Saturday, July 10, 2010

Cosmetic neurology

Cosmetic neurologyViews & Reviews Cosmetic neurology The controversy over enhancing movement, mentation, and mood Anjan Chatterjee, MD Abstract—Advances in cognitive neuroscience and neuropharmacology are yielding exciting treatments for neurologic diseases. Many of these treatments are also likely to have uses for people without disease. Here, I review the ways in which medicine might make bodies and brains function better by modulating motor, cognitive, and affective systems. These potential “quality of life” interventions raise ethical concerns, some related to the individual and

others related to society. Despite these concerns, I argue that major restraints on the development of cosmetic neurology are not likely. Neurologists and other clinicians are likely to encounter patient-consumers who view physicians as gatekeepers in their own pursuit of happiness. NEUROLOGY 2004;63:968–974 Are better brains better? Advances in basic neuro- science and neuropharmacology are beginning to yield therapies for cognitive disorders. While we ea- gerly anticipate treatments for dementing illnesses, stroke, traumatic brain injury, and developmental abnormalities, these very treatments raise uncom- fortable questions. If we can improve cognitive systems in disease, can we also do so in health? Should we? The possibility of “better brains” has captured the attention of the press, policy pundits, and ethi- cists. 1–10 With few exceptions, 11 neurologists have not contributed to these discussions, despite the fact that clinicians would be centrally involved as this drama unfolds. In this paper, I review the landscape of cos- metic neurology and offer preliminary speculations about its future. While cosmetic neurology certainly includes the use of botulinum toxin to brush away wrinkles, the focus here runs deeper. I start by con- sidering the purpose of medicine to frame the ethical dilemmas of cosmetic neurology. Then, I...

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