. This is especially relevant with the use of stimulants to treat ADHD because of the large number of children receiving stimulant medication. In 2008, 3.5% of children under 18 in the United States received stimulant medication. This was even higher in school age children and adolescents, with 5.1% of 6-12 year olds and 4.9% of 13-18 year olds receiving stimulant treatment. This data indicates that an estimated 2.8 million children received stimulant medication for the treatment of ADHD in 2008¹.

Are stimulants overused? (Source)

The safety of stimulant medications in children is a large concern because there have not been many longitudinal studies on the effects of stimulant usage, especially for children beginning stimulant usage at a young age. There has been some evidence of serious side effects, including cardiovascular risk, growth suppression, and development or early onset of other psychiatric diseases^2,3. Since 2007, the FDA has made stimulant medication provide warnings for these potential side effects².

As we did in 2011, in 2012 Emory’s First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course.

These posts will be delivered in 4 weekly installments, each week featuring a commentary on a different neuroethics piece.

This week, we feature blogs covering the following article:

Beyond polemics: science and ethics of ADHD Nature Reviews Neuroscience 9, 957-964 (December 2008).

From www.health.com

What if how wealthy your parents were before you were born and while you were developing changed who you are, how smart you are and how well you are going to do in life? Well, it turns out that your socioeconomic status during development really does affect your life that dramatically. In a recent review by Meany et al. the authors discuss how different aspects of low socioeconomic status affect childhood development. In the first part of this blog post I will discuss the findings of this article and in the second I will discuss the ethical issues of discussing this type of human condition as a disease.

Socioeconomic status' influence on development (source)

According to Meany et al. socioeconomic status has wide ranging and influential effects on the developmental outcomes of childhood development. These effects may be accounted for by three quantifiable variables: access to quality prenatal care, the quality of parental care, and the quality of stimulation from the home environment.

The question of socioeconomic status in scientific research is an interesting one. Many experiments do not take socioeconomic status into account, yet studies show that socioeconomic status can significantly alter the human brain. The article, “Socioeconomic status and the brain: mechanistic insights from human and animal research” addresses some of these issues. However, one of the main problems I noticed with this article is the equivalence of socioeconomic status with quality of parental care. The article seems to associate lower socioeconomic status with parental neglect. Conversely, higher socioeconomic status is associated with higher quality parental care. While there may in fact be a correlation, status is by no means a perfect predictor of parental quality.

Parental care in rats (source)

As we have witnessed firsthand through the recent presidential election campaign season, this topic is as electrifying as any, placing labels of “haves” and “have-nots”. With the notion held by some that this is due to a lack of effort or motivational drive alone, disdain is often an emotion conjured in the minds of many when discussing poverty; but, what if the differences between an individual of high socioeconomic status and lower status was more than just attitudes, but was actually manifestation of completely different thought process? What if just the idea of being of a lower socioeconomic status was detrimental or toxic to the long-term development of the brain?

Socioeconomic status might have neural effects (source)

Numerous studies have begun to bring to light evidence that perhaps motivation or will may not be the only difference between socioeconomic status (SES), but it may lie even more intrinsically. Some evidence exists that individuals of different socioeconomic status may perceive and process stimuli differently, as children of a lower SES had increased activation of the right middle frontal gyrus when attempting to learn unfamiliar rules, which is an thought to inhibit the accuracy of applying new rules (Sheridan et al, unpublished data). Although this differential processing exists, do we truly have enough knowledge in the field to declare a certain pattern of neural activation as detrimental to one’s mental processing?

As we did in 2011, in 2012 Emory’s First Year Neuroscience Graduate Students were asked to write a blog post for the Neuroethics portion of their Neuroscience and Communications Course.

These posts will be delivered in 4 weekly installments, each week featuring a commentary on a different neuroethics piece.

This week, we feature blogs covering the following article:

Socioeconomic status and the brain: mechanistic insights form human and animal research Nature Reviews Neuroscience 11, 651-659 (September 2010)

Gray Matter Volumes Correlated with SES PLOS | One Jendnorog et al, 2012 http://www.plosone.org/article/info:doi/10.1371/journal.pone.0042486