May 2, 2023 by Donald Gorassini, howinfluenceworks.com
This blog examines the social influences that lead directly to the physical alteration of the brain. It pays to have a look at these processes because they can be profound. I focus on the treatment technologies used in medicine and surgery.
What is the social influence component of direct brain change? Someone does something that directly changes the cells of the brain. The cells are are of two types, neurons and glia. Neurons communicate with each other and with the body. Their complex interactions manifest in perception, thought, feeling, control of action, and your sense of who you are. There are several billion neurons in your brain. Glial cells provide many support functions for the neurons, including maintaining their environment and regulating their functioning. There are about the same number of neurons as glial cells, although this varies by brain region. You can alter neuronal activity directly by doing something to neurons or indirectly by doing something to glia.
When it comes to brain diseases, the patient is treated by the doctor after the patient provides informed consent. This is the nature of the social influence process that changes your brain. Both you and your doctor are the social portion. From this relationship all physical changes follow. We can take a look at a few of the treatments used nowadays. This examination illustrates the profundity of social impacts on the brain.
I am struck by two things when I survey the procedures involved. They are marvellous. That is the focus of the present blog. The second reaction is curiosity regarding what the advances being made in brain change technologies could mean for the future. Will there be an increased chance of misuse? Will further developments in these brain change technologies create an increased chance of influence by people other than you and your doctor? I will address this latter issue in a future blog.
Here are descriptions of a number of brain changing procedures. The set is not comprehensive but is a sampling of the more prominent methods in the field. It is sufficient for me to illustrate my points about direct social influence of the brain.
Amazing Treatments
If we were to say nothing except, terrific, in regard to medical and surgical treatments of the brain, we would have said a lot. The treatments extend lives, restore functioning, bring relief, and produce cures. What follows are descriptions of several treatments in current use.
Drugs
A major method for treating the brain is by medicine. After assessment, the doctor prescribes a drug and you agree to take it or you refuse. If you take it, the drug affects neural interaction in your brain, and this gives rise to the targeted psychological effects. Mood disorders (depression, mania), anxiety disorders (general anxiety, panic), thought disorders (schizophrenia), pain, autism, disruptive conduct in children (ADHD), obesity, and sleep disorders are commonly treated with medications. Scientists have an idea how the drugs operate but many questions remain unanswered. Millions of prescriptions for these medications are filled every year with resulting decreases in suffering and disruption. All drugs have side effects. Drug therapies are commonly part of a treatment approach that also consists of social (e.g., family therapy) and psychotherapeutic components.
Surgery
Surgery on the brain is a practice that goes back thousands of years. Nowadays it is used for various reasons, usually to remove tumours. It is also used to remove blood clots, treat infection, reduce pressure inside the skull, repair blood vessels, ablate (technical term for destroy or remove) malfunctioning cells, implant new cells, and implant technological devices. Brain surgery commonly involves a craniotomy, the removal of a portion of the skull so that the surgeon can gain access to an affected area of the brain. Keyhole brain surgery is less invasive, involving a small hole drilled through the skull or an incision made elsewhere (in the nose or mouth) and a stereotax (long needle) or endoscope (narrow instrument) inserted under visual guidance to ablate tissue, extract specimens, reduce pressure, introduce a chemical, or implant cells or technology.
Deep Brain Stimulation (DBS)
A procedure known as deep brain stimulation has been used with increasing frequency over the past 25 years. Several electrodes emanating from a lead, used to deliver a mild electrical current, are surgically implanted in a selected portion of the brain. A battery powered pulse generator is implanted elsewhere, usually under the skin in the upper chest, and serves as the power source and computer of the device. The lead and pulse generator are connected by a wire, which runs under the skin, through the skull, and into the brain. An electrical current is sent through the electrodes into the adjacent neurons in order to alter their activity.
DBS is used to treat movement disorders (essential tremor, Parkinson’s disease), epilepsy, and obsessive-compulsive disorder. The method might have application in the future in the treatment of pain and major depression.
Methods for controlling when therapeutic current is turned on and off are becoming ever more sophisticated. Early DBS treatment of Parkinson’s disease involved continuous stimulation. Adaptive DBS, a method introduced recently, sends current only when symptoms threaten. A similar method is being tested in the treatment of epilepsy. Complex computer algorithms are being used in the detection of epileptic seizure onset and in the timing of current in relation to detection.
Electroconvulsive Therapy (ECT)
This method, introduced in 1938, is noninvasive, meaning that no surgery is involved. In present day application, an electric current is applied through electrodes contacting the scalp of an anesthetized patient who has also been rendered temporarily paralyzed. The result is a brain seizure, a flurry of activity over a vast swath of neurons. Placement of electrodes determines the extent of seizure activity. If one electrode is placed on each temple, the seizure encompasses both hemispheres of the brain. If the electrodes are placed on one side of the head, the seizure is confined to the hemisphere of that side. Each method has its uses.
The therapy is used for serious mental disorders that have not responded to conventional treatments. This includes major depression, bipolar disorder, and schizophrenia. ECT is usually given two to three times per week until a therapeutic effect is observed.
Stereotactic Radiosurgery
Introduced in 1949, stereotactic radiosurgery is a noninvasive therapy that uses several separate weak beams of radiation originating outside the skull to ablate targeted neurons in the brain. The beams, from their separate sources, are all aimed at one destination, where their combined strength produces a lesion. Each beam is too weak, by itself, to cause any brain damage on its way to the point of convergence. The procedure is used primarily for ablating tumours.
Transcranial Magnetic Stimulation (TMS)
This noninvasive method appeared on the scene in 1985. A TMS coil is placed just outside of an awake patient’s head. The coils come in various shapes and sizes, usually no larger than a person’s head. The device puts out a pulsing magnetic field that penetrates below the skull into the brain, where the activity of neurons is altered but no seizure is induced or ablation made. Normally, only a small area of the brain located directly under the coil is affected. TMS treatments vary in physical properties, such as the depth into the brain the field penetrates and the number of treatments applied.
The method is an approved therapy for major depression. In that application, the coil is placed adjacent to a specific area of the left scalp (in the region of the left dorsolateral prefrontal cortex), where the pulse increases the activity of neurons 2-3 centimetres into that portion of the brain. Repeated sessions are usually required before the symptoms of depression begin to improve.
We see in the above descriptions a variety of treatments reflecting innovation in the medical and surgical fields. Each technique has developed and is developing. In the next section, I will speculate on future advances in the techniques based on the past trajectories of their changes. Such an exercise, I feel, has implications for social influence, specifically with predicting who in the future will exert direct influence over your brain or perhaps your grandchildren’s brains; and it might be a bigger group than patient and doctor.
Future Directions
In surveying brain therapies, we can see a few interesting trends emerging. They continue to inspire awe at possibility but foreboding at a growing potential for misuse. The trends are occurring within three domains: the use of drugs; the use of brain implants; and the use of forces emanating from outside the head.
The Medical Approach
Drugs are continuously in development. It has always been the case that drugs could be targeted toward certain parts of the brain. This process is becoming more sophisticated and the number of functions affected has increased. As an example, diet drugs affect neural activity (particularly in the hypothalamus) that regulates hunger. These medications would normally be prescribed by a doctor for medical reasons such as problematic corpulence or anorexia nervosa.
The use of a diet drug could also have an application outside the doctor-patient relationship. Many people wish to lose weight on their own. If the distribution of the medications were expanded to over-the-counter, sales for a pharmaceutical company would explode. This would be an instance of how the pharmaceutical company would be motivated to and might become a social influence on the brain outside of the doctor-patient relationship. I will have more to say about this in a future blog.
The Implant Approach
In contemporary neurosurgery, several types of computer-brain devices are being implanted. In DBS in its current version, the device is distributed over distinct body regions. Lead and electrodes are embedded in the brain. Computer and power source are placed in the upper chest. The connecting wire is run in between.
Implants are becoming more sophisticated. They are getting smaller. They are using monitoring algorithms that match the complexity of some neural patterns. They are exerting more complex forms of control over neural activation.
All of the work done in neurosurgery has been aimed at returning diseased brains as close as possible to a normal state. The current technology could also be used to alter a normal brain in some way, perhaps using DBS to temporarily eliminate fear in a soldier. I will use soldier and battlefield examples here to illustrate my points. The range of possible applications would encompass, not just soldiers and battlefields, but every aspect of human life.
The computer-brain devices will get much smaller. There is every reason to expect that, with nanotechnology, the entire device will fit inside the brain. Indeed, several interacting devices could fit. So, a DBS could be used to make a soldier both less fearful and more alert; or control three functions; or four; and so on.
Installing devices is likely to become simpler, not always requiring the inconvenience of neurosurgery. With greater miniaturization, technology can be placed into the brain through incisions made in easily accessed blood vessels, likely in the neck.
The programming of computer-brain devices is presently self-contained. There is no reason why a device’s processing could not be integrated into a cloud. The device could then use functions and data available in the cloud and the cloud could add readings from the device into its database. So, functions occurring in an entire battlefield of soldiers could be monitored and controlled from a central location.
So far, the functions targeted in neurosurgery are simple as far as the brain goes. This will change. Complex neural functions, such as the ones underlying thinking and planning, will one day be monitored and controlled by a computer-brain device. Once that happens, not only will it be possible to render soldiers on a battlefield less fearful and more alert but also monitor perceptions from and place individualized task intentions and martial skills into each individual.
The No-Implant Approach
The implant approach involves placing a technological device into the brain. Some brain change procedures do not require this step! ECT produces diffuse neural changes using electric current passed through electrodes. Using TMS, no electrodes are required to pass magnetic fields into targeted portions of the brain to change neural functioning. The targeting cannot be called precise. Many thousands of neurons fire or are blocked in these applications. There is also no patterning imposed spatially or temporally. That could change. Researchers are currently testing ways to activate much smaller groups of targeted neurons in the brain by using media such as magnetism and radiation originating outside the scull. Perhaps it will be possible to exert precise control over neural processing using forces emanating from outside the head and without the need for any implantation. The technical challenges here appear to be much greater than in the case of implants.
Summary
Current brain change procedures not only provide humanity with a host of therapeutic procedures now, they suggest where the technology could be heading. Medications are becoming ever more sophisticated. Very small implants capable of controlling any number of brain processes from epileptic seizures to what we think, feel, and do could be coming in the generations to come. Wireless monitoring and control of neural processes, without any need for implantation, might also reside on some distant horizon.
This should both hearten and frighten. In a future blog, I will address the potential dangers that future brain change technology might bring. As with an engineer building a bridge, every contemplated plan must go through a worst case scenario critique in order to identify problems that could arise in reality. This is what I will do with respect to the future brain change methods discussed above. As the author of this website, I am interested in the topic because many of the dangers associated with future brain change technologies could take the form of untoward social influences.
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