COMMENTARY

January/February 2004: Mind Over Matter -- How Human Nature Will Save Us From Ourselves

Priscilla Scherer

Disclosures

February 10, 2004

Neuroscience has been all over the news lately. Neuromarketing, neurogenesis, stem cells, and an interface between computer cursors and thought: The final weeks of 2003 forecast astonishing progress in our ability to see into the brain, manipulate it, regenerate it, and use it in a variety of scenarios. After decades of germination, seed science appears to be bearing fruit.

Neural grafting, neural repair, and neural transplantation for stroke, epilepsy, Alzheimer's, Parkinson's, and spinal cord injury are becoming reality. Indeed, if diagnosed in utero, some neurodevelopmental disorders (eg, cerebral palsies) may be prevented by intraventricular introduction of stem cells via viral vectors into the developing brain. Even closer to reality are clinical trials delivering neural cells to the site of acute spinal cord injuries to stimulate neural repair and prevent or reverse paralysis.

And for those with long-standing spinal cord injury, or those who are "locked in," or aphasic, or suffering from ALS, or otherwise impaired, there is the brain-computer interface (BCI), whereby just thinking hard about clicking a mouse or tapping a computer keyboard is transmitted with or without wires to the computer, allowing the paralyzed to surf the Web and the locked-in to communicate, among other things. Thus, just as our mothers told us, we learn how powerful and smart we really can be if we just set our minds to it.

Maybe too smart for our own good, to quote another motherism. Neuroscientists are also teaming up with marketers to pinpoint and manipulate the brain locus that embraces product. It seems they will have but to tickle that neuroanatomical spot to make one product the preferred product that we consumers will be compelled to buy, buy, buy. Or, coming at it from the other side, learning what kinds of things tickle that spot, the colors and words and images that make me and you embrace Medscape instead of Fast Eddie's Medical Information Homepage as a reliable site for information may enable marketers to feed us the kinds of things that will compel us to embrace Fast Eddie's after all.

I read about this partnership with some initial horror that marketing manipulation had become so scientific and sophisticated, and neuroscientists were deeply involved in the process. At centers throughout the world, neuroscientists are studying the "buy buttons" in the brain, most purely out of intellectual curiosity, but some with other, less pure motives. The Mind of the Market Laboratory at the Harvard Business School is underwritten by various corporations; researchers there conduct brain-business research and share results with, yes, the lab's corporate sponsors. The BrightHouse Institute for Thought Sciences is a neuromarketing firm with offices in the neuroscience wing at Emory University Hospital in Atlanta. "You are going to see more large companies that will have neuroscience divisions," said Clinton Kilts, professor of psychiatry and behavioral sciences at Emory and scientific director of BrightHouse, to the New York Times' Clive Thompson.

These neuromarketing pioneers are enthusiastic and brightly optimistic about the implications. In a Canadian Broadcasting Company interview last year, Adam Koval, another BrightHouse executive, claimed that neuromarketing "will actually result in higher product sales or in brand preference or in getting customers to behave in the way they want them to behave." Oh, goody. Just what we consumers need.

Of course, behavioral manipulation has been going on for a long time in advertising. These experts are insightful and clever -- why else would you introduce products to happy, relaxed, vacationers in the mood to spend, unless you want to trigger that happy, relaxed, consuming association with your product the rest of the year? And why else are smokers portrayed as gorgeous, glowing, pink-cheeked, happy, and relaxed? But getting us to behave exactly the way "they" want us to behave? I think we're more complex than neuromarketers are giving us credit for.

Because with all these other neuroscience advances, along comes Nicholas Schiff, an assistant professor at Weill-Cornell Medical College in New York, with a big surprise -- we don't know as much as we thought about what's going on inside those skulls of ours. Schiff and Joy Hirsch, from Columbia-Presbyterian, used PET to look for brain activity that might indicate cognition in patients in the persistent vegetative state (PVS).

PVS has always been puzzling, at least for those of us who are neuroscientifically naive and basically hopeful about consciousness. For us, it's hard to believe that it's all projection when a person smiles when a nurse cracks a joke, and weeps when her grandson says goodbye, and looks you deep in the eyes when you talk to him. We've always believed that it was at least possible that there was intelligence in those brains, some higher functioning, but something was interfering with its expression.

According to Schiff and Hirsch, even the vegetative state is more nuanced than previously thought. Some patients are, indeed, "minimally conscious," and structures deep inside their brains are responding as mine does to things like familiar conversation, music, TV shows. Despite the patient's inability to follow commands or communicate, the cortical networks for language comprehension are "hearing." So they seem to be somewhere between locked-in and comatose, with a less predictable wakefulness than the "locked-in."

It may seem to be an unlikely leap, from PVS to neuromarketing, but nonetheless, that is why I am not so concerned about marketers pushing my "buy button" -- because I think human beings and our thoughts, desires, motives, preferences, natures, indeed our brains, are a lot more complex than anyone can know now, and perhaps ever. And our buy buttons, if they do exist, may not be so easily and reliably pushed. With so much progress in 2003, I can't wait to see what happens in neuroscience in 2004, and ahead.

If you have comments or questions about this editorial or the Neurology & Neurosurgery site, please contact me at neuroeditor@webmd.net.

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