Electrical brain stimulation for soldiers: a shot in the dark

German soldiers
Noninvasive brain stimulation could enhance the effectiveness of military training and improve the performance of soldiers on the battlefield, but its collateral effects on the mind are largely unknown. Photograph: public domain

Ever since the invention of the two-handed club, warfare and technology have been inextricably linked. More often than not, the humans who are sent into battle have been mere pawns in these hi-tech contests. So we shouldn’t be surprised if the military are eying up one of the most exciting new technologies in neuroscience, noninvasive brain stimulation (NIBS), which uses electrical or magnetic fields to remotely influence the activity of particular parts of the brain and could boost physical and mental performance.

A recent review of research involving NIBS found that it could improve attention, working memory, planning, “deceptive capacities”, precision, speed, strength and endurance. The effects were found to last anything from minutes to several months. The authors of the review, which was published last month in Frontiers in Neuroscience, suggest that the technology could become part of the training of military and security personnel.

Collateral damage

The journal has now published a response to that article, pointing out some ethical and practical dangers. Bernhard Sehm and Patrick Ragert from the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany, say we can’t guarantee that enhancing one cognitive function will not have an adverse effect on another, because the effects of NIBS may not be restricted to a particular brain region.  We also don’t know what the long-term consequences of brain stimulation would be for soldiers’ mental and physical wellbeing. For example, it can sometimes increase the risk of epileptic seizures.

Evidence that NIBS may have an important role to play for treating mental illness and memory loss keeps rolling in. A study published earlier this month suggests it can enhance memory in older people. But Sehm and Ragert argue that it is one thing to use NIBS in a clinical setting, where the balance of risks and benefits are more clearly in the patient’s favour and where potential long-term side-effects can be systematically checked, and quite another to apply it in a less controlled, military setting.

“In a clinical setting, patients are under close medical supervision and individually elected for specific treatments, based on a careful assessment of individual risks and benefits. In addition, due to a longitudinal medical monitoring, potential long-term changes may possibly be identified.”

Obeying orders

Could a soldier even be said to have given informed consent? Needless to say, the military culture is one of obeying orders without question. Saying ‘no’ to NIBS may not be an option.

“Do we want to take the risk of changing the brain processing in people who (i) potentially cannot make autonomous decisions concerning the application of NIBS and (ii) are responsible for their own lives as well as the lives of others?”

All the same arguments could be deployed against the use of drugs to enhance the performance of military personnel, for example stimulants that allow them to stay alert for longer in a combat situation. Can soldiers truly give their consent to taking such a drug? What might the unintended consequences be for them and for other people? The stimulant might be addictive. It might improve their reaction times, while at the same time suppressing their sense of responsibility and increasing their irritability levels – in other words making them more trigger-happy.

Smart drugs

Of course this particular genie has been out of the bottle for a very long time. Modafinil, which was developed to treat narcolepsy, is just the latest example of stimulants being used to enhance the performance of soldiers and military pilots. It has become widely used because its side-effects are minimal. In particular, if used carefully it doesn’t disrupt normal sleep, unlike amphetamines.

One would hope that if any military organisation was considering the use of noninvasive brain stimulation to boost the performance of troops, either in training or in the field, it would proceed with extreme caution, reviewing the scientific literature and carrying out its own thorough, ethically sound research. The stakes are very high, higher than for the general population using these new technologies, because of the highly stressful and incendiary environments in which troops operate and the weaponry at their disposal.

The drug Larium was banned by the US military after it was implicated in the apparently motiveless massacre of civilians in Afghanistan by Staff Sergeant Robert Bales in 2012. Britain’s Ministry of Defence has yet to ban the drug, despite evidence that it raises the risk of psychosis. British troops are still taking it.

Larium is an antimalarial, but its psychological effects are potentially catastrophic. The wider lessons are plain: tinkering with the minds of soldiers, whether with drugs or electrical/magnetic stimulation, should not be taken lightly.

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