Brainiacs or Cognitive Enhancers

Cognitive Enhancement is often defined as the effort to increase the performance of cognitive function like attention & concentration, memory, problem-solving in healthy individuals.
While every species including humans have consistently and continuously evolved day by day to improve themselves. However, using medications and technological advances in increasing cognitive functions is a relatively new aspect and is a matter of debate on the ground of ethical, philosophical and sociopolitical.

Nonpharmacological cognitive enhancers

• Physical exercise

Both aerobic and anaerobic exercise has been reported to improve cognitive functions. The proposed mechanism involves increased volume, connectivity and blood flow in the hippocampus and increased efficiency of brain area concerned with cognitive function.

• Sleep

A good sleep especially REM (Rapid Eye Movement) part enhances cognitive function as compared to sleep-deprived persons.

Meditation, Yoga and music may enhance cognitive functions like attention, executive function and general cognition.

• Caffeine

 

It is a well known and most used cognitive enhancer. However, it commonly associated with side effects like irritability, palpitation, headache and insomnia. More severe one are chest pain, tachycardia and arrhythmias. The excessive use of caffeine results irritability in children. That why its use in children is restricted.

• Brain training or cognitive training

Brain training or cognitive training is a process that uses intense mental exercises to enhance cognitive skills like attention, short term and long term memory, logic and reasoning, decision making etc.
It can be helpful in slowing the cognitive decline in elderly. its benefits are also seen in children suffering from ADHD and dyslexia.

• Transcranial Magnetic Stimulation (TMS)

A non-invasive technique used to stimulate brain areas. Benefits depend on which area is stimulated. areasrTMSBrain stimulation approaches. It has been shown that TMS improves cognitive functions like verbal fluency, visual-spatial attention, and analogic reasoning speed.

Pharmacological

Here it’s very important to understand that use of medications is off-label and there is a little evidence of efficacy.

Psychostimulants include Methylphenidate and dextroamphetamine. These are commonly used to treat ADHD, Narcolepsy, fatigue associated with cancer, and in depression as an augmentation strategy.
However, they have side effects like decreased appetite and weight, insomnia, headache, irritability, and mood changes, palpitations, tachycardia, and potential of abuse. Analysis of current literature suggests no or little evidence except slight positive effect on memory. So, use of psychostimulant to enhance cognitive function should be used cautiously keeping in mind the potential side effects caused by them.

Modafinil a wake-promoting agent that has been mainly used by the healthy individual like students, academics and physician. It is also used to treat ADHD and narcolepsy however it has life-threatening side effects in children, that’s why FDA did not approve it for ADHD.
Reseach has shown a moderate effect of Modafinil on attention in well-rested individual and more pronounced in sleep-deprived individuals which might be due to “overconfidence” effect.

Other medications like Cholinesterase inhibitors and the NMDA antagonist memantine have shows no consistent effect even they are well tolerated.

Ethical issues

Individuals suffering from ADHD or Narcolepsy are compelled to take the stimulant to maintain pace with their peers. However, use in the healthy individual has complicated issues. As cognitive enhancer increased productivity in some profession in which sustained concentration is required, the risk of abuse or potential side effects like weight losses, the cardiac risk may outweigh the potential benefits. Finally, they predispose the individuals to the risk of substance use.