# Improving Shared Decision Making in Early use of Neurotechnologies Across Different Disease Stages

> **NIH NIH R01** · PENNSYLVANIA STATE UNIVERSITY, THE · 2024 · $410,778

## Abstract

ABSTRACT
Recent research emphasizes the opportunities of using neurotechnology earlier in the disease progression. However,
earlier use of neurotechnology also raises significant ethical concerns. There are trade-offs and uncertainties involved
in deciding to offer and undergo advanced neurotechnology treatments earlier in the disease progression. This has
changed the ethical decision-making landscape for patients and treating clinicians. For patients, it can be challenging
to assimilate clinical information and make risk–benefit trade-offs to select the most appropriate treatment. For
clinicians it can be challenging to decide when in the disease progression is best to discuss with patient’s advanced
neurotechnologies as therapies. While the literature addresses the opportunities that early use of neurotechnologies
can bring, there is limited research on ethical concerns and decisional needs around their earlier use among patients,
caregivers, and clinicians, and lack of support in decision-making about early use of neurotechnology. This proposed
study addresses those significant gaps by (1) identifying neuroethical issues around shared-decision making (SDM)
associated with the early use of neurotechnology, and (2) developing and testing a patient-centered decision aid
(PtDA) for advanced neurotechnology that can be used at different disease stages. Using a pragmatic neuroethics
framework together with the International Patient Decision Aids Standards (IPDAS) Collaboration guidelines our goal
is to develop a tool to support SDM and the responsible use of these interventions in different stages of disease
progression. To achieve this goal, our established, transdisciplinary research team, guided by a distinguished Steering
Group, will answer two questions: (1) Are there any relevant differences in ethical issues and decisional needs when
considering advanced neurotechnologies earlier in the disease progression vs. in advanced disease stages? (2) What
impact does a PtDA about advanced neurotechnologies have on decision-making about this type of interventions
(whether and timing), knowledge and attitudes about them, decision conflict, decision satisfaction/regret, and
patient perceived involvement in care? To answer these questions, we will analyze data from interviews and
validated instruments (Aims 1-3). We will examine key neuroethical concerns and decisional needs among patients,
caregivers and clinicians (Aim 1). These results will inform the development of a PtDA (Aim 1). We will then evaluate
comprehensibility and acceptability of PtDA (Aim 2) and evaluate small-scale efficacy and feasibility (Aims 3). The
significance of this work lies in the in-depth new knowledge it will generate regarding specific neuroethical concerns
and decisional needs raised by the earlier use of neurotechnology among patients and clinicians. Responding to the
BRAIN Initiative imperatives, our PtDA will support SDM and ethical use of advanced neurotechnology at diff...

## Key facts

- **NIH application ID:** 10948286
- **Project number:** 1R01MH133659-01A1
- **Recipient organization:** PENNSYLVANIA STATE UNIVERSITY, THE
- **Principal Investigator:** Laura Yenisa Cabrera Trujillo
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $410,778
- **Award type:** 1
- **Project period:** 2024-08-09 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10948286

## Citation

> US National Institutes of Health, RePORTER application 10948286, Improving Shared Decision Making in Early use of Neurotechnologies Across Different Disease Stages (1R01MH133659-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/10948286. Licensed CC0.

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