Artificial intelligence

1st February 2008 at 00:00
If a pill could make your pupils brainier would you let them take it? Madeleine Brettingham investigates the brain-boosters that could transform schools.

Are your pupils' brains the equivalent of an Apple Mac or an Atari 2600? Would it surprise you to know that by popping a pill they could improve their memory, concentration and ability to plan ahead?

It may sound like the stuff of Aldous Huxley's Brave New World, but dozens of so-called "smart drugs" - brain-boosting compounds that increase academic ability - are being developed by pharmaceutical companies and military organisations, and scientists believe that in 20 years they could find their way into the classroom.

From "brain Botox" to Ritalin, the implications of these drugs, an estimated 40 plus of which are in development, are huge, especially as new chemicals are being developed that deliver bigger improvements with fewer side effects.

Scientists envisage that within decades they could be commonplace in universities, schools and the workplace, giving rise to the science fiction-like prospect of pushy parents paying for pills and children being submitted for Olympic-style drugs tests before sitting exams.

Smart drugs divide opinion like nothing else. Some scientists believe they should be embraced as an educational tool. Others see them as a threat, which could potentially coerce children into self-medicating in order to compete.

The Government is expected to release a report on the controversial subject next month. Ahead of this, The TES Magazine asks: what are smart drugs and how concerned should educators be?

Research into smart drugs, or cognitive enhancers, began after it was discovered that prescription medications such as Ritalin, which is used to treat attention deficit disorder (ADHD), and modafinil, sold as a treatment for narcolepsy, the sleep disorder, can improve the thinking skills of healthy individuals, at least under laboratory conditions.

Experiments at Cambridge University showed that modafinil improves short-term memory and planning while several studies suggest Ritalin, or methylphenidate, boosts spatial memory, the ability that helps you recall locations on a map.

Modafinil, which is commonly sold under the brand name Provigil, is already used by academics and pupils to cram for exams and presentations, and in the United States, 2.5 per cent of eighth graders (13 to 14-year-olds) were found illicitly using Ritalin by a National Institute on Drug Abuse study. Both are available over the internet, with a 100-tablet bottle selling for pound;20 upwards.

As more research money is ploughed into drugs for conditions such as Alzheimer's disease and age-related memory loss, it's inevitable that scientific gains in this area will be made. But should such drugs be sold to healthy individuals? And is it conceivable they will one day be used to boost performance in school?

"In a certain sense it is already happening, in that children diagnosed with ADHD are treated with Ritalin," says Trevor Robbins, a professor of cognitive neuroscience at Cambridge University. "The medication is used to reduce their disruptive behaviour at school and so prevents them being stigmatised by being expelled or suspended."

Astonishingly, the number of prescriptions made to pupils in England for behaviour-altering drugs such as Ritalin and modafinil has risen tenfold in the past decade, from more than 48,000 in 1996-97 to more than 450,000 last year, according to the Department for Children, Schools and Families (DCSF).

The prospect of adding smart drugs to the equation worries some experts, and not only because of fears over the long-term effects of existing medications for ADHD. Critics include Baroness Susan Greenfield, a professor of pharmacology at Oxford University and an authority on the issue. She and other academics have warned the drug may have "profound effects" on the way children think and behave (see Brain behaviour on page 36).

"The concern is that people would feel coerced into giving them to their children if they thought others were taking them too," says Barbara Sahakian, a professor of clinical neuropsychology at Cambridge University, and the author of several studies into cognitive enhancers.

"There is also the risk they could exacerbate existing inequalities in society. If they become something you have to pay for, like private tuition, some children will be disadvantaged and it will increase disparity."

Martha Farah, a professor of psychology at the Centre for Cognitive Neuroscience, Pennsylvania University, has researched Ritalin abuse in the United States. She believes that smart drugs are a worrying reaction to deeper societal pressures. "Academic competition has increased enormously. In the United States, good elementary schools have more applicants than they can accept and some parents hire coaches to help them groom their preschoolers for acceptance in the 'right' kindergarten.

"Of course, it only gets worse in high school. Under these circumstances, it's no surprise people are looking for an extra edge," she says.

Inevitably, not everyone feels comfortable with the idea of ambitious pupils popping pills to make them brainier. After all, what's achievement without hard work and perseverance? But some scientists believe we shouldn't be so quick to judge.

"Cod liver oil is taken as a cognitive enhancer," says Dr Anders Sandberg, a neuroscientist at Oxford University's Future of Humanity Institute, which investigates how technology will affect the human race.

"Even something as simple as eating a biscuit at the right moment can improve your performance, yet no one would complain about that except your dentist. It doesn't matter how you bring about change. What matters is the result.

"Surely, anything that improves the ability to learn is a good thing," says Dr Sandberg.

Research on the potential uses of smart drugs is in its early stages. Pharmaceutical companies develop drugs for diseases, not for healthy individuals, meaning their research and development budgets aren't directed towards lifestyle drugs.

Professor Robbins, who has contributed to the Government's forthcoming report on cognitive enhancers, believes this provides a window of opportunity to take stock of the ethical issues surrounding their use.

"I don't think you can argue against self-improvement unless people are causing harm to themselves or others," he says.

"However, in a competition situation, such as an exam, it carries problems."

In future, regulatory bodies such as schools or the DCSF could restrict the use of smart drugs in exam halls, he says. And while he cannot reveal the contents of the Government's forthcoming report, Professor Robbins himself is reluctant to endorse an outright ban on such substances. He says: "New discoveries always attract reactionary thinking. But you have to assess objectively their harms and benefits."

At the moment, the DCSF treats the use of medical study aids as a health issue. It says that there is no evidence such compounds are being used as a study aid. But for how long? As well as Ritalin and modafinil, a host of potential smart drugs are on the horizon, many of which work by affecting the production and reabsorption of chemical messengers in the brain, such as dopamine and noradrenalin, which stimulate brain activity.

Ampakines and Mem compounds, medicines developed to treat Alzheimer's disease, have been shown to improve memory, and there is evidence Donepezil, which treats dementia, makes it easier to learn new information. Adderall, another ADHD and narcolepsy drug, is already used as a study aid by university students.

Then there are the futuristic-sounding procedures reminiscent of Barbarella, the 1960s psychedelic flick, such as transcranial magnetic stimulation and deep-brain stimulation. Transcranial magnet stimulation has been dubbed "Botox for the brain" for its quick effects, although it's unlikely Harley Street doctors will be adopting it soon.

It involves targeting a particular part of the brain by directing a magnetic pulse through the scalp, and has been shown to reduce the time it takes, for example, to name a picture or an object.

Deep-brain stimulation, a much more invasive therapy, has been nicknamed a "brain lift" by waggish neuroscientists. It involves inserting electrodes through the skull and sending tiny electric currents through them, via a generator inserted under the skin of the chest like a pacemaker.

Incredibly, it is already used to treat Parkinson's disease, and has been used experimentally to treat phantom limb pain and depression, as well as to improve memory in rats.

Even more stunningly, the US military, via its Defence Advanced Research Projects Agency, is investigating brain-machine interfaces that combine technology and neuroscience to "soup up" the human mind.

Its researchers have trained rats to move left, right, climb and jump, via instructions sent through electrodes planted in their brains. Its experts are also developing high-tech binoculars that can pick up a soldier's neural signals and alert them to threats in their field of vision before they are consciously aware of them.

Many cognitive enhancing treatments either already exist or are in development. But no one can yet predict how governments and the public will react to their growing availability.

In the words of Dr Anders Sandberg: "The situation could change relatively quickly over the next decade. In that time we need to set out some ground rules and work out what kind of education system we want."

Open your mind

What does it feel like to use the so-called cognitive enhancer, modafinil? Professor Philip Harvey takes the compound roughly two or three times a year. When he flies from America to Europe to give a presentation, he will take a 100 milligram tablet to combat jet lag.

"I think the effects are best with fatigue," says the professor of psychiatry and behavioural sciences at Emory University School of Medicine in Atlanta.

"I take it first thing in the morning and it kicks in after about an hour, so by the time I have done security and taxis, it is active. It lasts for about 14 hours and will take me through to the evening. It ensures I give my presentation fluently and don't fall asleep in the middle of anyone else's."

Modafinil is prescribed to combat fatigue among shift workers in America, so Professor Harvey obtains it from his doctor, paying around a dollar a pill through his medical plan (the market price is $11, pound;5.50).

He hasn't noticed any cognition-enhancing benefits.

"I use it to stay awake. If I didn't, I would have to fly the day before and spend hours recovering. This ensures I can get back and spend more time with my wife and kids."

But if a safe, smart drug was invented? "I'd be standing in line with everyone else."

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