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Brain Boosting Dilemma

For decades people have nipped a wrinkle here, reduced a nose size there or paid for help boosting test scores. With this history of paying to improve our bodies and minds, why not extend that liberty to memory-improving drugs or brain-enhancing implants?

These and other questions being raised by modern neuroscience were the topic of a meeting of neuroscientists, ethicists and psychologists funded by the National Science Foundation and the New York Academy of Sciences. The group, led by Judy Illes, PhD, senior research scholar in biomedical ethics and in radiology at the Stanford University School of Medicine, published its thoughts in a recent issue of Nature Reviews Neuroscience. The group's goals were to outline both the ethical issues raised by modern neuroscience and the steps scientists should take, if any.

Plastic surgery and neural enhancement both raise safety issues, Illes says. However, she and co-chair Martha Farah, PhD, professor of psychology at the University of Pennsylvania in Philadelphia, feel the risks are more acceptable when treating an illness rather than taking normal, healthy people and trying to make them better.

Illes says the key difference between physical enhancements such as plastic surgery and neural enhancement through drugs or brain implants comes down to personhood. A nose job doesn't change who you are. Drugs might, she says. "Am I the same person on Ritalin as off?" Farah asks.

There have been no studies that establish the long-term effects of brain function in children who take Ritalin to control hyperactivity or in people who take medication for depression, says Farah. It could be that drugs alter the way the brain works, fundamentally changing personality. The drugs may even have unanticipated consequences such as speeding the brain's decline with old age.

The question becomes more complicated for drugs such as modafinil, which can improve memory or the ability to concentrate. These have obvious appeal for professionals wanting an edge, but at what cost?

"I think it is important for science to move forward," Illes says. "I worry about how the science will be conveyed to the public. Will it play on fears of not having a competitive edge?"

If the answer is yes, Illes brings up a few hypothetical situations. What if some people in a given field take a drug to make themselves doubly productive? Will their productivity put pressure on colleagues to use the drugs, much like some professional athletes feel competitive pressure to take steroids? Would differences in productivity cause conflicts between colleagues or inequalities in pay?

These scenarios raise issues about what scientists should do to prevent the abuse of brain enhancement research. In their review, Illes and her colleagues quote Francis Fukuyama, PhD, from the Paul H. Nitze School of Advanced International Studies at Johns Hopkins University in Washington, D.C., who has called for legislation to control the use of drugs or devices that alter the way the brain functions.

Legislation isn't necessary, according to the group, but caution is. Illes and Farah argue that by being proactive in thinking about ethical issues, ethicists, neurologists and physicians can develop guidelines to aid decisions about how research findings are used and communicated to the public.

Robert Cook-Deegan, MD, director of Duke Institute for Genome Sciences and Policy's Center for Genome Ethics, Law and Policy, hopes that such guidelines will distinguish between potentially harmful brain alterations and the type of brain-altering activities that have taken place since the dawn of civilization. Every time a person smokes a cigarette, drinks a glass of wine or wakes up with a cup of coffee, the workings of that person's brain are being changed, he says, so how is taking a drug any different?

"Caffeine then modafinil; what is next?" asks Cook-Deegan, a co-author of the paper. Cook-Deegan says drug treatments follow a well-traveled path from development for treating a disease such as depression, Alzheimer's or narcolepsy, to use for less established medical conditions. Ritalin, used to treat children with attention deficit hyperactivity disorder, is a classic example. Where it was once a welcome relief to those rare parents with hard-to-manage kids, the drug is now widely prescribed and is even taken by college students needing help focusing before exams.

In addition to drugs, Illes says that modern brain imaging techniques may reveal aspects of personality such as a tendency to lie or be aggressive. As the technology improves physicians must decide who should have access to this information and whether they should treat a neural tendency rather than an actual behavior.

Illes says the panel's discussion was limited to examples of what neuroscientists may be able to detect or treat in the future. Through such meetings, she hopes the medical community will be poised to act responsibly when those future technologies become a reality.

— Stanford University

Lazy Kids? Researchers Say Blame the Boob Tube

Children and adolescents who consistently watch television for two hours or more a day are at an increased risk of being overweight, to smoke and to have high cholesterol concentrations in early adulthood – substantial risk factors for long-term health problems later in life conclude authors of a study from New Zealand in a recent issue of The Lancet.

Previous research has identified associations between television viewing and poor health outcomes such as high cholesterol and obesity; no longitudinal study has assessed these effects into adulthood. Robert Hancox of the University of Otago, New Zealand, and colleagues studied nearly 1,000 children born in Dunedin, New Zealand, in 1972-73 who were checked at numerous intervals until age 26 years. During this time parents (for children aged 5 to 11 years) and adolescents (aged 13 years and older) provided details of the duration of weekly television viewing. Body-mass index (BMI), blood pressure, cholesterol concentration and cardiovascular fitness were assessed at 26 years of age.

A clear association was found between extensive television viewing (more than two hours a day) among children and adolescents and increased BMI, raised cholesterol, greater proportion of smoking and poor cardiovascular fitness at age 26 years; no association was found between television viewing and blood pressure. These associations remained after adjustment for potential confounding factors such as childhood socioeconomic status, BMI at age 5, parental BMI, parental smoking and physical activity at age 15.

The investigators estimate that among all 26-year-olds, 17 percent of obesity, 15 percent of raised blood cholesterol, 17 percent of smoking and 15 percent of poor fitness can be attributed to watching television for more than two hours a day during childhood and adolescence.

"Although the adult health indicators we have found to be associated with child and adolescent television viewing are unlikely to result in clinical health problems by the age of 26 years, they are well-established risk factors for cardiovascular illness and death later in life," says Hancox.

The results suggest that excessive television viewing in young people is likely to have far-reaching consequences for adult health. The researchers agree with suggestions from the American Academy of Pediatrics that parents should limit children's viewing to one to two hours per day; in fact, data suggest that less than one hour a day would be even better.

"Although parents might find this difficult to maintain, lifestyle modifications in adulthood to reverse overweight, poor fitness, high cholesterol and smoking are also notoriously difficult to achieve," says Hancox. "Parents will need support and encouragement at individual, community and societal levels. Adults are likely to obtain health benefits themselves if they lead by example and turn off the television. We believe that reducing television viewing should become a population health priority."

— The Lancet

Have You Googled Yourself?

"Self-Googling," searching for your own name on the Google search engine, may seem like an innocuous act of vanity, but a University at Buffalo (UB) communications professor recommends it as a shrewd form of "personal brand management" in the digital age.

"Self-Googling is not simply narcissism, though that's certainly part of it," explains Alexander Halavais, PhD, assistant professor of communication in the UB School of Informatics. "People should Google themselves for the same reason corporations do, to help to manage their public face."

"Given that everyone from potential employers to potential mates is likely to be Googling you, you should have a good idea of what they will find," he adds.

Halavais, who studies how social networks are formed over the Internet, is currently experimenting with what he calls an extreme form of self-Googling. Halavais recently purchased prime location on Google for his personal weblog using Google's Adwords feature – a paid advertising program designed primarily for businesses and consultants who want to promote their products or services.

The ad, which reads, "Alex Halavais He sees all, knows all. Want to know why?" pops up prominently whenever someone searches for "Halavais," or variations of his name and university title. Google provides Halavais with daily click-through counts of how many times he is Googled by other people. The count currently is about 60 per week.

"It gives me an idea of how often people are Googling me, but not who or why," he says. "So I know roughly how many times people Google me from day to day, and I can, perhaps, guess at "why.'"

The experiment has reinforced Halavais's belief in the importance of managing and monitoring one's online presence, and it produced a surprise.

Several weeks after Halavais's ad was posted, Google suddenly canceled the ad because his weblog contained commentary critical of President Bush. Google reinstated the ad a few days later after reviewing the weblog and after Halavais pointed out the existence of hundreds of pro- and anti-Bush Web sites on Google.

Issues of free speech aside, Halavais says the experience is an example of how something you say on the Web can come back to haunt you. He has encountered several other examples of people's weblogs "biting back," he says.

In one case, a former student had posted commentary accusing a particular company of fraud. More than 100 people responded on the student's weblog, agreeing with the accusation.

After the student graduated and landed his first job, he scrambled to remove his online accusations, upon the request of his employer, because the company in question was a client. The student's criticisms were prominently displayed on Google whenever someone had searched for the company.

"This is one example of why it's important to actively put your best foot forward on the Web," Halavais says. "At this stage, most people who try to manage their public profile online do so pretty informally."

"As the occupational profile of the United States changes and more people perform freelance work, a more strategic use of Web presence is likely to evolve," he contends.

To manage your online image, Halavais recommends regularly Googling yourself, as well as your e-mail address, to see what turns up. If you have a common name, try to find pages that are personally relevant by including keywords related to your profession or hobbies.

If you find negative or inaccurate material on the Web, a polite e-mail to the author often will yield a beneficial result, Halavais says. A threatening letter most likely will result in another negative remark appearing on the Web.

"The best way of controlling your message is by creating it yourself," Halavais says. "Promote your work actively on the Web to help to bolster your online reputation.

"Starting your own weblog or Web site can help you to shape your public image, and make sure that it accurately reflects your abilities and interests," he concludes.

— UB