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Could Deep-Brain Stimulation Fortify Soldiers’ Minds?

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

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As many as 20 percent of war veterans return from combat in Afghanistan and Iraq with post-traumatic stress disorder (PTSD) or major depression, according to a 2008 report from the RAND Corporation. Many experience constant nightmares and flashbacks and many can’t live normal lives. For significant number of veterans, available medications do not seem to help. In 2010, at least 22 veterans committed suicide each day, according to the Department of Veterans Affairs. In her book, Demon Camp, the author Jen Percy describes damaged veterans who have even resorted to exorcism to alleviate their PTSD symptoms.

U.S. Army Soldiers with the 4th Brigade, 1st Infantry Division stand guard at a market in Al Doura in Baghdad, Iraq, April 5, 2007, providing security for Ryan Crocker, U.S. ambassador to Iraq. (U.S. Army photo by Sgt. Curt Cashour via Flickr)

As part of President Obama’s BRAIN Initiative, the federal Defense Advanced Research Projects Agency (DARPA) plans to spend more than $70 million over five years to develop novel devices that would address neurological disorders such as PTSD. DARPA is particularly interested in a technology called Deep Brain Stimulation (DBS). DBS involves inserting a thin electrode through a small opening in the skull into a specific area in the brain; the electrode is then connected by an insulated wire to a battery pack underneath the skin; the battery pack then sends electrical pulses via the wire to the brain.

About 100,000 people around the world today have a DBS implant to ameliorate the effects of Parkinson’s disease, epilepsy and major depression. There is evidence that DBS can also help with PTSD. Functional neuroimaging studies indicate that amygdala hyperactivity is responsible for the symptoms of PTSD and that DBS can functionally reduce the activity of the amygdala. In animal PTSD models, DBS has been found to be more effective than current treatment using selective serotonin reuptake inhibitors.

DARPA’s SUBNETS program seeks new neurotechnology for analyzing neuronal activity across sub-networks of the brain to enable next-generation therapies tailored to individual patients. (DARPA image)

DARPA wants to develop the next-generation, deep brain stimulators (call them DBS+) that do not require user input and that can a) read and monitor the brain’s activities in real-time using neural recording, and b) intervene in these activities in an automatic way through electrical stimulation.

DARPA’s officially stated goal is to treat soldiers who have PTSD and other related neurological disorders. However, once DBS+ is developed, theoretically it could also be used to fortify soldiers’ minds. For example, DBS+ could be used to pre-empt PTSD. Suppose that a soldier has just experienced a potentially traumatic event. DBS+ could be used to detect and categorize the emotional reaction in the amygdala. Like tsunami warnings, there could be different categories. If DBS+ detected a Category 4 reaction, it would automatically reduce the activity in the amygdala to a certain degree. If DBS+ detected a Category 5 reaction, it would slow the amygdala to a halt.

When the emotional strength of one’s memory is reduced, the memory tends not to get consolidated as strongly into long-term memory. Indeed, in both military and non-military settings, the beta-blocker propranolol has been used to dampen the emotional strength of one’s memory as a means of reducing potential trauma. By monitoring the brain in real time and intervening when necessary, DBS+ has the potential to be more precise and efficient while having fewer side effects.

The research team led by Massachusetts General Hospital will use a combination of commercial-off-the-shelf electrodes and custom technology developed by Draper Labs to create novel systems. The proposed design will focus on an ultra-low-profile, hermetically sealed interface device capable of being recharged through inductive coupling. (DARPA image courtesy of Massachusetts General Hospital and Draper Labs)

Once DBS+ is developed, it could also be used to modulate other emotions. Suppose that a soldier is about to enter combat. DBS+ could be used to reduce/remove fear and/or increase courage by increasing adrenaline in the soldier, much like psychotropic drugs such as amphetamine that some soldiers now use. In animal models, DBS reduces fear expressions when applied to the dorsal area of the ventral striatum.

The development of DBS+ will raise familiar but important questions that pertain to the development of all new biotechnologies, including safety and risks. Also, DBS+ is likely to raise some of the same ethical issues that current DBS faces, such as those of authenticity and alienation. For instance, after using DBS, some patients have said things like “During those years of illness, I was asleep. But now I’m going to take my life back.” Others have said things like “I don’t recognize myself anymore.”

The benefits of DBS+ will therefore need to be weighed against its damaging potential to distort or disturb our sense of self. Moreover, DBS has been known to have unintended negative and positive effects. In some patients with Parkinson’s disease, DBS has taken away their tremors but also their passion to lead an active life. In other patients with Parkinson’s disease, DBS has made these patients feel ‘well’ and ‘happy’ even though DBS has not reduced their symptoms. These issues will make DBS+ a future technology that is likely to generate serious public debates.

But even if DBS+ is safe, some people will rightly be concerned that soldiers may be forced to use this kind of brain modification. Suppose soldiers were only equipped with DBS+ on condition of their informed consent after being properly informed of the various risks and benefits. Would all the ethical concerns have been addressed? Perhaps not.

Even if there were informed consent, there could be subtler forms of coercion. The military command structure is hierarchical. This could make “consent” less than fully voluntary. If a commanding officer were to strongly urge the use of DBS+, would this not influence the choices of subordinate officers? Also, there may be subtle or not-so-subtle forms of peer pressure. A soldier may agree to use DBS+ because the soldier does not want to let fellow soldiers down. Moreover, if a soldier does not use DBS+, the soldier may be at a competitive disadvantage. Soldiers with DBS+ may be more reliable under pressure than soldiers without DBS+ and may therefore be more likely to be called upon and shouldered with responsibility.

Could we just ban the use of DBS+ in the military, just as we ban the use of steroids in sports? It is not clear that this is a viable option. Soldiers are already enhanced in other ways. They have access to night vision goggles, Apache helicopters and drugs such as Modafinil to improve alertness and Ritalin to enhance attention. Also, banning doping in sports is usually done for considerations of fairness, but these reasons are unlikely to sway any soldier/state institutions. Would any soldier voluntarily give up advanced military weaponry just to level the playing field? Moreover, if one’s enemies have acquired the technology and are using it, this will undoubtedly provide a strong incentive for its use.

Others might worry that using DBS+ would lead to conscienceless soldiers who would kill indiscriminately in ways that are out of reasonable proportion. This is a serious and important concern. Interestingly, this may be a “technical” problem.

Brain implants that reduce or eliminate our sense of morality are morally undesirable and are not really enhancements as such. Efforts should therefore be made to ensure that the kind of brain implants we develop do not have these unwanted side effects. In the short term, the brain implants we develop may well be imperfect in just such a way. If so, this would be a good reason to ban such devices in the short term. The interesting theoretical issue is what happens when we have perfected the technology and have brain implants that would enable a soldier to kill at the right time, for the right reasons, and in a proportionate manner? Would we still have ethical problems with soldiers using such a technology?

S. Matthew Liao About the Author: S. Matthew Liao is the Director for the MA Program in Bioethics, the Associate Director of the Center for Bioethics and a Clinical Associate Professor of Bioethics at New York University. From 2006 to 2009, he was the Deputy Director and James Martin Senior Research Fellow in the Program on the Ethics of the New Biosciences in the Faculty of Philosophy at Oxford University. He was the Harold T. Shapiro Research Fellow in the University Center for Human Values at Princeton University in 2003–2004, and a Greenwall Research Fellow at Johns Hopkins University and a Visiting Researcher at the Kennedy Institute of Ethics at Georgetown University from 2004–2006. In May 2007, he founded Ethics Etc, a group blog for discussing contemporary philosophical issues in ethics and related areas. He is interested in a wide range of issues including ethics, epistemology, metaphysics, moral psychology and bioethics. Follow on Twitter @smatthewliao.

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

Comments 10 Comments

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  1. 1. Jerzy v. 3.0. 10:07 am 09/5/2014

    Eerily reminds me of communist Eastern Europe, where the government experimented with giving various drugs and forms of simulation to soldiers and police. The goal was to make soldiers and police more ‘effective’ and follow inhumane orders and stop questioning and breaking down.

    All these experiments failed.

    Link to this
  2. 2. AlexeyVSun 1:30 pm 09/5/2014

    I am sorry… I think I am missing something here. There is such thing as a right reason as well as the right time to kill someone in proportional manner? Interesting take on life. Love it. Sociopaths and psychopaths of the world unite!

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  3. 3. patpentz 4:40 pm 09/9/2014

    It wasn’t just Eastern Europe. the US (Army I believe) had a horrible program testing LSD and stronger drugs for poorly thought out reasons. Another big failure.

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  4. 4. Raghuvanshi1 6:30 am 09/10/2014

    There are some positive effect of PTSD on some patient he made his own identity If new technique cure him what happen to his old identity?Take example of famous writer Dostoevsky he was patient of PTSD study show that the overcome this disease he wrote his world famous novels if he was cured by new technology what happened to his old identity,I think Van Gulf also patient of PTSD can he draw his immortal painting.?I am curious to know new identity of cured patient

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  5. 5. jackvandijk 5:20 pm 09/10/2014

    The use of marijuana has proven to work. The THC molecule seems to make the user forget and it seems to work for soldiers. so why not allow them to use it, it has less bad side effect than alcohol.
    No, I am not a scientist and no I cannot describe this more accurate.

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  6. 6. raeran 9:39 pm 09/10/2014

    We have been at war nearly every year since we were founded as a nation. How about instead of investing in brain implants to change our behavior let’s stop going to war so often. Instead of spending so much on repairing injured people let’s just have fewer people injured/killed then we can invest the enormous amount of military spending elsewhere.

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  7. 7. iplanes2 3:54 am 09/11/2014

    Am I missing something here? According to the above figures something like 6000 soldiers commit suicide per year. This is more than are dying in combat and it is also (I suspect) than the number of “enemy” killed per year. The obvious answer is to stop the war or is this too obvious?

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  8. 8. jackvandijk 3:28 pm 09/15/2014

    There are many things in the USA that are obvious, from the non-participation in what is supposed to be a democracy by not voting, to giving mine-resistant vehicles to the police who are dressed up in jungle fatigues, in the city.
    From calling companies a person, to not allowing women to make their own choices about their own lives and bodies.

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  9. 9. IceMartian 4:05 pm 09/25/2014

    In 2010, at least 22 veterans committed suicide each day, according to the Department of Veterans Affairs.

    22 is actually the average per year, if I read the info in the link “22 veterans committed suicide each day” correctly.

    Please correct this mistake as it might worsen a depressed persons outlook!

    Link to this
  10. 10. Slavon 8:03 am 01/18/2015

    I think that the military in itself is a ‘discriminatory’ organisation, because a military needs the most suitable people to win in war. Men over the age of 34 aren’t allowed to join the infantry either, colour blind people aren’t allowed to be fighter pilots or snipers, those with mental or physical disabilities can’t join at all.

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