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Sport Enhancement: From Natural Doping to

Brain Stimulation

Article in International Journal of Technoethics · October 2014

DOI: 10.4018/ijt.2014070106

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 Sport Enhancement: from Natural Doping to Brain Stimulation
José Luis Pérez Triviño
(Universidad Pompeu Fabra, Barcelona)

Abstract

Doping, or in more morally neutral terms, enhancement, has always been present in sport prac-
tice and not only at the present time, which is marked by professionalism and competitiveness. The
latest development in doping seems linked to biotechnological advances, and one of the tech-
niques that will apparently be particularly important in the near future is neuroscience, notably
transcranial stimulators. These devices promise to improve not only physiological aspects in sport
performance, but also mental and emotional ones. On the other hand, they can seriously affect
sport ethics insofar as they can be economically accessible to professional and amateur athletes.
Keywords: doping, enhancement, neuroscience, brain stimulation,

Introduction

Technology has penetrated in most aspects of our lives (economy, education, society) (Luppici-

ni, 2012; Luppicini, 2009) and sport is one these areas (Miah, 2011). In this context we need to

think reflectively about the consequences of technology on the traditional practice and spirit of

sport, given the fact that each technical innovation can imply an ethical dilemma. In this sense

sport authorities should question themselves how to adapt these new advances to the convention-

al moral principles or if it is convinient to adapt our moral comprehension of sport. In this sense the

increase of technology in sport is a challenging topic for technoethics.

Classical historic studies dealing with sports have identified two so-called golden eras, ancient

Greece and Victorian England, where athletes practiced sport without spoiling its playful nature. At

these times, sport took place as an end in itself (Young, 1984 p.7). It was clear for participants that

what was important was taking part in the activity and having fun while at the same time testing of

their physical abilities. The aim, therefore, was not to win, but to reach the highest level of devel-

opment of these physical skills, physical excellence. Victory would be merely the result of excel-

lence.

1
 However, recent historical studies cast doubt on the existence of these golden ages, demon-

strating in fact, that wherever the sport has existed, its protagonists have always tried to make use

of all possible means available to gain a competitive advantage over other contestants. The idea of

a pure sport, practiced by itself as a means of achieving physical excellence is therefore nothing

more than fiction.

This is especially true today, where professionalized sport prevails. In this kind of sport, the pri-

mary purpose is victory, not only for the economic benefits, but for cultural reasons: the social glori-

fication of the winner and consequently the loser’s oblivion. The excessive desire for victory that

governs sport in our time has driven participants to extreme rationalization. Athletes follow specific

diets and perfectly controlled workouts; they take all sorts of nutritional supplements and use

sports equipment designed exclusively for them, all in order to achieve that slight advantage that

puts their performance above the rest. Thus, our sports world is more than ever linked to interests

and elements that go beyond the pure sport practiced by Greek and British amateur athletes.

It is therefore not surprising that given these peculiarities, many athletes choose to artificially

improve their sport performance. The consumption of substances with the aim of improving per-

formance is one of the strategic tools used to achieve that result. Doping has always been present

in sport due to athletes’ desire to gain a competitive advantage or simply facilitate their quest to be

physically superior to the rest. The following four phases in the history of doping can be noted

(López-Frías, 2014):

a) Natural doping

b) Single or first generation chemical doping

c) Systematic and second generation chemical doping

d) Biotechnological doping

The aim in this article is to provide a short overview of one of the biotechnological enhance-

ments that could have become notoriously relevant in the practice of sport: neuroscience, particu-

larly transcranial stimulators. But before going into this area, it seems appropriate to offer a brief

2
summary of how neuroscience enhancements are involved in a vision of sport performance in

terms of a combination of physiological and brain elements (which include cognitive and emotional

or mood components).

Doping: A Short Chronicle

Natural doping

The quest for all possible means of improving physical performance is a constitutive element of

competition in sport, and this psychological attitude was even present in ancient societies. This

search for a "competitive advantage" was carried out mainly through training and diet, but also by

consuming naturally-found products which increase an individual’s physical performance by affect-

ing an athlete’s organs (Vesali, 2002, p. 42).

Cases of this type of doping have already been found in ancient Greece. At that time empirical

knowledge was held regarding the use of anabolic and androgenic testicles through the study of

the effects of neutering pets. For example, Greek athletes thought something related to physical

performance must reside in the testes, and in a way, their view was not entirely misguided, consid-

ering what is known about the actual role of testosterone in the body. Intake lamb testicles became

common practice among them in order to gain that vital force that castrated animals seemed to

lack due to their lack of testicles.

During this time, athletes were also aware that diet was key to their physical performance, so

they designed diets based on certain types of herbs, mushrooms, hallucinogenic plants, cheese,

and flour-based products, and specific diets of wheat and meat. Mushrooms and pain-relieving

plants allowed physical symptoms of fatigue and overwork to be overcome in order to allow a high

level of competition to be maintained. Many of the uses of these substances are documented in

mythological texts from ancient civilizations, such as those which document Greek Dionysian ritu-

als.

Chemical Doping

With the development of civilization and modern science, especially medicine, began the stage

of ‘chemical doping.’ It is feasible to distinguish two generations within this stage. The first is char-
3
acterized by the simplicity of doping treatments, which were carried out through pure chemicals

products such as cocaine, heroin, caffeine, and alcohol. As they had immediate short-term effects

on performance, they had to be taken in key moments of the competition, for example, at the start

of a competition.

As in the classical period, there were athletes who designed their diets following the advice of

some medical experts with certain scientific knowledge. Science offered to athletes pure chemical

substances whose effects on the body were beneficial to sport practice. At this time it was common

to use coca leaves and other alkaloids, whose main effect was to eliminate feelings of fatigue and

tiredness. For example, in the 19th century, cyclists ingested a chemical called ‘speedball,’ mixing

heroin and cocaine, which had an effect identical to that of natural hallucinogens from handmade

products extracted from nature by the Greeks. It was precisely in 19th century, in the era of ama-

teurism, when the term "doping" appeared. According to Verroker (2005), it is likely this term

comes from the term “dop used in South Africa in the 1700s to refer to a stimulant alcoholic bever-

age. Others point out that it may come from the Dutch term ‘doop,’ which later came to designate

in English a substance with sedative and hallucinogenic effects. At the end of the 19th century, the

term was used to refer to beverages with narcotic effects and at the turn of the 20th century, it be-

gan to be used in reference to enhancement on physical performance, although initially it referred

to the enhancement of race horses.

The first documented case of chemical doping in a sport competition is that of Thomas Hicks in

the St. Louis Olympics of 1904 (Vesali, 2002, p. 6). Having just crossed the finish line and winning

the marathon, he fell to the ground, having taken doses of alcohol and strychnine throughout the

race.1

Chemical doping: Second generation

1The participants in these 1904 Olympic were only amateurs, who did not receive any award,
payment or reward for winning. Thus, as I mentioned previously, natural doping and chemical do-
ping were in fadt present at times which some experts had conceived of as the golden (or pure)
age of sport.
4
 In the second stage of chemical doping, chemical products and chemical enhancement treat-

ments were of a more complex nature, with longstanding and dangerous effects. They were not

used individually, but rather in a systematic way, controlled by doctors and specialists. Ampheta-

mines, anabolic steroids and blood doping were the prevalent enhancement treatments throughout

the second half of the 20th century.

Anabolics were used for the first time by Soviet weight lifters in the 1950s. The doctor of the US

track team, John Bosley Ziegler, applied them to their athletes after observing the excellent results

of the Soviet team. Given the great rivalry between the capitalist and communist countries, the re-

spective national sports associations developed what came to be known as ‘Doping State,’ whose

most extreme cases occurred in the German Democratic Republic. But the truth is that the use of

doping during this decade was not exclusive to Eastern countries.2

From the 1960s, knowledge about the disastrous health effects of anabolic substances ingested

in massive quantities was generalized. Thus, in 1960 the first victim of doping fell during the Rome

Olympics Rome: the Danish cyclist Knut Jensen died from the effects of Ronicol, an amphetamine.

In 1967 the effects of doping was seen by millions of spectators during the Tour de France: the

British cyclist Tom Simpson3 died during the race, the cause of death being the excessive use of

amphetamines and brandy.4

At the end of the Cold War, it was discovered that several Eastern European countries had car-

ried out systematic doping in order to show the world the superiority of the communist regime. But

health effects of that systematic doping were devastating: suicide, sex changes, injuries and dis-

ease. However, this systematic and scientifically controlled doping did not disappear. Rather, it be-

2Recently, the discovery of documents has demostrated that West German athletesy players
would have taken some type of amphetamines in the 1954 Football World Cup final. At the time it
was quite surprising that West Germany team defeated the favorites, the hungarian team.
3 Simpson had been appointed in 1965 as a "Sports Personality" by the BBC.
4 That same year, the IOC set up the Medical Commission against Doping whose aim was protec-
ting athletes’ health, sport, medical ethics, and equality among athletes. As a result, in 1968 the
first victim of the drug testing took place in Mexico Olympics. Out of 667 tests performed, only one
athlete tested positive: Hans-Gunnar Liljwewall a pentathlete who was stripped of his bronze me-
dal for consuming excessive alcohol.
5
gan to be adopted by associations or economically powerful individuals who had the economic re-

sources to access to the best scientific and medical treatments.

Biotechnologycal doping

The recent decades have seen more profound changes to the relationship between human be-

ings and technology: the development of genetics, robotics, cybernetics, nanotechnology, and

biomedicine are making it possible to posit that in the future human beings will be able to geneti-

cally modify and clone themselves; they will be able to create hybrid beings or interact with com-

puters or other components from within the human body itself. A transhuman world, in which hu-

man beings are not limited by constraints imposed by nature, in which they can experience what-

ever physical change with the goal of increasing their physical or mental capacity, is for some the

Fukuyama case, the most dangerous idea that lies in wait for humanity (Fukuymana). But not

everybody agree with that pessimistic forecast (Savulescu, 2007).

Scientific and biotechnological developments will have an inevitable impact on the sport through

genetic engineering (Miah, 2004; Pérez-Triviño, 2011) and enhancements provided by body im-

plants and prosthetics that can lead to the creation of cyborgsportsperson (Pérez-Triviño, 2013).

But the enhancing athletic technique to wich I devote my attention here is neuroscience, and in

particular, the impact of transcranial stimulators. But to better understand the effects of these stim-

ulators it seem necessary a previous presentation of the different types of sports performance en-

hancements. Indeed, historically the focus of doping has been only physiological performances.

But in sport practice there are combination of factors besides physiological one, cognitives and

emotionals (mood). Insofar these factors can be boosting intervening in the brain, neuroscience

will be relevant in the near future as a mean to enhance sport performance. Before going to exam-

ine Transcranial Stimulator, let me explaining briefly physical, cognitive and mood enhancing.

Types of sport performance enhancements

Physical doping

Physical enhancement can be understood as any type of development that enhances a physical

function of a human body (Holme & McNamee, 2011, 291). Sport performance is, by definition, an

6
expression of physiological abilities, and the constitutive aim of sport is the improvement of physi-

cal performance in its different expressions such as speed, endurance or flexibility. The tools for

improving physical performance– in different areas such as training techniques, equipment or nutri-

tion – have been evolving and continue to do so.

The connection between physiology and sport performance means that substances and meth-

ods of physical improvement that enhance traits tied to movement or endurance have been the

focus of anti-doping efforts. The majority of prohibited substances influence physical performance

directly, such as anabolic androgenic steroids (AAS), hormones, beta-2 agonists, anti-estrogens,

stimulants, narcotics, cannabinoids, glucocorticosteroids, alcohol, and beta blockers. Most effort

has been focused on the now infamous erythropoietin (EPO) (which enhances endurance by creat-

ing red blood cells to deliver oxygen to working muscles) and AAS (assisting strength and recovery

by increasing protein synthesis in muscle cells).

A variety of stimulants also appear on the Prohibited List which have a direct effect on physical

performance, and also leave a trace in the peripheral nervous system. As Foddy (2011) explains:

“The purpose of this story is to show how many neural processes are involved in the execution
of physical actions. Even in producing basic physical motion like a kick, a player needs to engage
a large and complex web of neural mechanisms. Some of these mechanisms, like decision making
and judgment are confined to the central nervous system and the brain. Others, like stage fright
and elevated heart rate, are primarily involved with the peripheral nervous system” (p. 315).
For that reason “neurophysical enhancements” can positively affect sport performance. These

mechanisms can be treated pharmacologically to produce neural improvements. For example,

amphetamines activate some adrenergic receptors in the organs of the body, including the brain,

which act to increase heart rate, eliminate fats, supply glycogen, and dilate blood vessels. These

improvements can have an impact on the abilities and skills that any athlete can develop.

Cognitive enhancements: cognitive doping

As the understanding of enhancing sporting performances has evolved, there is growing interest

in non-physical factors, and in particular cognitive enhancements. In fact, the recognition that cog-

nitive abilities are involved in sport performance arose almost simultaneously with the knowledge

of the importance of the physiological elements, but its radical development has taken place in re-

7
cent decades (Sánchez & Lejeune, 1999). In the short span of sport history the interest in how

psychology can enhance sporting performance has grown remarkably (LeUnes, 2011). This has

been captured by Hoberman’s (1992) observation that from the outset of natural science:

"...early sport physiologists discovered that scientific study of athletic performance must operate
at this frontier where physiology and psychology overlap" (p. 157).
There have been two ways through which cognitive improvements are relevant for sport perfor-

mance. The first is that there are sporting competitions which demand both a physiological test and

one of cognitive character; chess provides a standard case. In some sport events success de-

pends on strategising the event, such that the physical ability also relies on superiority on psycho-

logical factors. The second is that it is impossible to sever the link between body and the brain;

between physical performance and brain activity. Thus, in all sport performance the brain plays a

role. As Foddy (2011, p. 313) points out "all such variations (physical actions) in performance are

mediated, at least in part, by the actor's brain, spinal cord and peripheral system. Neurological sys-

tems play a role in determining how far we throw a javelin, how deeply we breathe while swim-

ming... how long we can withstand the pain of endurance cycling” (see also Foddy, 2008).

Cognition can be understood as the process an organism uses to organize information, a

process that includes the following abilities: i) acquisition (perception); ii) selection (attention); iii)

representation (understanding) and iv) retention (memory), and usage of abilities to guide be-

haviour (reasoning and coordination of motor outputs) (Sandberg, 2011, p. 71). Thus, cognitive im-

provement can be defined as all increase of the capacities involved in the process of cognition by

any system, internal or external, of information processing. However, although there is a symbio-

sis between physiological and cognitive factors, I will treat them separately insofar they have been

analysed historically as separated.

The concern over how cognition influences sport performance has been present since the birth

of modern sport. In this regard, Hoberman (1992) examined the birth of sport psychology during

the first decades of 20th century, arguing that:

"The idea of manipulating the mind to enhance human performances -a popular preoccupation
of our own era- seldom appears during this period." (p. 157)

8
 The progressive importance of cognitive processes in sport performance has doubtlessly had a

substantial impact on this area. Some authors point this out, although perhaps in a somewhat ex-

aggerated fashion. For example, Sanchez and Lejeune (1999) cite two famous quotes suggesting

that “the difference between winning and losing is 99% psychological” and that “90% of the sport is

mental and the other half is in the head”. Such characterisations of the influence of cognition on

sport outcomes underpin the commonly accepted notion that sports performance can be improved

by methods focusing on mentation, such as guided imagery and cognitive restructuring. Training

using imagination is “the symbolic repetition of a physical activity in absence of any big muscular

movement” (p. 22). The athlete imagines metadynamically, consciously and repeatedly, a sport ac-

tion without carrying out the practical execution, to facilitate the motor skills improving the sport ex-

ecution, control attention and concentration and accelerate recovery from injuries (28). Cognitive

restructuring refers to “the group of techniques that aim to directly change athletes’ thoughts to bet-

ter face the demands of competition” (p. 26). With this athletes can improve their self-confidence,

motor abilities and control over attention and concentration.

Emotional enhancements: emotional doping

The part of human mental reality that has seen recent remarkable development relates to the

understanding of emotions. The expansion of understanding of the role of emotion in mental health

has spurred studies in this area of psychology. Mental health (e.g. depression, fear, and shyness)

represents an ongoing challenge for sport, and can noticeably affect physical performance. An ath-

lete might have great physical potential, talent, or technical aptitude, but can fail at the time of

competition due to anxiety or depression. Athletes can suffer "emotional blocks", arising from per-

formance pressure exerted by coaches, family, or fans, or the loneliness of being an elite athlete,

expressed as fear or lack of confidence that prevents normal sport performance. Equally, an elite

athlete who has a fear of flying is unable to travel to important international matches. More famous-

ly, the steep decline in the tennis player Rafa Nadal’s performance was attributed to depression

following his parents’ divorce. Anxiety and depression can be so severe that there are famous cas-

es of athletes who have committed suicide, such as Gary Speed and Robert Enke.

9
 Hoberman (186) points out that from the beginning of the 20th century psychologists have been

trying to help athletes suffering from anxiety, depression, fear or other emotional disorders to reach

peak performance. With this goal in mind, multiple techniques or psychological methods were de-

veloped to improve the emotional state of athletes to prevent it from affecting normal physiological

functioning. Like pharmaceutical substances, the therapeutic approaches to psychology were

adapted to achieve performance outcomes among those in the normal range of the curve. This is

what is known as "the medicalisation of normality" (Berghmans, ter Meulen & Vos, 153). Sandel

(2007) offers a deeper account of this phenomenon.

Emotional or mood doping in sport therefore occurs when psychological therapies are used to

make athletes experience states of optimism, confidence, plenitude or aggression to enhance

sport performance. Problems for the anti-doping policy emerge when substances mediate the

emotional state of athletes rather than psychological therapies.

Generally speaking mood enhancement is defined negatively as the treatment directed at the

lack of good mood, or in the case of depression the inability to find pleasure in aspects of everyday

life. However, these products are being prescribed for individuals without such illnesses. In these

cases, mood enhancers have the effect of making people feel “better than well”. Individuals usually

recognize that such substances make them feel energetic, more alert and better suited to face re-

ality (Liao-Roache, 246). In the initial approach, improving negative mood into a state of positive

mood is desirable and thus the goal of any technology or chemical is to improve negative mood in

a safe and effective form is positive (Berghmans et al,161). Psychological therapy has been a

longstanding treatment for mood, although progress in neuroscience is increasing the understand-

ing of how the patterns of brain chemicals lie at the root of some of these emotional disorders.

Psychological treatment has been replaced in some instances with pharmacological substances

that affect states of emotion or mood (e.g. sadness, depression, fear, shyness, etc.), such as flu-

oxetine (e.g. Prozac). Fluoxetine is used to treat a range of psychological disturbances from de-

pression to obsessive-compulsive disorder to premenstrual dysphoric disorder to alcoholism, mi-

graines and Tourette’s syndrome (Berghmans et al, 154).

10
 The main problem arises when these substances are applied with the aim of enhancing perfor-

mance among individuals with no mood disturbance. This phenomenon leads to a blurring of lines

between psychiatric and psychopharmacological issues and the medicalisation of emotional and

social problems (Sandel, 2007).

Sport must consider the implications that arise from the increasing use of substances that en-

hance mood states. Indeed athletes could use such substances as a tool that allows them to com-

pete in a better psychological state than their rivals in order to achieve a competitive advantage.

For example, dextroamphetamine might be used to reduce impulsivity, which is particularly rele-

vant in sports where inhibiting action is crucial, such as baseball or cricket.

Neuroscience and sport

As we have seen before, cognitive enhancement in sport is moving from traditional psychologi-

cal approaches towards neuroscience (Davis, 2013). The early 21st century has seen significant

developments in this area, opening up the possibility to examine brain processes in depth. Neuro-

science roughly consists of the study of the cerebral mechanisms at the base of the essential cog-

nitive functions of the individual: the capacity to remember, to argue, to decide, etc. Such functions

are observed through powerful instruments such as functional magnetic resonance imaging [fMRI],

positron emission tomography [PET scans], and magnetoencephalography [MEG] (which monitors

the electrodynamic flow of the neurons). Advances in measurement of the brain have seen the

ideas advanced by psychology regarding the connection between brain and the movement func-

tions measured and explained by neuroscience. In some ways the neuroscience revolution can be

compared to Galileo’s impact on the field of the physics or Darwin’s on biology; this puts sport as a

potentially significant contributor and recipient of significant advances in knowledge that were un-

thinkable in the 20th century (Tamorri, 10).

Neuroscience can inform sport by introducing the possibility to identify which structures (circuits)

in the brain are associated with specific movements, with strategising sport events, or with intuition

in game situations. Tamorri (2004) is so confident in this line of research that he believes that it will

be possible to discover the mechanisms that turn an athlete into a champion:

11
 “A champion is a mix of muscle and biomechanical reaction, possible and developed through a
fragile, fine and complex process of gathering information, decoding and programming in the brain,
in his biology, in its neurotransmitters and finally, in its cognitive processes, in its organic back-
ground but also, in its emotional and cultural elements” (p. 11).
Progress in understanding and boosting the brain’s role in physiological performance has seen

pharmaceutical laboratories identify substances that improve cognitive skills and abilities. These

cognitive enhancers were initially designed for the treatment of neurodegenerative illnesses that

primarily affected people as they age. However, such medicines have recently found a market in

healthy people and are used to increase the duration of a wakeful state, maintain high levels of at-

tention and concentration even under conditions of mental stress and improve memory (Eronia,

2012, p. 7). These replicate the effect of other stimulants that have appeared on the Prohibited

List (e.g. amphetamines, cocaine and caffeine), although they make use of different mechanisms.

Among these medicines modafinil (Provigil) and methylphenidate (Ritalin) stand out for their ef-

fects on memory and concentration abilities. Modafinil particularly enhances wakefulness, but it

also improves reaction time, pattern recognition, working memory and spatial planning ability

(Foddy, 2011, 316). The first individuals who tested these substances were pilots and soldiers

since they allowed the individuals improve the potential for concentration and avoid the effects of

fatigue (Housden et al, 118). Methylphenidate was originally used for the treatment of attention

deficit disorder and hyperactivity. However, it is widely used because of the perception that it also

can provide similar effects in people without these conditions. Its use has spread to university staff,

university students and high school students who that have discovered that the stimulant improves

concentration (Housden et alii, 17). The influence of such cognitive enhancers on physical perfor-

mance emerges in terms of increases in information transmission speed and ability to focus on

specific tasks. Improvements in information transmission and focus can have a significant impact

in sports such as javelin, archery and golf (Foddy, 2011, p. 316).

Cognitive enhancers appear to be prohibited for their potential effect on sporting performance

and also for their health implications. Some studies have shown that these substances can have

unwanted side effects on health, such as dependency (Foddy, 2011, 318). Thus, it is unsurprising

that these substances would be added to the Prohibited List. However, unlike other stimulants, the

12
effect of cognitive enhancers is less about enhancing a person and instead about enabling a differ-

ent kind of functioning within normal neural limits, and the safety data indicates the risks to ath-

letes’ health is approximately the same as some permitted prescription substances (Foddy, 2011,

318). This raises the question if the prohibition of cognitive enhancers is justified.

But there are other neurotechniques capable of enhancing the brain functions. As Merkel et al

point out, beyond pharmacological substances there are three more main types of physiological

interventions in the brain: genetic, electro-magnetic and surgical. The latter may be differentiated

further into four subclasses: a) the implantation or neuroprostheses, including brain computer inter-

faces (bionics), b) the intracranial grafting or implantation of cells (neural non neural, or embryonic

stem cells) for tissue repair or cell-containing devices for the local delivery of bioactive com-

pounds, c) intracranial gene transfer techniques to enhance or dampen protein expression for

cure. But here we will focus on techniques for electrical stimulation of defined brain areas.

Brain Stimulation Techniques

Although at the beginning of experiments of brain stimulation techniques there was a limited

hope in its use in sport (Goodall, 2012, p. 7), recent advances in neuroscience suggest that the

skills and abilities underpinning sport performance can be enhanced using technologies that

change the activity of the brain. These factors may include motor learning, enhanced muscular

strength or reduced fatigue, or even changes to mental state or concentration.

Davis suggests that “modulating the activity of the brain during training or during sport will lead

to benefits comparable to those of using drugs. The devices needed to generate these effects are

already available, and are currently in use in laboratories or clinics to produce short or long-term

changes in performance” (649). There are other advantages to these devices so the risks of using

brain stimulators are relatively low, when used within established safety parameters. Only the case

of multi-session stimulation could alter the risk. Nonetheless, currently there is not sufficient knowl-

edge to determine appropriate doses of stimulation in a given situation, specially when it is used

outside the laboratory or the clinic. More research will be needed to guarantee safety and efficacy.

And finally, there is no security regarding how brain stimulation could affect mood or mental state.

Two main brain stimulation techniques are available:

13
 1.Transcranial magnetic stimulation (TMS) is a method to cause depolarization or hyperpolar-

ization of the neurons of the brain. TMS uses electromagnetic induction to induce weak electric

currents using a rapidly changing magnetic field; this can cause activity in specific or general parts

of the brain, allowing for study of brain functioning and interconnections. The immediate effect of

this is to generate action potentials in those cells, followed by a refractory period as the cell recov-

ers. These effects outlast the stimulation phase by several tens of minutes, with the possibility of

longer-term reorganisation of brain activity if the stimulation is applied at regular intervals. (Davis,

2013, p. 649-650)

2. Transcranial current stimulation (tCS) comes in two common variants:

a) Transcranial direct current stimulation (tDCS): a form of neurostimulation which uses con-

stant, low current delivered directly to the brain area of interest via small electrodes. The mag-

nitude and polarity of the electric field at the brain surface near the electrodes determines its

effect: cells in the vicinity of the anode will tend to increase in excitability, through a process

thought to involve a modulation of the resting membrane potential of the cells. Although it was

originally developed to help patients with brain injuries such as stroke, tests on healthy adults

have demonstrated that tDCS can increase cognitive performance on a variety of tasks, de-

pending on the area of the brain being stimulated (Kanai et al.).

b) Transcranial alternating current (tACS): uses a similar principle, except that the current al-

ternates at a specific frequency.

As Davis points out, there are some relevant differences between two these techniques. TMS is

a more focal technique, with a relatively small area of the brain being affected by the stimulation,

whereas the electric field induced by tCS is spread across the whole brain surface; tCS has a

number of advantages over TMS.

TCS technology is cheaper and more portable. Indeed, wireless tCS stimulators are now com-

mercially available, and websites exist that give instructions for home-made tCS stimulators.

14
 For that reason Davis argues that neurodoping will become a key technology for the future of

sport and sports medicine, although given the current state of development, the use of brain stimu-

lation must be carefully considered.

Davis foresees two domains where neurodoping may potentially change performance in sport.

The first benefit takes place immediately following stimulation, a time at which participants have

demonstrated enhanced motor skills including: improved time-to-fatigue, response time, and

tremor suppression. After this time, approximately 20 to 60 minutes, the effects begin to decline. In

any case, the enhanced motor skills could be very useful for these initial minutes in sports like

shooting a pistol or jumping out of the gates on a ski slalom.

The second use of neurodoping is related to skill acquisition:

“Skills learned in the context of anodal tDCS are acquired more rapidly, and reproduced more
accurately, than those learned without. Sports performance at the highest levels require good
technique and good timing. These are skills learned during training, so enhancing the efficiency of
learning during the training phase will be of greater benefit at competition time. I suggest that an
athlete could use these techniques to make training more efficient and thereby gain an advantage”.
(Davis, 2013, p. 652)

It is not difficult to foresee that an area of development will be the application of neurodoping is

sport training and performance. Coaches will be in a better position to understand how and when

to incorporate brain stimulation into training. It is likely that as more brain stimulation is used there

will be a reduced dose of stimulation delivered to the athlete.

In any case given that each sport determines its own functioning and values, the tolerance of

brain stimulation could be diverse according to each competition. For example, performance in a

sport such as pistol-shooting would be greatly improved by tremor reduction so governing bodies

will have to decide whether shooters should be prevented from using tACS during or immediately

before competing to reduce tremor, just as beta-blockers are banned in many sports. Conversely, a

tennis player’s performance in a match is heavily influenced by the probability of regularly getting

the first serve in, which is a skill learned in training and therefore potentially susceptible to neu-

rodoping. Neurodoping is one of many potential forms of enhancement that may affect sport per-

formance, and the development of technology should be mirrored by a development in how such

enhancements are viewed and dealt with.

15
 Some remarks about the validity of experiments with Transcranial Stimulators

There are two problems with the tests that have been carried out until now. The tests mentioned

in this article have been conducted with a subject who sits down in a chair to receive stimulation

and to perform a task. Until future stimulators are free from wires, it will be difficult to capture the

extent of the relation between brain stimulation and enhancing sport-relevant motor performance.

Secondly, as Davis points out the experiments have been conducted on “normal people”, not

with athletes. In that sense

“It is possible that neurodoping will add little to the performance of elite athletes. Most studies of
brain stimulation recruit non-expert, healthy participants from the community of the laboratory (in
practical terms, university students) and test in conditions where performance is likely to be
changed but not reach its maximum. Elite athletes who are already performing close to the physi-
cal limits of the human body may not gain from the potential benefits of brain stimulation”. (Davis,
2013, p. 650)

Conclusions

Enhancement methods have actually been present in sport practice from its origin. However,

from the first natural forms used to carry out this enhancement to the present time there have been

many varied treatments and substances experimented by athletes. In the near future, it seems that

the more prevalent enhancements will be biotechnological due to the fact that these appear to

promise better and safer sport performance enhancement.

On the other hand, such treatments and substances will not necessarily have the athletes’ phys-

iology (muscles mainly) at their core of action. So far scientific knowledge has offered certainties

about the connection between the brain (mental and emotional factors) and the rest of the human

body in sport performance; this will be also at the core of the experiments aimed at enhancing

sport performance. For that reason, it is easy to understand the increasing importance of the neu-

roscience for sport.

In the last section of the article I have tried to show the novelty that transcranial stimulators

could suppose. It is essential to highlight that these stimulators which act on brain neurons can di-

rectly improve sport performance by increasing reaction times or by reducing fatigue; they can bet-

ter athletes’ capacity to learn sport skills. These traits would make it possible to describe these en-

16
hancement treatments as other products that belong on the list of substances prohibited by the

World Anti Doping Association (WADA). But their peculiarity does not stop here. The use of these

stimulators could be extended to both professional or amateur athletes, since they are commercial-

ly accessible. In any case, what is sure to come is an interesting and controversial discussion

about their use - or not - in sports.

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