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What if your brain showed signs of Alzheimer’s disease—decades before any symptoms occurred? Would you want to know? Alzheimer’s disease, which “can’t be slowed, stopped, or prevented,” is the sixth leading cause of death in the United States, according to the Alzheimer’s Association. Among older Americans, Alzheimer’s is more feared than any other disease, including cancer, stroke, heart disease, and diabetes. Research suggests that the molecular changes of Alzheimer’s disease and other dementias may occur up to two decades before symptoms appear. Clinicians are able to clarify diagnoses of Alzheimer’s disease using molecular “biomarkers” found through techniques such as lumbar punctures or molecular brain scans. Someday, these techniques could be applied to cognitively normal people to predict whether or not they’ll develop the disease. But should they? Professional societies have cautioned against this use, given the lack of proven treatments to prevent Alzheimer’s disease in cognitively normal individuals who test positive. Many of us would value knowing this health information, either in its own right or to help us plan for our futures. But society hasn’t caught up to living with a brain at risk. There are laws prohibiting employment insurance discrimination based on our genetic information; however these laws don’t apply to molecular biomarkers. Those who seek predictive testing may also face serious, unintended consequences from receiving this information.

In 1991, using powerful magnets and “sewer pipe, wire, epoxy, and finger tapping,”* a few research groups converged on the idea of utilizing the magnetic resonance properties of gray matter to image the active, thinking human brain—what the world now knows as functional magnetic resonance imaging (fMRI). Since then, cognitive neuroscience has developed apace, with an explosion of ingenious techniques and sophisticated tools. Each new advance is greeted with a chorus of scholarly and popular speculation on its potential application to other arenas of human endeavor. Discussions about the ‘promise of neuroscience’ are often tinged with a mixture of hope and fear. Nowhere is this ambivalence more evident than in the courts, as conjecture runs rampant about the legal impact of this research, stoked by claims that neuroscience may soon detect liars, objectively determine criminal responsibility, quantify suffering, and predict violence. But is neuroscience ready for courtroom use? Does brain imaging permit us to measure a person’s feelings, thoughts, and intentions? Can jurors understand and effectively weigh neuroscientific evidence? Please join host David Faigman along with Dr. Kent Kiehl of the University of New Mexico and Professor Amanda Pustilnik of the University of Maryland and Harvard University to discuss the fascinating and wide-ranging challenges posed by the use of contemporary neuroscience in the courtroom.

Peer inside the thinking brain, using state-of-the-art functional magnetic resonance imaging. Scientists Gary Glover and John Desmond of the Richard M. Lucas Center for Imaging at Stanford University conduct cognitive tests on an Exploratorium staffer. Imaging tools display the active areas of the brain in real time.