Researcher Views on Changes in Personality, Mood, and Behavior in Next-Generation Deep Brain Stimulation

Abstract

The literature on deep brain stimulation (DBS) and adaptive DBS (aDBS) raises concerns that these technologies may affect personality, mood, and behavior. We conducted semi-structured interviews with researchers (n = 23) involved in developing next-generation DBS systems, exploring their perspectives on ethics and policy topics including whether DBS/aDBS can cause such changes. The majority of researchers reported being aware of personality, mood, or behavioral (PMB) changes in recipients of DBS/aDBS. Researchers offered varying estimates of the frequency of PMB changes. A smaller majority reported changes in personality specifically. Some expressed reservations about the scientific status of the term ‘personality,’ while others used it freely. Most researchers discussed negative PMB changes, but a majority said that DBS/aDBS can also result in positive changes. Several researchers viewed positive PMB changes as part of the therapeutic goal in psychiatric applications of DBS/aDBS. Finally, several discussed potential causes of PMB changes other than the device itself.

Keywords:

• Neuroethics
• deep brain stimulation
• personality changes
• anger/impulsive behavior
• psychiatric disorders
• movement disorders

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Notes

1 de Haan et al. (2017, 8) note that patients feeling more authentic (i.e., “more themselves”) could in principle be negative, as a behavior could be judged negatively yet still “experienced as expressive of one's authentic self.” Despite this possibility, the feelings of greater authenticity experienced by de Haan et al.’s patients seem to have been primarily positive (de Haan et al. 2017, 21–22). We thank an anonymous reviewer for drawing our attention to this important conceptual point.

2 Furthermore, some theorists (Baylis 2013; Gallagher 2021; Goddard 2017) have for this reason adopted relational accounts of identity and/or agency. We thank an anonymous reviewer for drawing our attention to this connection.

3 We thank an anonymous reviewer for encouraging us to expand on this point.

4 The language of “core” features of a person used by one researcher suggests an essentialist as opposed to dynamic view of self (see Pugh 2020 for an overview). For most other researchers interviewed, it was unclear where they might stand on this conceptual issue. Arriving at a consensus understanding of personality among researchers may require investigating to what extent they have committed views on the issue of essentialism vs. dynamism. We thank an anonymous reviewer for raising this issue.

5 We thank an anonymous reviewer for raising this point.

6 See Pugh (2020, 1675–76) for discussion.

Additional information

Funding

The research for this article was funded by the BRAIN Initiative-National Institutes of Health (NIH), parent grant R01MH114854 and supplemental grant R01MH114854-01S1 (PIs Lázaro-Muñoz, McGuire, and Goodman). The views expressed are those of the authors and do not necessarily reflect views of the NIH, Harvard Medical School, Baylor College of Medicine, University of Puerto Rico, the University of California, San Francisco, or Massachusetts General Hospital.