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Why Optogenetics Doesn’t Light Me Up: The Sequel

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When asked about my style of journalism, I sometimes say that my goal isn't necessarily to get people to agree with me. It's to provoke readers into reconsidering some issue.

Has coverage of optogenetics, which thus far has only been tested in animals, exaggerated therapeutic potential for humans?

Well, my recent critique of optogenetics has provoked lots of folks, and most don't agree with me. We've been whacking each other on Twitter, but that format—I've belatedly realized--brings out the worst in me. Someone smacks me, I smack back, reflexively. I want world peace but can't control my own aggression. Embarrassing.

My obnoxiousness makes it too easy for people to attack the messenger and ignore the message. So instead of continuing to bicker with my fellow Twits, I decided to respond in a more measured fashion to several points made by bloggers who have criticized my post. My hope is that this exercise will lead to some useful lessons about science reporting.

Did I call for "the end of optogenetics"? My Scientific American colleague Scicurious suggests that I want to "throw out [optogenetics] because we haven’t cured anything yet." Journalist Paul Raeburn, similarly, says that the guy who proclaimed The End of Science (the title of my first book) is now calling for "the end of optogenetics."

But nowhere in my column did I urge that optogenetics research end--any more than in my criticism of the big new U.S. Brain Initiative last spring I urged that neuroscience stop. I want the hype to end. Believe it or not, my criticism of optogenetics and its coverage was meant to be constructive.

Did I overstate the hype? Lots of folks still insist that I exaggerate the degree to which scientists and journalists have touted the potential of optogenetics to transform treatments for human brain disorders. But that potential is a theme—implicit or explicit--of virtually all reporting on the field, including all the pieces I cited in my original post.

Here is how optogenetics pioneer Karl Deisseroth introduces his 2010 overview of the technique in Scientific American: "Despite the enormous efforts of clinicians and researchers, our limited insight into psychiatric disease (the worldwide-leading cause of years of life lost to death or disability) hinders the search for cures and contributes to stigmatization. Clearly, we need new answers in psychiatry."

Neuroscientist Richard Tomsett says one of my examples of hype—a TED talk by Ed Boyden, another leader of optogenetics—doesn't count because "the whole point of such talks is hype and speculation." Really? So scientists shouldn't be criticized for hyping their research in mass-media venues like TED—which reaches gigantic audiences--because no one is taking them seriously? Surely that can't be right.

Now, you could say that scientists and journalists have a right--and even responsibility--to envision possible directions of research. Fine. But they also have a responsibility to discuss limitations of such research, so as not to raise false hopes. The bulk of coverage has not gone far enough in outlining these limitations.

Should I have mentioned Helen Mayberg's research? Journalist David Dobbs calls me "wrong to declare that no one has yet identified any neurological correlates" of mental illness. He cites neurologist Helen Mayberg, whose research he calls "one of the past decade’s most significant lines of work in depression." Mayberg has reported alleviating depression in patients by stimulating a brain region called A25 with pulses of electricity delivered by implanted electrodes.

According to Dobbs, Mayberg has suggested that "it might be possible to use other means less intrusive than drills and wires--optogenetics in particular--to tweak the circuit she’s been buzzing with her stimulators." There it is again, the therapeutic promise of optogenetics.

I'm less impressed than Dobbs with Mayberg's work, for several reasons. First, her published brain-stimulation results involve small numbers of patients and have not been replicated in controlled, clinical trials. Dobbs mentions this caveat. What he does not mention is that Mayberg has received consulting fees from manufacturers of implantable nerve-stimulating devices.

Mayberg, oddly, has also served as a paid consultant for the prosecution in over 40 capital punishment cases, in which she has argued against the use of brains scans as mitigating information. I learned about Mayberg's corporate and legal consulting activities by reading posts written in 2010 and 2011 by journalist Alison Bass, who raises questions about Mayberg's conduct here, here, here and here. Bass, when I contacted her recently, said she stands by her reporting.

Dobbs has vigorously defended Mayberg against Bass's criticism, calling Bass "wrong, wrong and wrong." But Dobbs does not dispute the basic facts of Mayberg's consulting activities; he just thinks they have no bearing on her credibility. Dobbs should nonetheless have disclosed Mayberg's corporate and death-penalty consulting in his reporting on Mayberg, including a laudatory feature article in The New York Times Magazine in 2006, even if—indeed, because--that information would have cast Mayberg in a darker light.*

Are high costs of U.S. health care relevant to optogenetics? Several bloggers found my discussion of U.S. health care to be unfair and irrelevant to a discussion of optogenetics. Scicurious writes: "I also don’t understand the idea that you can’t get excited about opto because some people don’t have healthcare… That’s like saying that many people don’t have adequate transportation and therefore we shouldn’t get excited by going to Mars."

Actually, that's a pretty good analogy. I think that the poor state of public transportation and other government-funded services should have a bearing on discussions of and funding for big scitech programs, like missions to Mars or the Moon. For an especially eloquent expression of this perspective, check out this YouTube recording of the poet-rapper Gil Scott-Heron's famous poem "Whitey on the Moon."

In the same way, the abysmal state of health care in the U.S. should have a bearing on discussions about biomedical research. I'm not saying that journalists, every time they report on a biomedical advance, need to analyze its potential impact on our health-care problems. But knowledge of these woes should inform coverage of biomedical advances, especially since technological innovation is arguably contributing to our high health care costs.

I understand the desperation of scientists, journalists and everyone for progress in our understanding and treatment of brain disorders. I'm desperate too; mental illness has ravaged people close to me. The question is, How do we balance hope with skepticism? How do we avoid succumbing to what blogger Brandon Keim (in a lonely positive commentary on my original post on optogenetics) calls "the appetite of our public culture for (often tech-centric) narratives of progress and imminent improvement"?

I don't have any magic formula. My reporting on biomedicine is no doubts at times too skeptical and critical--but that's because of my conviction that most reporting is not skeptical and critical enough.

*Addendum: David Dobbs on Twitter says that "by my memory, Mayberg had no consulting relationship w device maker in 2005/6, when I wrote the Times piece." He adds, "I respectfully ask that you remove that accusation unless you can find that she did." Mayberg started serving on an "advisory board" for Cyberonics, a Texas-based manufacturer of vagus nerve stimulators, in 2003, according to this press release: http://www.ahrp.org/cms/content/view/293/29/. Dobbs tweeted, "Amazed u consider Bass credible." Bass is more credible than Dobbs--or Mayberg, for that matter.

Image: http://www.buzzcritic.com/wp-content/plugins/wp-o-matic/cache/532d9_oct2109eng-optogenetics.jpg

The views expressed are those of the author and are not necessarily those of Scientific American.

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