Build to Order Cognitive Enhancement

In a recent conversation with Dr. Stephen Ferris, one of the world's leading experts on Alzheimers's Disease and Cognitive Assessment, who heads the Silberstein Center for Aging and Dementia at NYU, we learned of the next frontier in pharmaceutical research, designing and developing drugs that may enhance certain aspects of cognitive performance. Companies such as Memory Pharmaceuticals have been focusing on development of this important market, and others may now be about to enter the field.

A recent issue of the journal Neurology discussed some of the implications. In the future, we may see some of the following:

Imagine a television makeover show where instead of plastic surgeons working on eyes and noses, neurologists work to enhance brains.

In this scenario, healthy people would receive cutting-edge drugs and treatments not to cure a brain disease, but to make them better people

While the idea might seem farfetched, an era of "cosmetic neurology" may be upon us soon.

"We live in an environment where there is a lot of pressure to excel," said Anjan Chatterjee, an associate professor of neurology at the University of Pennsylvania. "I think it is absolutely likely that we are going to be seeing more of this."

Drugs developed for treating disease could instead be prescribed for healthy people hoping to enhance their cognitive or emotional performance, he said.

He offered several examples:

• Drugs normally prescribed for Alzheimer's disease patients might be given to commercial airline pilots or others in highly skilled jobs to improve attention and memory. The drugs also might be used for healthy seniors to prevent normal forgetfulness.

• Amphetamines, which in small doses can improve motor learning, already have been used in rehabilitation therapy for stroke patients. They might also be used to learn to play the piano.

• Transcranial magnetic stimulation, which is used to treat clinical depression, might be applied to improve the mood of healthy people who are just having an off-day.

• Newer, nonaddictive drugs intended to treat attention deficit hyperactivity disorder could be used by college students studying for exams.

• Beta-blocking drugs, which can blunt the effects of emotionally traumatic events such as battle stress or a car accident, could be used to minimize memories formed during less-disturbing events such as a stressful family gathering.

In the future, Chatterjee said, neurologists might become "quality-of-life consultants."

On the other hand, struggling with pain builds character. Chatterjee cautioned that getting a boost without doing the work is cheating.

"A fundamental concern is that chemically changing the brain threatens our notion of personhood," he wrote.

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