Brain implants: Will they be used to heal or for control?

Brain implants: Will they be used to heal or for control?
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Would you trust a Manchurian Candidate or a Terminator to heal you? Shouldn’t you automatically distrust anyone who has received a brain implant by the military?

In "Terminator Two" and "Judgment Day," the character played by Arnold Schwarzenegger protects and defends John Connor from harm; in the real world, if you were to see a robot arm directed by a glassy-eyed stare coming your way, I would advise you to run for cover.

The Defense Advanced Research Projects Agency is an agency of the United States Department of Defense responsible for the development of emerging technologies for use by the military. In 2016, DARPA unveiled a big advance in the area of utilizing brain implants to control a robotic arm. This was a big day for all rehabilitative medicine. 

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Microelectrodes were implanted in the brain in a patient with a spinal cord injury. Touch sensations were generated and it was perceived they were coming from the paralyzed hand. These sensations could be varied in intensity to fit the stimulus. These results are being extended to civilian use and they bode well for the future of brain-controlled robotics.

DARPA also expanded its program to develop brain machine interfaces, for the expressed goal of restoring sensation and effective neurological therapies in wounded soldiers.

This program — Neural Engineering System Design (NESD) — includes a $65 million Pentagon grant and involves research at Brown and Columbia Universities, Fondation Voir et Entendre (The Seeing and Hearing Foundation); John B. Pierce Laboratory; Paradromics and the University of California, Berkeley.

Last year, Philip Alveida, founding NESD Program Manager, announced the goals of the program: to develop advanced neural devices for “precision sensory interface for therapeutic applications.” Alveida added, “By increasing the capacity of advanced neural interfaces to engage more than one million neurons in parallel, NESD aims to enable rich two-way communication with the brain at a scale that will help deepen our understanding of that organ’s underlying biology, complexity, and function.”

Deepening our understanding of neurobiology is an important goal. But the term “two-way communication” is cause for some concern. It is one thing for brain implants to be used therapeutically to connect the brain to a robotic replacement arm, but what about the potential for abuse, with reverse input into that same device being used to control a soldier’s behavior in combat?

Congress has correctly stated the need to both support and monitor DARPA’s progress and purposes.

But it is unclear how to properly regulate DARPA’s goals of enhancing human capabilities. Clearly, improving brain function including memory will give competitive advantage, which any military wants. But will the day come soon when all members of the military are given implants to enhance function, which can then be used for monitoring and stimulation? Where will the needs of the military end and the rights of the individual soldier resume?

Back in 2014, DARPA developed the Systems-Based Neurotechnology for Emerging Therapies (SUBNETS) program, which utilizes teams at top medical centers (UCSF and MGH). The stated purpose of the program is to, “reduce the severity of neuropsychological illness in service members and veterans by developing closed-loop therapies that incorporate recording and analysis of brain activity with near-real-time neural stimulation.”

The troubling aspect, here again, is where to draw the line? SUBNETS is based on the understanding that neural systems involve different parts of the brain at once and that these pathways — when disrupted — can be altered in the name of healing.

The 2014 DARPA announcement of the program stated, “Plasticity runs counter to previously held ideas that the adult brain is a “finished” entity that can be statically mapped. Because of plasticity, researchers are optimistic that the brain can be trained or treated to restore normal functionality following injury or the onset of neuropsychological illness.”

Psychic healing is of course laudable, but who is going to define “normal functionality” and for what purpose?

I sincerely hope we don’t have to turn to Manchurian Global or George Orwell to ask.

Marc Siegel, M.D., is a professor of medicine and medical director of Doctor Radio at NYU Langone Health. He is a Fox News medical correspondent.