NIH pairs cutting-edge neuroethics with ground-breaking neurotechnologies

October 18, 2019

With support from the National Institutes of Health's Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative, scientists are developing powerful new devices and technologies to monitor and regulate brain activity. To ensure NIH keeps pace with rapid technological development and help clinicians and researchers ethically fit these new tools into practice, a paper recently published in JAMA Neurology highlights potential issues around and offers recommendations about clinical research with both invasive and noninvasive neural devices.

"NIH is leading the way for proactively considering and addressing potential ethical considerations as the BRAIN Initiative leads to novel ways of measuring and influencing the activity of the brain," said Walter Koroshetz, M.D., director of the NIH's National Institute of Neurological Disorders and Stroke (NINDS). "Having discussions in real time is of paramount importance as clinical researchers investigate the use of such tools to reduce the burden of brain disease."

Considerable attention has been given recently to neural devices, which can be used to record or alter brain activity. In some cases, they are implanted within the brain for the purpose of stimulating or inhibiting specific regions to treat a disorder. Recent high profile investments in neural device companies have increased public attention to an already promising field of study. However, it is crucial that doctors and industry emphasize protection of research participants as they conduct trials to test and optimize these devices.

By bringing together neuroscience researchers, clinicians, and ethicists, the NIH is supporting an effort to address the ethical challenges associated with clinical research advances. Shortly after the launch of the BRAIN Initiative in 2013, the NIH BRAIN Initiative's Neuroethics Working Group was formed as a working group of the NINDS Advisory Council to recommend approaches for identifying and addressing ethical questions raised by the development and use of the resulting tools and technologies.

"Cutting-edge science requires cutting-edge ethics." said Khara Ramos, Ph.D., Director of Neuroethics at NINDS and co-author of the paper. "The BRAIN Initiative is moving the field of neuroscience forward at a rapid pace, and we are fortunate to collaborate with experts from diverse backgrounds to help us evaluate and anticipate the ethical implications of that research."

In their paper, the authors discuss three main areas of ethical challenges related to neural devices. Two of these build upon established issues: weighing the risks and benefits involved in clinical experimentation and the importance of informed consent--whether a trial participant is provided with enough information, and under the right circumstances to be able to decide on enrolling.

The third area of focus is relatively new for these devices: what responsibilities do researchers, manufacturers, and funders have to the research participants once a trial has ended? Unlike participation in most drug trials, individuals who participate in a device trial often walk away with long-lasting changes--invasive brain implants or other devices--that have an impact on their future. Who is responsible for making sure that the implant or device continues to work properly weeks, months, or years later? The authors suggest that, at a minimum, researchers and those who fund that research need to anticipate any future care needs trial participants may have, including associated costs.

The paper looks at some of those needs including long-term maintenance (such as repairs, battery replacement, and software updates), the care required for possible adverse effects that could arise after the trial, and long term support by manufacturers who may continue to improve their devices based on research or commercial interests.

"This important research is only possible through the generosity and trust of human research participants, many of whom are themselves patients seeking treatment for serious neurological conditions," said Winston Chiong, M.D., Ph.D., associate professor in residence, University of California, San Francisco Neurology and co-author of the paper. "It's very important that this research is guided not only by researchers' good intentions, but also by deliberate consideration about present and future risks to participants. This also includes considerations of cost and broader practical questions about what it's like to live with one of these devices."
-end-
The BRAIN Initiative was launched in 2013 with the goal of developing the tools to see the brain in action and to use this knowledge to reduce the burden of illness. This paper came out of discussions during an NIH-hosted workshop in October 2017, "Ethical Issues in Research with Invasive and Non-invasive Neural Devices in Humans." A recording of that workshop is available at https://braininitiative.nih.gov/about/neuroethics-working-group.

Reference:

Hendriks S., Grady C., Ramos, KM., et al. Ethical challenges of risk, informed consent, and posttrial responsibilities in human research with neural devices: a review. JAMA Neurology. October 17. DOI: 10.1001/jamaneurol.2019.3523

This work was supported by the NIH Clinical Center Department of Bioethics, NIH BRAIN Initiative, and NIH Intramural Research Program.

For more information:

https://braininitiative.nih.gov/about/neuroethics.htm

https://www.braininitiative.nih.gov/

The NIH's Brain Research through Advancing Innovative Neurotechnologies® (BRAIN) Initiative is aimed at revolutionizing our understanding of the human brain. It is managed by 10 institutes whose missions and current research portfolios complement the goals of the BRAIN Initiative: NCCIH, NEI, NIA, NIAAA, NIBIB, NICHD, NIDA, NIDCD, NIMH, and NINDS.

NINDS is the nation's leading funder of research on the brain and nervous system. The mission of NINDS is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disease.

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIH/National Institute of Neurological Disorders and Stroke

Related Brain Articles from Brightsurf:

Glioblastoma nanomedicine crosses into brain in mice, eradicates recurring brain cancer
A new synthetic protein nanoparticle capable of slipping past the nearly impermeable blood-brain barrier in mice could deliver cancer-killing drugs directly to malignant brain tumors, new research from the University of Michigan shows.

Children with asymptomatic brain bleeds as newborns show normal brain development at age 2
A study by UNC researchers finds that neurodevelopmental scores and gray matter volumes at age two years did not differ between children who had MRI-confirmed asymptomatic subdural hemorrhages when they were neonates, compared to children with no history of subdural hemorrhage.

New model of human brain 'conversations' could inform research on brain disease, cognition
A team of Indiana University neuroscientists has built a new model of human brain networks that sheds light on how the brain functions.

Human brain size gene triggers bigger brain in monkeys
Dresden and Japanese researchers show that a human-specific gene causes a larger neocortex in the common marmoset, a non-human primate.

Unique insight into development of the human brain: Model of the early embryonic brain
Stem cell researchers from the University of Copenhagen have designed a model of an early embryonic brain.

An optical brain-to-brain interface supports information exchange for locomotion control
Chinese researchers established an optical BtBI that supports rapid information transmission for precise locomotion control, thus providing a proof-of-principle demonstration of fast BtBI for real-time behavioral control.

Transplanting human nerve cells into a mouse brain reveals how they wire into brain circuits
A team of researchers led by Pierre Vanderhaeghen and Vincent Bonin (VIB-KU Leuven, Université libre de Bruxelles and NERF) showed how human nerve cells can develop at their own pace, and form highly precise connections with the surrounding mouse brain cells.

Brain scans reveal how the human brain compensates when one hemisphere is removed
Researchers studying six adults who had one of their brain hemispheres removed during childhood to reduce epileptic seizures found that the remaining half of the brain formed unusually strong connections between different functional brain networks, which potentially help the body to function as if the brain were intact.

Alcohol byproduct contributes to brain chemistry changes in specific brain regions
Study of mouse models provides clear implications for new targets to treat alcohol use disorder and fetal alcohol syndrome.

Scientists predict the areas of the brain to stimulate transitions between different brain states
Using a computer model of the brain, Gustavo Deco, director of the Center for Brain and Cognition, and Josephine Cruzat, a member of his team, together with a group of international collaborators, have developed an innovative method published in Proceedings of the National Academy of Sciences on Sept.

Read More: Brain News and Brain Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.