Sci-fi today: Transcranial Magnetic Stimulation

Let's talk about a modern neuro technology that could be a sci-fi writer's best friend.

Hi friends! Here we are once again on a Friday morning (where I am at least). For some of you, that means that it’s Sci-Friday. For others, it's just another Friday. Regardless, I wanted to take today to discuss something really cool I saw in science fiction that happens to be a current technology in its infancy that I think could be fun to see more of in the world of fiction. Before I delve into this, I want to divulge some of my credentials. I don’t talk about this often on substack, but I’m currently working on getting my doctorate in neuroscience. That does not make me an expert in what we’re about to discuss BUT I know a little more than the average person. That does not mean this will be perfect, but I’m really excited to share further information and I felt it would only be pertinent to share this so you didn’t think I was just spouting nonsense with unwarranted confidence. With that in mind, let's get on with it…

One of the things I love about sci-fi is how often people in the sciences can go ‘Hey, I recognize that!’ It’s a cool experience I never thought I would have. Sometimes neuroscience is overlooked in sci-fi, which is disappointing because the brain is a fantastic playground. More often than not, I find that the stuff that sneaks into sci-fi that’s related to the brain is so far removed from the truth that it hurts. See the movie Lucy. No you do not use only 10% of your brain. You do not need to unlock the other 90%. That’s like saying your car hasn’t unlocked its full potential because you don’t go forward and backwards simultaneously. Different functions just don’t occur at the same time. Anyway, that’s a personal gripe that I won’t be diving into today.

Instead, let’s talk about when interesting brain-related science does slide its way into sci-fi. Today I want to show you an interesting example, talk about its current real world applications, then give some ideas or concepts of how it could potentially be used. I hope it may inspire the writers amongst you to try using it yourselves in some sci-fi. Or maybe this is just some fun info-tainment for you. Either way, here is one of my favorite examples from an anthology book I recently read that takes place in The Expanse universe…

(Background: Paolo Cortazar is a scientist interviewing for a job with the company Protogen. During the interview his potential boss, Dresden, asks him if he thinks it’s more ethical to test on humans or animals. When Cortazar hesitates in his reply, Dresden asks him to take part in a voluntary test as part of his interview.) 

Before I could act on my fear, the doctor leaned in close to me. She smelled of lilacs. “You might feel a little odd,” she said. “Can you please count backward from twenty?”

I did, the autodoc clicking and shifting on the wall as the numbers grew smaller and smaller. At twelve I stuttered, lost myself. The doctor said something, but I couldn’t make sense of her words or find any of my own. Dresden answered her, and the ticking stopped. The doctor smiled at me. She had very kind eyes. Sometime later - a minute, an hour - language came back to me. Dresden was still there.

“The preliminary we’re doing here is magnetic. It suppresses some very specific, targeted areas of your brain. Reduces fixity. Some of our staff finds that it helps them see things they wouldn’t have otherwise.”

“It feels…”

“I know,” he said, tapping his temple. “I did it too.”

I sat up. A feeling of almost superhuman clarity washed through me. A calm like the sea after a storm smoothed my muscles. It was better than all the drugs I’d taken at the university - the focus of the nootropics, the euphoria of sedatives. I remember thinking at the time ‘Ooh, this could get addictive.’ Whatever fear I might have felt no longer seemed important.

“It’s nice,” I said.

“So tell me,” he said. “Is animal testing ethical? Or does it make more sense to skip to human trials?”

I blinked at him, and then I laughed…

-Memory’s Legion, The Vital Abyss by James S. A. Corey

So what happened here? Well, my experience in neurosciences made this very very familiar to me. Magnets? Clicking? Loss of speech? It reminded me of this:

Pretty cool, right? James S. A. Corey is implying here that in the future world of The Expanse the practice of Transcranial Magnetic Stimulation (TMS) is so advanced that not only can you use it to inhibit higher cognitive functioning, but also specific treatments can make this inhibition permanent. The attached video from the BBC is from 13 years ago, and TMS has come so far since then, so why not? In fact, I wouldn’t be surprised if it was further than Corey speculates by the couple hundred years into the future that The Expanse takes place in. That involves putting moral questions aside though. So now we see a rather interesting use of TMS in a published work of fiction, but how is TMS used today?

Quick note: There are many forms and uses of TMS out there. A single jolt of TMS is temporary, but repetitive TMS (rTMS) accelerated repetitive (arTMS) and others may include repetitive uses, continuous uses, or maybe even uses in reaction to something (such as with migraines) can show more long term effects. I will just be using the broad term of TMS for the sake of simplicity given that I’m not writing an academic review here. 

TMS has been approved for use with depression, OCD, nicotine addiction, and anxious depression disorder by the FDA. Outside of the US it has been approved for even more. I seem to recall seeing handheld devices that patients could potentially activate themselves to prevent migraines when they experienced a migraine aura, but I couldn’t find evidence of that while researching that article, so that could’ve been purely hypothetical when I saw it many years ago. Even if it is purely hypothetical, this is amazing stuff. This is all well and good, but I don’t want to get too deep into the woods of treatments. We’re here to talk about the sci-fi of it after all. 

So, when discussing what uses TMS has, I think we should first have a look at how it works exactly as per this helpful graphic from the Mayo clinic:

As we can see, you place the coil over a brain region, activate the coil, the coil begins to click as electric current passes through the apparatus and the magnetic field generates, and whatever region is being targeted becomes stimulated by the creation of a magnetic field. If it’s the part of your brain pathway associated with speaking, suddenly the words aren’t coming out right. If it’s the part of your brain associated with some form of motor functionality, you might not be able to walk quite right - or if you have erratic or dysfunctional motor neurons such as in Parkinson’s, there’s potential that a brief burst intermittently could lead to regulated movements. These are the basics of how we currently use TMS, an amazing thing that takes advantage of the natural electric currents in our brains. Now let’s get into the Sci-Fi of it.

So, we already know that Corey considered the unethical with disrupting higher cognitive functioning, but what if we used it to suppress stress response?

So, let’s circle back to the excerpt from The Vital Abyss. In this case, Corey is asserting that an advanced form of TMS hundreds of years in the future could be used to remove a person’s ability to have empathy in exchange for a willingness to do what the average person would consider morally dubious. In this case, Cortazar is taking on this loss of his higher emotional functionality in exchange for a willingness to pursue knowledge no matter the moral boundaries he needs to cross to do it. This is certainly an interesting use of the technology, but I want to explore what other uses TMS could have. Instead of using TMS for morally dubious reasons like performing human trials, what if we used it to improve a super soldier’s functionality. Let’s say for example… Oh, I don’t know…

Carson is a cybernetic super soldier, sent out into the neon night to track down a rogue droid. Carson, cyber soldier extraordinaire, finds the droid on a rooftop contemplating its own mortality, but he tells the affront to humanity that it needs to come with him for immediate reprogramming. Of course, our rogue droid tells Carson it just can’t do that and prepares to fight Carson.

Immediately, Carson’s heart rate increases, cortisol floods his body, traveling up into his brain, leading to a collection of regions lighting up in a panic ‘We’re in trouble we’re in trouble!’ This is a survival response. Luckily, the scientists back at the facility know that Carson is genetically predisposed to flight rather than fight when his sympathetic nervous system kicks in. Carson has a TMS regulator installed on his skull that activates in response to steroid receptors binding to cortisol in the brain. This specific TMS implant sits just right to negate the stress and anxiety response that may make him run away… or worse: freeze up. 

Now, Carson’s physiological response is completely uninhibited by fear. Instead, he can act thoughtfully and methodically. His cybernetic enhancements kick into action, the deep clicking sound he grew to recognize as a soothing rhythm against his skull click click clicking. His brain feels clarity. His perception slows around him as a magnetic field lights up his brain, allowing him to see and feel everything he needs to to react in time with his body’s cybernetic enhancements. The droid fires an arm mounted gun at Carson, and he dodges the volley, lunging for the droid. He throws himself at the droid, sending them both crashing down to the rain-soaked black asphalt below. The mechanical monster’s body bucks and fights beneath Carson, but it can’t stop him from deactivating its motor circuitry. The droid’s body pulses. Carson hears a strangely familiar clicking sound coming from the metallic cranium of the droid. The head flicks and twitches and the droid’s empty eyes become a plea of terror “What am I?” It asks Carson. He hesitates. His mind reeling at the sound. At the question. Then, click click click. His mind goes clear. His head no longer buzzes with the stress of the encounter.

“Agent 217, return Facility property and prepare for debriefing.” There wasn’t an option in the statement. It wasn’t what he was asked to do or told to do. It was what he was going to do. He didn’t know about this mod…

(Side note: I actually really liked this tropey cyber-noir I just pulled out of thin air and am now genuinely considering writing more for this story. Let me know if that’s something you’d be interested in in the comments!)

Of course, I took a lot of liberties with general physiology there, but that’s the fun of sci-fi! We create a modern day scaffold that we climb all over to tell our sci-fi story. 

I think one of the most important parts of this is that any action your brain can do, think about how it can be disrupted. Could you block off pain response by activating it just right? Could you use this to disrupt memory so that someone didn’t quite see what they thought they did? Instead of placing a bag over someone’s head, what if the space mob stuck one of these on the back of your skull and suddenly you're blind? Imagine if one of these was placed between the brain and the spinal cord. Activate it and the field disrupts your control of your own body. That’s a much scarier, much darker use of the ability, but if you like your sci-fi extra dark, that’s something worth thinking about. Something that is outside of our ability right now but doesn’t have to be in the world of sci-fi or the future though is using TMS to activate regions, not just deactivate. Many sources discuss ‘stimulation’, but that usually just leads to inhibiting something, but what if we activated something?

The possibilities are literally as endless as the functionality of your brain! TMS is a really cool, untapped augmentation that we can utilize in science fiction. I recall a lecturer once asking the class to imagine a world where if you had a mental illness, brain injury or cognitive dysfunction, you kept a handheld battery powered magnetic stimulation mechanism on your person. You could put it in the space your doctor prescribed you to, and you activate it. Things feel weird for a moment, maybe your head itches a tiny bit. Then, the pain is gone. Or your mind is clear. Or your vision clears up. 

Here’s some questions to consider if this is something that has stimulated your interest in using this item in sci-fi: How might TMS work a hundred years from now? A thousand years from now? How available are they? How common? Not only are the possibilities of the region impacted endless, but so is the way in which it is used. Is TMS used to help people? Control people? Imagine some sort of magic being who could control these currents with their hands. Imagine robots that could!

There’s so much to explore with TMS. I hope through this short discussion you have some interesting concepts to consider. I encourage you to check out the links below for more in depth information about TMS and more detail on the things I simplified or outright left out for the sake of brevity. I hope this gave you some insights into possible sci-fi ideas, or just an interesting topic you may not know much about. Thanks for checking in to my little corner of Substack!

Sources:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100715/

• https://www.mayoclinic.org/tests-procedures/transcranial-magnetic-stimulation/about/pac-20384625

• https://www.ncbi.nlm.nih.gov/pmc/?term=transcranial+magnetic+stimulation+and+review

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5567575/

• https://my.clevelandclinic.org/health/treatments/17827-transcranial-magnetic-stimulation-tms (I think this is the most interesting informational link that I read through in doing further research on this)

A very special thank you to my colleague, Mandy, who was so kind as to not only be an avid reader of my substack but also to proofread this and make sure I wasn’t spouting misinformation or that I didn’t leave anything too important out! Thank you Mandy!

Lastly, I want to thank the Sci-fi Soothsayers

Rachel LaDue

and

SDG Lemaître

who were supportive of this idea when I brought it up to them. I appreciate all the fun we have being nerdy scientists online and I look forward to more of it as we go!