title: The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people.
abstract: In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish.
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK bjs1001@medschl.cam.ac.uk.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Sahakian
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
authors.forename: Annette B
authors.initials: AB
authors.lastname: Bruhl
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cook
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Killikelly
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK.
authors.forename: George
authors.initials: G
authors.lastname: Savulich
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Piercy
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK CAMEO North Team, 3 Thorpe Road, Peterborough PE3 6AN, UK.
authors.forename: Sepehr
authors.initials: S
authors.lastname: Hafizi
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK CAMEO South Team, Block 7, Ida Darwin Site, Fulbourn, Cambridge CB21 5EE, UK.
authors.forename: Jesus
authors.initials: J
authors.lastname: Perez
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK.
authors.forename: Emilio
authors.initials: E
authors.lastname: Fernandez-Egea
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK.
authors.forename: John
authors.initials: J
authors.lastname: Suckling
authors.affiliation: Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain and Mind Sciences, Forvie Site, Robinson Way, Cambridge CB2 0SZ, UK MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 3EB, UK.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
mesh_terms: D000544:Alzheimer Disease / Q000188:drug therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy; D003071:Cognition / Q000187:drug effects*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D019965:Neurocognitive Disorders / Q000188:drug therapy* / Q000628:therapy; D009488:Neurosciences / Q000639:trends; D018697:Nootropic Agents / Q000627:therapeutic use*; D010300:Parkinson Disease / Q000188:drug therapy; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy; D018910:Video Games
chemical_list: D018697:Nootropic Agents
keywords: cognitive enhancers; cognitive training; game; neuroethics; schizophrenia; smart drugs