Science and technology advances at an ever-increasing rate and that requires us to adjust to its advantages and dangers. We are all adjusting to changes brought about by the use of AI but an even bigger change is upon us. It is the extraordinary developments of neurotechnology.
With neurotechnology we can expect major advances in the treatment of neurological diseases and mental health. Recent technological developments are increasing the sophistication and capability of neurotechnology devices, opening up the opportunity to address many more neurological conditions that have proven resistant to pharmaceutical or therapeutic interventions.
There is also human augmentation promising a future where our natural human limitations can be extended in some remarkable ways including enhanced intelligence.
Big Tech are of course interested. Elon Musk, for example, has stated that the long-term aim for his company Neuralink is to allow human brains to be “symbiotic with AI”. Whereas Meta, Facebook’s new parent company, are building devices that aim to allow users to perform computer commands using brain signals being sent to their hands.
Enormous opportunities but also serious dangers and that is why we need to start talking about an ethical and regulatory framework that can allow us to use this technology but also protect our basic human values.
By looking at depression, we can begin to get a sense of what neurotechnology can offer medicine. Estimates vary but globally, it is thought that some 5% of adults suffer from depression. But despite its prevalence an estimated one third of depressed patients don’t respond to pharmaceutical treatment. It is hoped that neurotechnology will be able to step in where pharmacology falls short.
Transcranial magnetic stimulation (TMS) is a non-invasive treatment option for severe depression that was pioneered in the UK and is being driven forward by Wales-based Magstim. The technique involves firing magnetic pulses into the brain to activate neurons and boost patients’ mood.
Recently an experimental technique using a brain implant was able to return a patient, Sarah, with severe depression to “a life worth living”. The approach involved identifying brain activity in Sarah that was uniquely associated with her experience of suicidal ideation and delivering an electrical pulse whenever the device detected this activity.
As neurotechnology develops, these treatment options will no doubt improve. They may also bring about a cultural change in how we view depression and mental health disorders more broadly. For Sarah, the success of the device confirmed to her that her depression was rooted in brain biology and “not a moral failing, but a disorder that can be treated”.
New, experimental treatments will always generate headlines, but neurotechnology’s aren’t all new. Cochlear implants to treat hearing loss are worn by over 400,000 worldwide and deep brain stimulation (DBS) to treat tremors in Parkinson’s has been approved by the FDA since 1997.
So far so good. But ask this question. If we can alter moods like depression, will we soon be able to alter aggressive instincts? Would it be societally acceptable to use neurotechnology to control temper outbursts resulting in attacks on other people? And how would this technology be used in Hong Kong against angry demonstrators or against the Uighurs of Xinjiang? And we don’t need to go as far as the authoritarian states like Russia or China, it could equally be used here in a way that impacted on human rights.
When I worked as a probation officer often with seriously disturbed and angry clients, we found a new approach using anger management techniques. But this is a verbal technique. A neurotechnology device is likely to be far more reliable and accurate.
Defence and security are also candidates for neurotechnology, and it will come as no surprise that China and the USA are also deeply involved in this work.
The Royal Society produced it’s seminal iHuman report in 2019 dealing with neural interface technologies. From that came a request that the UK seek to stimulate innovation in the field, while constructing responsible regulation around the technology as it develops.
I had written to the Minister last year suggesting that the UK has a remarkable research base in the universities and a great institution in the NHS that would enable us to use such techniques for the good of all. Alas, the answer was not very encouraging, but I think there has been movement since then.
Innovate UK and the Knowledge Transfer Network (KTN) have submitted a proposal to BEIS for a £45 million Neurotechnology Innovation Centre which, if funded, would be transformational for the UK’s neurotechnology sector. Defence and security organisations in the UK are now seriously exploring the security and ethical implications of human augmentation. And the Regulatory Horizons Council is now undertaking a deep dive into the regulatory opportunities for neurotechnology.
What are the UK’s advantages? It has a world leading research base in fundamental neuroscience, medical imaging, bioelectronic medicines, brain-computer interfaces and neural prosthetics. There are a growing number of exciting start-ups now commercialising this world class research. And the NHS, where so much of this work will have the most positive advantages, provides a unified national platform for research, innovation and commercialisation.
But along with the health and social benefits comes the inevitable danger of misuse of the technology. How will the public react to these advances? And how do we ensure the public has a voice in defining the future of the field?
Humanity still has the opportunity to guide the development of neurotechnology. Our priorities should be accelerating medical applications of the technology and developing ethical and regulatory frameworks to manage the risks associated with wider use. The UK has a huge role to play here and should become a global leader in responsible use of the technology. But this will only happen with significant and sustained support from the government (as is already happening elsewhere in the world). The UK cannot afford, economically or societally, to take a back seat on one of the most important technological developments of this century.