Furrer Rémy A, Merner Amanda R, Stevens Ian, Zuk Peter, Williamson Theresa, Shen Francis X, Lázaro-Muñoz Gabriel
medRxiv. 2024 Jun 10:2024.06.09.24308176. doi: 10.1101/2024.06.09.24308176.
Advances in the development of neurotechnologies have the potential to revolutionize treatment of brain-based conditions. However, a critical concern revolves around the willingness of the public to embrace these technologies, especially considering the tumultuous histories of certain neurosurgical interventions. Therefore, examining public attitudes is paramount to uncovering potential barriers to adoption ensuring ethically sound innovation.
In the present study, we investigate public attitudes towards the use of four neurotechnologies (within-subjects conditions): deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), pills, and MRI-guided focused ultrasound (MRgFUS) as potential treatments to a person experiencing either mood, memory, or motor symptoms (between-subjects conditions). US-based participants (N=1052; stratified to be nationally representative based on sex, race, age) were asked about their perceptions of risk, benefit, invasiveness, acceptability, perceived change to the person, and personal interest in using these neurotechnologies for symptom alleviation.
Descriptive results indicate variability between technologies that the U.S. public is willing to consider if experiencing severe mood, memory, or motor symptoms. The main effect of neurotechnology revealed DBS was viewed as the most invasive and risky treatment and was perceived to lead to the greatest change to who someone is as a person. DBS was also viewed as least likely to be personally used and least acceptable for use by others. When examining the main effects of symptomatology, we found that all forms of neuromodulation were perceived as significantly more beneficial, acceptable, and likely to be used by participants for motor symptoms, followed by memory symptoms, and lastly mood symptoms. Neuromodulation (averaging across neurotechnologies) was perceived as significantly riskier, more invasive, and leading to a greater change to person for mood versus motor symptoms; however, memory and motor symptoms were perceived similarly with respect to risk, invasiveness, and change to person.
These results suggest that the public views neuromodulatory approaches that require surgery (i.e., DBS and MRgFUS) as riskier, more invasive, and less acceptable than those that do not. Further, findings suggest individuals may be more reluctant to alter or treat psychological symptoms with neuromodulation compared to physical symptoms.
神经技术的发展进步有可能彻底改变基于大脑疾病的治疗方式。然而,一个关键问题围绕着公众接受这些技术的意愿,尤其是考虑到某些神经外科干预措施动荡的历史。因此,审视公众态度对于发现采用这些技术的潜在障碍、确保符合伦理的创新至关重要。
在本研究中,我们调查了公众对四种神经技术(受试者内条件)的态度:深部脑刺激(DBS)、经颅磁刺激(TMS)、药物以及磁共振成像引导聚焦超声(MRgFUS),将其作为治疗出现情绪、记忆或运动症状的人的潜在方法(受试者间条件)。询问了美国参与者(N = 1052;根据性别、种族、年龄分层以具有全国代表性)关于他们对风险、益处、侵入性、可接受性、对患者的感知变化以及使用这些神经技术缓解症状的个人兴趣的看法。
描述性结果表明,如果出现严重情绪、记忆或运动症状,美国公众愿意考虑的技术之间存在差异。神经技术的主效应显示DBS被视为侵入性最强、风险最高的治疗方法,并且被认为会给一个人的本质带来最大的改变。DBS也被视为个人使用可能性最小且他人使用接受度最低的方法。在研究症状学的主效应时,我们发现所有形式的神经调节对于运动症状而言,被参与者认为明显更有益、更可接受且更有可能被使用,其次是记忆症状,最后是情绪症状。神经调节(对各种神经技术进行平均)对于情绪症状而言,被认为比运动症状风险显著更高、侵入性更强且会给患者带来更大的改变;然而,在风险、侵入性和对患者的改变方面,记忆症状和运动症状被认为相似。
这些结果表明,公众认为需要手术的神经调节方法(即DBS和MRgFUS)比不需要手术的方法风险更高、侵入性更强且可接受性更低。此外,研究结果表明与身体症状相比,个体可能更不愿意用神经调节来改变或治疗心理症状。