{"id":924,"date":"2014-06-24T23:34:09","date_gmt":"2014-06-25T06:34:09","guid":{"rendered":"http:\/\/blog.stevenreidbordmd.com\/?p=924"},"modified":"2014-06-24T23:40:04","modified_gmt":"2014-06-25T06:40:04","slug":"military-brain-chips-to-cure-psychiatric-disorders","status":"publish","type":"post","link":"http:\/\/blog.stevenreidbordmd.com\/?p=924","title":{"rendered":"Military brain-chips to cure psychiatric disorders?"},"content":{"rendered":"

\"subnets\"<\/a>Sounding like something straight out of science fiction, DARPA recently announced<\/a> grants to fund research and development of implantable brain-stimulation chips aimed to relieve, or even cure, mental disorders. \u00a0The Defense Advanced Research Projects Agency thinks big, and it has the money, i.e., our tax dollars, to back it up. \u00a0Decades ago, DARPA brought us\u00a0the internet. \u00a0In comparison,\u00a0revolutionizing psychiatry ought to\u00a0be a walk in the park \u2014 right?<\/p>\n

Find\u00a0a need and fill it: “Current approaches\u00a0\u2014\u00a0surgery, medications, and psychotherapy\u00a0\u2014\u00a0can often help to alleviate the worst effects of illnesses such as major depression and post-traumatic stress, but they are imprecise and not universally effective.” \u00a0You can say that again. \u00a0So DARPA created a program called SUBNETS<\/a> (Systems-Based Neurotechnology for Emerging Therapies) “to generate the knowledge and technology required to deliver relief to patients with otherwise intractable neuropsychological illness.” \u00a0\u00a0SUBNETS aims\u00a0to create an “implanted, closed-loop diagnostic and therapeutic system for treating, and possibly even curing, neuropsychological illness.” \u00a0In other words, computer chips in the brain.<\/span><\/p>\n

SUBNETS will pursue the capability to record and model how these systems function in both normal and abnormal conditions, among volunteers seeking treatment for unrelated neurologic disorders and impaired clinical research participants. SUBNETS will then use these models to determine safe and effective therapeutic stimulation methodologies. These models will be adapted onto next-generation, closed-loop neural stimulators that exceed currently developed capacities for simultaneous stimulation and recording, with the goal of providing investigators and clinicians an unprecedented ability to record, analyze, and stimulate multiple brain regions for therapeutic purposes.<\/span><\/p><\/blockquote>\n

SUBNETS is hedging its bets. \u00a0With an overall budget of $70 million<\/a>, it is funding both a diagnosis-based arm, in the manner of the DSM5<\/a> of the American Psychiatric Association\u00a0(APA), as well as\u00a0a\u00a0\u201ctrans-diagnostic\u201d approach, in the manner of the Research Domain Criteria (RDoC<\/a>) of the National Institute for Mental Health (NIMH). \u00a0 The ideological rift between the APA and NIMH last year was awkward and impolitic; fortunately,\u00a0 SUBNETS has the resources to avoid\u00a0choosing sides. \u00a0A research team at the University of California San Francisco (UCSF) will receive\u00a0up to $26 million to study diagnostic groups, specifically post-traumatic stress, major depression, borderline personality, general anxiety, traumatic brain injury, substance abuse and addiction, and fibromyalgia\/chronic pain. \u00a0Another team at Massachusetts General Hospital (MGH) will receive up to $30 million to\u00a0tackle trans-diagnostic traits,\u00a0such as\u00a0increased anxiety, impaired recall, or inappropriate reactions to stimuli. \u00a0Both groups will include public and private partnerships, including with device manufacturers Medtronic<\/a>, Draper Laboratory<\/a>, and the start-up Cortera Neurotechnologies<\/a>.<\/span><\/p>\n

What to make of this? \u00a0Well, it’s certainly ambitious. \u00a0As I read it, the effort relies on several\u00a0unproven premises. \u00a0First, that psychiatric diagnoses, as currently construed, can be differentiated by monitoring activity in specific brain pathways. \u00a0This has been tried before without success, and it isn’t clear that sensor technology was the reason. \u00a0An alternative model would suggest that mental states are an emergent property\u00a0of widely integrated brain states. \u00a0If so, chips implanted in specific areas could no more capture this complexity than carefully listening to the trombone section could capture a symphony.<\/p>\n

Another assumption is that carefully focused electrical stimulation can\u00a0treat a variety of mental disorders. \u00a0The efficacy of transcranial magnetic stimulation<\/a> (TMS) to treat depression provides some support for this idea. \u00a0In contrast, typical comparisons to\u00a0deep brain stimulation to treat seizures and severe obsessive-compulsive symptoms only go so far. \u00a0Analogous stimulators may quell a panic state or chronic pain. \u00a0It is less clear how complex interpersonal patterns, such as those seen in borderline personality or substance abuse, could respond to this type of intervention. \u00a0Of course, we shall see.<\/p>\n

A central tenet of SUBNETS is that implanted\u00a0technology can promote healthy (or curative) neural plasticity. \u00a0Plasticity is a popular concept at the moment, highlighting the fact that brain wiring is not static, as was previously assumed. \u00a0“Neurons that fire together wire together<\/a>” \u2014 that is, synaptic connections change dynamically in response to input, i.e., life experience. \u00a0This property underlies the hope that implanted stimulators may\u00a0change the activity of neural pathways in a permanent way, “firing” the pathway together to make it “wire” together, and allowing the device eventually to be removed. \u00a0Again, we shall see.<\/p>\n

Of course, there are many stumbling blocks ahead. \u00a0Implanting brain chips is no small matter, and this approach\u00a0is unlikely to be\u00a0used\u00a0in the foreseeable future for anything short of\u00a0the most severe,\u00a0treatment-resistant\u00a0disorders. \u00a0Initial public commentary immediately honed in on the “military mind control” aspect of the project, with visions of soldier drones being controlled on the battlefield via implanted chips. \u00a0The potential abuse of such technology is manifest and terrifying, and careful controls and standards are needed to assure freedom, not to mention safety.<\/p>\n

At the most mundane level, the technology will only work if the science behind it is sound, and that remains to be seen. \u00a0Nonetheless, if even a portion of the SUBNETS agenda comes to pass, it would represent\u00a0a monumental leap for psychiatric treatment.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Sounding like something straight out of science fiction, DARPA recently announced grants to fund research and development of implantable brain-stimulation chips aimed to relieve, or even cure, mental disorders. The Defense Advanced Research Projects Agency thinks big, and it has the money, i.e., our tax dollars, to back it up. Decades ago, DARPA brought us […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[4,51],"tags":[52,45],"class_list":["post-924","post","type-post","status-publish","format-standard","hentry","category-current-events","category-psychiatry-in-general","tag-neuroscience","tag-psychiatric-research","odd"],"aioseo_notices":[],"_links":{"self":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/924","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=924"}],"version-history":[{"count":5,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/924\/revisions"}],"predecessor-version":[{"id":930,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=\/wp\/v2\/posts\/924\/revisions\/930"}],"wp:attachment":[{"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=924"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=924"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.stevenreidbordmd.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=924"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}