Cyborg psychiatry to ensure agency and autonomy in mental disorders. A proposal for neuromodulation therapeutics.

Cyborg psychiatry to ensure agency and autonomy in mental disorders. A proposal for neuromodulation therapeutics.
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机器人精神病学以确保精神障碍的代理和自治。神经调节疗法的建议。

DOI:
10.3389/fnhum.2013.00463
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发表时间:
2013
影响因子:
2.9
通讯作者:
Dumas G
Dumas G
中科院分区:
医学3区
文献类型:
--
作者:
Micoulaud-Franchi JA;Fond G;Dumas G

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神经调节疗法,如反复经颅磁刺激(rTMS)和神经反馈,是精神病学的宝贵工具。然而,他们目前面临着一些限制:rTMS对神经激活模式有混淆作用,神经反馈在某些情况下无法改变神经动力学。在这里,我们提出了如何耦合rTMS和神经反馈可以解决这两个问题,在rTMS过程中适应神经激活和神经反馈过程中积极引导个人。因此,算法的挑战在于设计适当的记录、处理、反馈和控制不必要的效果。但这种新的神经调节技术也带来了伦理挑战:确保治疗发生在医学的生物心理社会模型中,同时考虑患者和精神科医生之间的互动,以及维护个人的自主性。我们的解决方案是Cyborg精神病学的概念,它体现了技术,包括患者和神经调节设备之间的自我参与互动。
Neuromodulation therapeutics—as repeated Transcranial Magnetic Stimulation (rTMS) and neurofeedback—are valuable tools for psychiatry. Nevertheless, they currently face some limitations: rTMS has confounding effects on neural activation patterns, and neurofeedback fails to change neural dynamics in some cases. Here we propose how coupling rTMS and neurofeedback can tackle both issues by adapting neural activations during rTMS and actively guiding individuals during neurofeedback. An algorithmic challenge then consists in designing the proper recording, processing, feedback, and control of unwanted effects. But this new neuromodulation technique also poses an ethical challenge: ensuring treatment occurs within a biopsychosocial model of medicine, while considering both the interaction between the patients and the psychiatrist, and the maintenance of individuals' autonomy. Our solution is the concept of Cyborg psychiatry, which embodies the technique and includes a self-engaged interaction between patients and the neuromodulation device.
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