The NIH BRAIN Initiative: Integrating Neuroethics and Neuroscience

Artificial cognition vs. artificial intelligence for next-generation autonomous robotic agents

The trend in industrial/service robotics is to develop robots that can cooperate with people, interacting with them in an autonomous, safe and purposive way. These are the fundamental elements characterizing the fourth and the fifth industrial revolutions (4IR, 5IR): the crucial innovation is the adoption of intelligent technologies that can allow the development of cyber-physical systems, similar if not superior to humans. The common wisdom is that intelligence might be provided by AI (Artificial Intelligence), a claim that is supported more by media coverage and commercial interests than by solid scientific evidence. AI is currently conceived in a quite broad sense, encompassing LLMs and a lot of other things, without any unifying principle, but self-motivating for the success in various areas. The current view of AI robotics mostly follows a purely disembodied approach that is consistent with the old-fashioned, Cartesian mind-body dualism, reflected in the software-hardware distinction inherent to the von Neumann computing architecture. The working hypothesis of this position paper is that the road to the next generation of autonomous robotic agents with cognitive capabilities requires a fully brain-inspired, embodied cognitive approach that avoids the trap of mind-body dualism and aims at the full integration of Bodyware and Cogniware. We name this approach Artificial Cognition (ACo) and ground it in Cognitive Neuroscience. It is specifically focused on proactive knowledge acquisition based on bidirectional human-robot interaction: the practical advantage is to enhance generalization and explainability. Moreover, we believe that a brain-inspired network of interactions is necessary for allowing humans to cooperate with artificial cognitive agents, building a growing level of personal trust and reciprocal accountability: this is clearly missing, although actively sought, in current AI. The ACo approach is a work in progress that can take advantage of a number of research threads, some of them antecedent the early attempts to define AI concepts and methods. In the rest of the paper we will consider some of the building blocks that need to be re-visited in a unitary framework: the principles of developmental robotics, the methods of action representation with prospection capabilities, and the crucial role of social interaction.

Translational Neuroethics: A Vision for a More Integrated, Inclusive, and Impactful Field

As early-career neuroethicists, we come to the field of neuroethics at a unique moment: we are well-situated to consider nearly two decades of neuroethics scholarship and identify challenges that have persisted across time. But we are also looking squarely ahead, embarking on the next generation of exciting and productive neuroethics scholarship. In this article, we both reflect backwards and turn our gaze forward. First, we highlight criticisms of neuroethics, both from scholars within the field and outside it, that have focused on speculation and lack of skepticism; the dearth of consideration of broader social issues such as justice and equality, both with regard to who speaks for neuroethics as a field and who benefits from its recommendations and findings; and the insufficient focus on the practical impact of our ethical work. Second, we embrace the concept of "translational neuroethics" to outline a vision for neuroethics that is integrated, inclusive, and impactful. Integration can help us identify more pertinent, real-world issues, and move away from speculation; inclusivity can help ensure that the questions we attend to are not merely relevant to a single subgroup but aim toward just distribution of benefits; and impact can help us think beyond guidelines and recommendations to focus on implementation. Our goal is for this call to action to help shape neuroethics into a discipline that develops rigorous research agendas through relationships with interdisciplinary partners, that is broadly inclusive and attends to issues beyond novel neurotechnologies, and that is devoted to the translation of scholarship into practice.

A comparative review on neuroethical issues in neuroscientific and neuroethical journals

This study is a pilot literature review that compares the interest of neuroethicists and neuroscientists. It aims to determine whether there is a significant gap between the neuroethical issues addressed in philosophical neuroethics journals and neuroscience journals. We retrieved 614 articles from two specialist neuroethics journals (Neuroethics and AJOB Neuroscience) and 82 neuroethics-focused articles from three specialist neuroscience journals (Neuron, Nature Neuroscience, and Nature Reviews Neuroscience). We classified these articles in light of the neuroethical issue in question before we compared the neuroethical issues addressed in philosophical neuroethics with those addressed by neuroscientists. A notable result is a parallelism between them as a general tendency. Neuroscientific articles cover most neuroethical issues discussed by philosophical ethicists and vice versa. Subsequently, there are notable discrepancies between the two bodies of neuroethics literature. For instance, theoretical questions, such as the ethics of moral enhancement and the philosophical implications of neuroscientific findings on our conception of personhood, are more intensely discussed in philosophical-neuroethical articles. Conversely, neuroscientific articles tend to emphasize practical questions, such as how to successfully integrate ethical perspectives into scientific research projects and justifiable practices of animal-involving neuroscientific research. These observations will help us settle the common starting point of the attempt at "ethics integration" in emerging neuroscience, contributing to better governance design and neuroethical practice.

The evolution of Big Data in neuroscience and neurology

Neurological diseases are on the rise worldwide, leading to increased healthcare costs and diminished quality of life in patients. In recent years, Big Data has started to transform the fields of Neuroscience and Neurology. Scientists and clinicians are collaborating in global alliances, combining diverse datasets on a massive scale, and solving complex computational problems that demand the utilization of increasingly powerful computational resources. This Big Data revolution is opening new avenues for developing innovative treatments for neurological diseases. Our paper surveys Big Data's impact on neurological patient care, as exemplified through work done in a comprehensive selection of areas, including Connectomics, Alzheimer's Disease, Stroke, Depression, Parkinson's Disease, Pain, and Addiction (e.g., Opioid Use Disorder). We present an overview of research and the methodologies utilizing Big Data in each area, as well as their current limitations and technical challenges. Despite the potential benefits, the full potential of Big Data in these fields currently remains unrealized. We close with recommendations for future research aimed at optimizing the use of Big Data in Neuroscience and Neurology for improved patient outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40537-023-00751-2.

An XYZ-axis Matrix Approach for the Integration of Neuroscience and Neuroethics

The recent, unprecedented advancement in neuroscience has led to new discoveries about the human brain and its function. Yet at the same time, it has spurred novel ethical and regulatory issues, and the field of neuroethics has emerged as an interdisciplinary endeavor to address these issues. Across the globe, extensive efforts have been underway to achieve the integration of neuroscience and Neuroethics, with active engagement not only from academia but also from the government, the public, and industry. However, in some countries, integrating neuroscience and neuroethics has proved to be a particularly challenging task. For example, in South Korea, the government has primarily driven the integration effort, and only a small group of researchers is properly trained for conducting an interdisciplinary evaluation of ethical, legal, social, and cultural implications (ELSCI) of neurotechnology. On the basis of the last few years of experience pursuing a government-funded neuroethics project in South Korea, we developed a new operational framework to provide practical guidance on ELSCI research. This framework consists of the X, Y, and Z axes; the X-axis represents a target neurotechnology, the Y-axis represents different developmental stages of the technology, and the Z-axis represents ELSCI issues that may arise from the development and use of the neurotechnology. Here we also present a step-by-step workflow to apply this matrix framework, from organizing a panel for a target neurotechnology to facilitating stakeholder discussion through public hearings. This framework will enable meaningful integration of neuroscience and neuroethics to promote responsible innovation in neuroscience and neurotechnology.

Human Brain Organoids in Migraine Research: Pathogenesis and Drug Development

Human organoids are small, self-organized, three-dimensional (3D) tissue cultures that have started to revolutionize medical science in terms of understanding disease, testing pharmacologically active compounds, and offering novel ways to treat disease. Organoids of the liver, kidney, intestine, lung, and brain have been developed in recent years. Human brain organoids are used for understanding pathogenesis and investigating therapeutic options for neurodevelopmental, neuropsychiatric, neurodegenerative, and neurological disorders. Theoretically, several brain disorders can be modeled with the aid of human brain organoids, and hence the potential exists for understanding migraine pathogenesis and its treatment with the aid of brain organoids. Migraine is considered a brain disorder with neurological and non-neurological abnormalities and symptoms. Both genetic and environmental factors play essential roles in migraine pathogenesis and its clinical manifestations. Several types of migraines are classified, for example, migraines with and without aura, and human brain organoids can be developed from patients with these types of migraines to study genetic factors (e.g., channelopathy in calcium channels) and environmental stressors (e.g., chemical and mechanical). In these models, drug candidates for therapeutic purposes can also be tested. Here, the potential and limitations of human brain organoids for studying migraine pathogenesis and its treatment are communicated to generate motivation and stimulate curiosity for further research. This must, however, be considered alongside the complexity of the concept of brain organoids and the neuroethical aspects of the topic. Interested researchers are invited to join the network for protocol development and testing the hypothesis presented here.

Emerging Subspecialties in Neurology: Neuroethics: An Emerging Career Path in Neurology

Essential to responsible practice and progress in neurology and neuroscience research is robust engagement with associated ethical dimensions and challenges. By virtue of the privileged relationship between personhood and the brain, and the importance of properties of the nervous system to what for most makes life worth living, conditions that affect neurologic function introduce a growing host of novel ethical and philosophical issues. Rather than serving a reactionary role, it is important for neurologists to anticipate such issues and develop familiarity with ethical analysis to inform quality medical practice and to safeguard neuroscience research. The field of neuroethics is an emerging career path devoted to identifying and evaluating such issues with the aim of informing optimal clinical practice and responsible neuroscience research. This article describes the past, present, and future of neuroethics, informed by an interview with one of the field's key founders and luminaries, Dr. James Bernat, with specific focus on training and career opportunities for neurologists in training.

Ethical Considerations in Clinical Trials for Disorders of Consciousness

As the clinical trial landscape for patients with disorders of consciousness (DoC) expands, consideration of associated ethical challenges and opportunities is of ever-increasing importance. Responsible conduct of research in the vulnerable population of persons with DoC, including those with coma, vegetative state/unresponsive wakefulness syndrome (VS/UWS), minimally conscious state (MCS), covert cortical processing (CCP), and cognitive motor dissociation (CMD), demands proactive deliberation of unique ethical issues that may arise and the adoption of robust protections to safeguard patients, surrogates, and other key stakeholders. Here we identify and critically evaluate four central categories of ethical considerations in clinical trials involving participants with DoC: (1) autonomy, respect for persons and informed consent of individuals with liminal consciousness; (2) balancing unknown benefits and risks, especially considering the epistemological gap between behavior and consciousness that complicates ordinary ascription of subjective states; (3) disclosure to surrogates and clinical teams of investigational results pertaining to consciousness; and (4) justice considerations, including equitable access to clinical trial enrollment across communities and geographies. We outline guiding principles and research opportunities for clinicians, neuroethicists, and researchers engaged in DoC clinical trials to advance ethical study design and deployment in this complex yet crucial area of investigation.

Neuroethics in the Era of Teleneurology

The accelerating integration of telehealth technologies in neurology practice has transformed traditional interactions between neurologists and patients, allied clinicians and society. Despite the immense promise of these technologies to improve systems of neurological care, the infusion of telehealth technologies into neurology practice introduces a host of unique ethical challenges. Proactive consideration of the ethical dimensions of teleneurology and of the impact of these innovations on the field of neurology more generally can help to ensure responsible development and deployment across stages of implementation. Toward these ends, this article explores key ethical dimensions of teleneurology practice and policy, presents a normative framework for their consideration, and calls attention to underexplored questions ripe for further study at this evolving nexus of teleneurology and neuroethics. To promote successful and ethically resilient development of teleneurology across diverse contexts, clinicians, organizational leaders, and information technology specialists should work closely with neuroethicists with the common goal of identifying and rigorously assessing the trajectories and potential limits of teleneurology systems.

The neuroethics of disorders of consciousness: a brief history of evolving ideas

Neuroethical questions raised by recent advances in the diagnosis and treatment of disorders of consciousness are rapidly expanding, increasingly relevant, and yet underexplored. The aim of this thematic review is to provide a clinically applicable framework for understanding the current taxonomy of disorders of consciousness and to propose an approach to identifying and critically evaluating actionable neuroethical issues that are frequently encountered in research and clinical care for this vulnerable population. Increased awareness of these issues and clarity about opportunities for optimizing ethically-responsible care in this domain are especially timely given recent surges in critically ill patients with unusually prolonged disorders of consciousness associated with coronavirus disease 2019 (COVID-19) around the world. We begin with an overview of the field of neuroethics: what it is, its history and evolution in the context of biomedical ethics at large. We then explore nomenclature used in disorders of consciousness, covering categories proposed by the American Academy of Neurology, the American Congress of Rehabilitation Medicine, and the National Institute on Disability, Independent Living, and Rehabilitation Research, including definitions of terms such as coma, the vegetative state, unresponsive wakefulness syndrome, minimally conscious state, covert consciousness, and the confusional state. We discuss why these definitions matter, and why there has been such evolution in this nosology over the years, from Jennett and Plum in 1972 to the Multi-Society Task Force in 1994, the Aspen Working Group in 2002 and up until the 2018 American and 2020 European Disorders of Consciousness guidelines. We then move to a discussion of clinical aspects of disorders of consciousness, the natural history of recovery, and ethical issues that arise within the context of caring for persons with disorders of consciousness. We conclude with a discussion of key challenges associated with assessing residual consciousness in disorders of consciousness, potential solutions and future directions, including integration of crucial disability rights perspectives.

Electrocorticography During Deep Brain Stimulation Surgery: Safety Experience From 4 Centers Within the National Institute of Neurological Disorders and Stroke Research Opportunities in Human Consortium

BACKGROUND

Intraoperative research during deep brain stimulation (DBS) surgery has enabled major advances in understanding movement disorders pathophysiology and potential mechanisms for therapeutic benefit. In particular, over the last decade, recording electrocorticography (ECoG) from the cortical surface, simultaneously with subcortical recordings, has become an important research tool for assessing basal ganglia-thalamocortical circuit physiology.

OBJECTIVE

To provide confirmation of the safety of performing ECoG during DBS surgery, using data from centers involved in 2 BRAIN (Brain Research through Advancing Innovative Neurotechnologies) Initiative-funded basic human neuroscience projects.

METHODS

Data were collected separately at 4 centers. The primary endpoint was complication rate, defined as any intraoperative event, infection, or postoperative magnetic resonance imaging abnormality requiring clinical follow-up. Complication rates for explanatory variables were compared using point biserial correlations and Fisher exact tests.

RESULTS

A total of 367 DBS surgeries involving ECoG were reviewed. No cortical hemorrhages were observed. Seven complications occurred: 4 intraparenchymal hemorrhages and 3 infections (complication rate of 1.91%; CI = 0.77%-3.89%). The placement of 2 separate ECoG research electrodes through a single burr hole (84 cases) did not result in a significantly different rate of complications, compared to placement of a single electrode (3.6% vs 1.5%; P = .4). Research data were obtained successfully in 350 surgeries (95.4%).

CONCLUSION

Combined with the single report previously available, which described no ECoG-related complications in a single-center cohort of 200 cases, these findings suggest that research ECOG during DBS surgery did not significantly alter complication rates.

Evolution of the Research Literature and the Scientific Community of Alzheimer's Disease from 1983-2017: A 35-Year Survey

This study surveys the development of Alzheimer's disease (AD) in the research literature, the scientific community, and the journals containing AD papers over a 35-year period. Research papers on AD published from 1983 to 2017 in journals indexed in the Web of Science were analyzed in seven five-year periods. The number of AD papers increased from 1,095 in 1983-1987 to 50,532 by 2013-2017 and in the same time period, the number of participating countries went from 27 to 152. The US was the most prolific country throughout, followed by several European countries, Canada, Australia, and Japan. Asian countries have emerged and by 2013-2017, China surpassed all but the US in productivity. Countries in Latin America and Africa have also contributed to AD research. Additionally, several new non-governmental institutions (e.g., ADNI, ADI) have emerged and now play a key role in the fight against AD. Likewise the AD scientific publishing universe evolved in various aspects: an increase in number of journals containing AD papers (227 journals in 1983-1987 to 3,257 in 2013-2017); appearance of several AD-focused journals, e.g., Alzheimer's & Dementia, Journal of Alzheimer's Disease; and the development of special issues dedicated to AD. Our paper complements the numerous extant papers on theoretical and clinical aspects of AD and provides a description of the research landscape of the countries and journals contributing papers related to AD.

Real-Time Simulation of a Cerebellar Scaffold Model on Graphics Processing Units

Large-scale simulation of detailed computational models of neuronal microcircuits plays a prominent role in reproducing and predicting the dynamics of the microcircuits. To reconstruct a microcircuit, one must choose neuron and synapse models, placements, connectivity, and numerical simulation methods according to anatomical and physiological constraints. For reconstruction and refinement, it is useful to be able to replace one module easily while leaving the others as they are. One way to achieve this is via a scaffolding approach, in which a simulation code is built on independent modules for placements, connections, and network simulations. Owing to the modularity of functions, this approach enables researchers to improve the performance of the entire simulation by simply replacing a problematic module with an improved one. Casali et al. (2019) developed a spiking network model of the cerebellar microcircuit using this approach, and while it reproduces electrophysiological properties of cerebellar neurons, it takes too much computational time. Here, we followed this scaffolding approach and replaced the simulation module with an accelerated version on graphics processing units (GPUs). Our cerebellar scaffold model ran roughly 100 times faster than the original version. In fact, our model is able to run faster than real time, with good weak and strong scaling properties. To demonstrate an application of real-time simulation, we implemented synaptic plasticity mechanisms at parallel fiber-Purkinje cell synapses, and carried out simulation of behavioral experiments known as gain adaptation of optokinetic response. We confirmed that the computer simulation reproduced experimental findings while being completed in real time. Actually, a computer simulation for 2 s of the biological time completed within 750 ms. These results suggest that the scaffolding approach is a promising concept for gradual development and refactoring of simulation codes for large-scale elaborate microcircuits. Moreover, a real-time version of the cerebellar scaffold model, which is enabled by parallel computing technology owing to GPUs, may be useful for large-scale simulations and engineering applications that require real-time signal processing and motor control.

Human-scale Brain Simulation via Supercomputer: A Case Study on the Cerebellum

Performance of supercomputers has been steadily and exponentially increasing for the past 20 years, and is expected to increase further. This unprecedented computational power enables us to build and simulate large-scale neural network models composed of tens of billions of neurons and tens of trillions of synapses with detailed anatomical connections and realistic physiological parameters. Such "human-scale" brain simulation could be considered a milestone in computational neuroscience and even in general neuroscience. Towards this milestone, it is mandatory to introduce modern high-performance computing technology into neuroscience research. In this article, we provide an introductory landscape about large-scale brain simulation on supercomputers from the viewpoints of computational neuroscience and modern high-performance computing technology for specialists in experimental as well as computational neurosciences. This introduction to modeling and simulation methods is followed by a review of various representative large-scale simulation studies conducted to date. Then, we direct our attention to the cerebellum, with a review of more simulation studies specific to that region. Furthermore, we present recent simulation results of a human-scale cerebellar network model composed of 86 billion neurons on the Japanese flagship supercomputer K (now retired). Finally, we discuss the necessity and importance of human-scale brain simulation, and suggest future directions of such large-scale brain simulation research.

The promise of the BRAIN initiative: NIH strategies for understanding neural circuit function

New neurotechnologies fueled by the BRAIN Initiative now allow investigators to map, monitor and modulate complex neural circuits, enabling the pursuit of research questions previously considered unapproachable. Yet it is the convergence of molecular neuroscience with the new systems neuroscience that promises the greatest future advances. This is particularly true for our understanding of nervous system disorders, some of which have known molecular drivers or pathology but result in unknown perturbations in circuit function. NIH-supported research on "BRAIN Circuits" programs integrate experimental, analytic, and theoretical capabilities for analysis of specific neural circuits and their contributions to perceptions, motivations, and actions. In this review, we describe the BRAIN priority areas, review our strategy for balancing early feasibility with mature projects, and the balance of individual with team science for this 'BRAIN Circuits' program. We also highlight the diverse portfolio of techniques, species, and neural systems represented in these projects.

Developing Collaborative Platforms to Advance Neurotechnology and Its Translation

Neurotechnological devices are failing to deliver on their therapeutic promise because of the time it takes to translate them from bench to clinic. In this Perspective, we reflect on lessons learned from medical device successes and failures and consider how such lessons might shape a strategic vision for translating neurotechnologies in the future. We articulate how the intentional design and deployment of "scientific platforms," from the technology stack of hardware and software through the supporting ecosystem, could catalyze a new wave of innovation, discovery, and therapy. We also identify specific actions that could promote future neurotechnology roadmaps and industrial-academic-government collaborative activities. We believe that community-supported neurotechnology platforms will prove to be transformational in accelerating ideas from bench to bedside, maximizing scientific discovery and improving patient care.

Simultaneous cortical and subcortical recordings in humans with movement disorders: Acute and chronic paradigms

Invasive basal ganglia recordings in humans have significantly advanced our understanding of the neurophysiology of movement disorders. A recent technical advance has been the addition of electrocorticography to basal ganglia recording, for evaluating distributed motor networks. Here we review the rationale, results, and ethics of this multisite recording technique in movement disorders, as well as its application in chronic recording paradigms utilizing implantable neural interfaces that include a sensing function.

Insiders and Outsiders: Lessons for Neuroethics from the History of Bioethics

Recent disputes over the NIH Neuroethics Roadmap have revealed underlying tensions between neuroethics and the broader neuroscience community. These controversies should spur neuroethicists to more clearly articulate an oft-cited ideal of "integrating" neuroethics in neuroscience. In this, it is useful to consider the integration of bioethics in medical practice as both historical precedent and context for integration in neuroethics. Bioethics began as interdisciplinary scholars joined biomedical institutions to serve on newly-created IRBs and hospital ethics committees. These early bioethicists identified as outsiders and their presence was initially resisted by some in the medical establishment, but over time they became integrated into the very institutions that many had originally come to critique. This work has transformed medical practice, but also required compromises and intellectual costs. Also, the successful integration of bioethics relied in part on structural features of postwar medicine with no clear analogue in contemporary neuroscience; for neuroethics, imaginative new approaches will also be needed. While neuroethics to date has focused somewhat narrowly on questions in neurotechnology, I argue that successful integration in neuroethics will likely require a broader vision, encompassing the clinical neurosciences as well as questions at the interface of neuroscience and society.