Assessing the Effects of Deep Brain Stimulation on Agency

Dartmouth College, Hanover NH

Investigators

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Abstract

Project Summary Recent advances in neurotechnologies have provided us with the ability to modulate brain function by direct and indirect interventions. Deep Brain Stimulation (DBS) is one such intervention that has already been FDA-approved for certain disorders, and its use has already raised ethical questions about ways in which direct brain stimulation may affect personal identity, autonomy, authenticity and, more generally, agency. Thus far the neuroethical worries have been largely based on anecdotal clinical reports. Further neurotechnological interventions developed as part of the BRAIN initiative are bound to raise similar questions, but we lack a clear framework in which to think of the ethical consequences of these interventions. The overall goal of this project is to articulate such a framework, to enable us to better evaluate and respond to the neuroethical challenges raised by our abilities to alter brain function. The more concrete objectives of our proposal are to 1) develop comprehensive assessment tools to measure changes in agency due to direct brain interventions, 2) to use this tool to assess changes in agency due to brain interventions using DBS patient populations as a test case; and 3) to develop a database to house the data we acquire with these tools to allow us to catalogue the effects and side effects of DBS. This will also make it possible to correlate the effects of DBS with electrode placement and white matter tractography, enabling better prediction of outcomes and aid in understanding of the mechanisms by which DBS works. We will analyze this data machine with machine learning methods to inform a more comprehensive neuroethical analysis of how brain interventions affect agency. Our approach is innovative in that it applies neurophilosophical insights about agency and employs deep learning algorithms in constructing and evaluating these assessment instruments. This contribution is significant in that it will provide a broad based assessment tool and database that will be a resource for researchers and clinicians using DBS, which could be used to improve therapeutic approaches and informed consent. The data will also inform a framework for further neuroethical thought about brain interventions, allowing us to better identify, articulate and measure changes on ?dimensions of agency.? Finally, the approach is generalizable, and thus could be adapted for use with other brain intervention techniques, such as brain-computer interfaces (BCIs) or pharmacological treatments.