A wide variety of interventions can change cognitive function. Some are behavioural, including exercise, meditation, sleep hygiene or cognitive training. More targeted approaches include drugs and nutritional supplements, such as the attention-boosting drugs methylphenidate and modafinil, initially developed to treat cognition-limiting disorders. At present, however, the most widely discussed strategies involve brain stimulation via electromagnetic fields: transcranial magnetic stimulation (TMS), transcranial direct-current stimulation (tDCS) and deep brain stimulation (DBS).

Future Horizons:

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5-yearhorizon

Brain-stimulation devices proliferate

Next-generation implants from a variety of companies are in human trials, allowing for simultaneous recording and stimulation in multiple regions across the brain. More electrode designs are approved for use in humans, including Stentrodes²³ and Neuropixels.²⁴ A DBS trial for Alzheimer’s sheds light on which brain areas are best for implantation. Edge computing aids processing on closed-loop devices, hastening the acquisition of clinical neurological data. Wearable EEG devices enhance the depth and quality of sleep.

10-yearhorizon

Miniaturisation drives wider adoption of cognitive modulation

Aided by AI, miniaturisation and brain-based chip design, safer closed-loop implanted devices treat an increasing variety of disorders including depression. It becomes possible to identify areas of the brain where electrical stimulation gives healthy people a boost in memory capacity.

25-yearhorizon

AI improves recovery from trauma

AI-enabled closed-loop systems are used to modulate brain signals that arise as a result of injury or disease, helping to reduce problematic symptoms. In some cases, patients are able to work with an AI system to retrain their brain so that it returns to its previous functionality.

tDCS and TMS have been shown to enhance certain cognitive functions, such as episodic memory in older adults.¹⁷¹⁸ DBS, which has been successful for Parkinson’s and obsessive-compulsive disorder, has also alleviated some symptoms of Alzheimer’s disease in some participants in a small clinical trial.¹⁹ Other penetrating electrical brain implants are mooted to provide prosthetic memories for people with traumatic brain injuries.²⁰

Further progress will come with “adaptive closed-loop systems”. These can read and decode brain signals, and respond by making decisions — often aided by AI — to engage stimulation in order to override, dampen or amplify a particular signal.²¹ Better materials,²² implantation devices and methods are under development.

Neuromodulation systems - Anticipation Scores

The Anticipation Potential of a research field is determined by the capacity for impactful action in the present, considering possible future transformative breakthroughs in a field over a 25-year outlook. A field with a high Anticipation Potential, therefore, combines the potential range of future transformative possibilities engendered by a research area with a wide field of opportunities for action in the present. We asked researchers in the field to anticipate:

The uncertainty related to future science breakthroughs in the field
The transformative effect anticipated breakthroughs may have on research and society
The scope for action in the present in relation to anticipated breakthroughs.

This chart represents a summary of their responses to each of these elements, which when combined, provide the Anticipation Potential for the topic. See methodology for more information.