The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people.

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Sahakian, Barbara J 
Bruhl, Annette B 
Cook, Jennifer 
Killikelly, Clare 
Savulich, George 

In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish.

cognitive enhancers, cognitive training, game, neuroethics, schizophrenia, smart drugs, Alzheimer Disease, Attention Deficit Disorder with Hyperactivity, Cognition, Cognitive Behavioral Therapy, Female, Humans, Male, Neurocognitive Disorders, Neurosciences, Nootropic Agents, Parkinson Disease, Schizophrenia, Video Games
Journal Title
Philos Trans R Soc Lond B Biol Sci
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The Royal Society
Medical Research Council (G1000183)
Medical Research Council (G0001354)
Wellcome Trust (089589/Z/09/Z)
Wellcome Trust (093875/Z/10/Z)
All cited psychopharmacological work from Professor Sahakian laboratory was funded by a Wellcome Trust Grant (089589/Z/09/Z) awarded to T.W. Robbins, B.J. Everitt, A.C. Roberts, J.W. Dalley, and B.J. Sahakian, and it was conducted at the Behavioural and Clinical Neuroscience Institute, which is supported by a joint award from the Medical Research Council and Wellcome Trust (G00001354). B.J. Sahakian receives funding from the Human Brain Project. We thank Janssen/J&J for funding the study on cognitive training in schizophrenia.