- Division of Neurosurgery, Institute of Medical Research Dr Alfredo Lanari, University of Buenos Aires and Academic Council on Ethics in Medicine, Buenos Aires, Argentina.
DOI:10.25259/SNI_591_2020Copyright: © 2021 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Alejandra T. Rabadán. Neurochips: Considerations from a neurosurgeon’s standpoint. 19-Apr-2021;12:173
How to cite this URL: Alejandra T. Rabadán. Neurochips: Considerations from a neurosurgeon’s standpoint. 19-Apr-2021;12:173. Available from: https://surgicalneurologyint.com/surgicalint-articles/10734/
A neurochip comprises a small device based on the brain-machine interfaces that emulate the functioning synapses. Its implant in the human body allows the interaction of the brain with a computer. Although the data-processing speed is still slower than that of the human brain, they are being developed. There is no ethical conflict as long as it is used for neural rehabilitation or to supply impaired or missing neurological functions. However, other applications emerge as controversial.
Keywords: Brain-machine interface, Cyborg, Human enhancement, Neuroethics, Neuromorphic chip
A neurochip, or neuromorphic chip, is a small implantable device in the central nervous system that may allow the interaction of certain areas of the brain with a computer. The neurochips have brain-machine interfaces (BMIs) that emulate the functioning of synapses; although the data-processing speed is still slower than that of the human brain, they are being developed.[
Discussions about neurotechnology are predominantly limited to a small circle of academics such as neurotechnological engineers, science fiction enthusiasts, artists, philosophers, and bioethicists. Why do we address neurosurgeons? Because they will be directly involved; neurosurgical skills will be necessary and will be required to perform procedures.
It seems reasonable from a neurosurgical point of view, starting to reflect about the participation of neurosurgeons in interdisciplinary teams, providing the concepts of medical indications, contraindications, decision-making process, techniques to prevent or reduce complications, and even participating in the design of devices to preserve normal structures. Consideration of social, political, economic and legal aspects of invasive procedures are also inherent to the neurosurgical activity and these aspects should be taken in consideration.
To the best of our knowledge, there have no been publications about the neurosurgical role in the application of this neurotechnological advance. The aim of our communication is to promote reflections and debate between neurosurgeons to anticipate the scenarios to come.
The functional basis of the system is an artificial synapse unit composed of what is known as “memristor” or memory resistance. First descriptions date back to 1808 by Sir H. Davy, and to 1960 by B. Widrow who in fact coined the term memristor to describe the components of an artificial neural network. Subsequently, numerous technical experiences were carried out until León Chua considered a new element of two terminal circuits with a link between the electrical charge and the magnetic flux.[
Modern memristors have excellent qualities, can reproduce the mechanism of synapses, and can be adapted to the technical requirements of the neuromorphic computing systems.[
The minimally invasive implantation of the devices has been proposed through stereotactic with robotic guides in a similar way to deep brain stimulation (DBS)[
To minimize risks of the implantation procedure, Raza et al. are studying other ways to reach the brain utilizing the endovascular connection.[
Moreover, it is not completely unrealistic to speculate about the contribution of the nanotechnology in the future design of the brain implants and endovascular devices.
The BMI using neuromorphic chips is maintained at an experimental level; technology is not completely developed yet but it is evolving. Future directions of neurochips’ applications are based on the results of the following well known technological procedures: DBS, invasive non-DBS implants, and the noninvasive transcranial magnetic stimulation (TMS).
DBS was traditionally performed to relieve a variety of neurological symptoms refractory to medical treatment (pain, tremor, severe depression, obsessive compulsive disorder, anorexia, disorders of consciousness, the use of brain signals to control a prosthetic arm for motor assistance in cases of quadriplegia, terminal phase of lateral amyotrophic sclerosis, or the locked-in syndrome).[
Invasive non-DBS implants were also used for many years. For example, cochlear implants for partial restoration of hearing can under specific circumstances, such as in a very noisy environment, endow the patient with better than human hearing capabilities, when the microphone and software of the cochlear implant can filter out human voices from background noise; bionic eyes for retinitis pigmentosa to partially restore vision.[
The other technological advance that has provided a basis for future applications of neurochips is the experience with noninvasive TMS. Nowadays, it was used to treat some difficulties in learning; in other cases are simply used to experiment new experiences, or even to obtain pleasure, for example, increasing erotic experiences.[
DBS, invasive non-DBS, TMS, and neurochips share the objective of improvement the people’s quality of life, but neurochips would speculatively have the advantage of an expected more sophisticated neuromodulation.
There would not be ethical conflict in the use of neurochips for rehabilitation purposes to replace or improve missing or impaired neurological functions. Negative ethical aspects would undoubtedly lead to its use for manipulation or other despicable reasons. Neuroethical conflict may arise when gray areas appear; when the objective is not to cure or rehabilitate but to seek for neurocognitive enhancement or new modalities of sensory perceptions.
Some questions naturally arise such as what would be the long-term effects on the human brain? Who would regulate the improvement? Who would be chosen for their application? And in any case, who would cover the costs? Would this increase of cognition or perceptions be for everyone? or just for some?[
There are also concerns about the way in which these devices could affect the basic aspects of the human being: autonomy, free will, responsibility, intentionality of the acts; allowing to question the moral values of cyborgs in our society.[
The impacts of neurotechnology in the near future have been foreseen in 2013 by the European Commission for Emerging Technologies which supports the Human Brain Project, and also by the National Institutes of Health that simultaneously started the Brain Initiative (Brain Research through Advancing Innovative Technologies).[
Science neither stops nor moves backwards and its progress has acquired an accelerated rhythm. Therefore, these issues require reflections that may help neurosurgeons to act responsibly in a new and constantly changing environment. Perhaps worldwide ethical recommendations should be anticipated by the neurosurgical community, even in collaboration with the WHO, considering the possible impact of the neurochips on the multiple dimensions of the human being.
Neurosurgery is facing new challenges. The future neurosurgeon will have to be a very different type of neurosurgeon, a master of many fields. The neurosurgical societies, and especially directors of training programs, should prepare young doctors to anticipate these kinds of neuroethical issues.
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