Imagine a new reality television makeover show, but instead of plastic surgeons working on eyes, noses and breasts, it’s neurologists attempting to enhance brains.

In this contest, healthy people get cutting-edge drugs and treatments, not to cure a brain disease, but to make them “better” people.

While such a scenario might seem farfetched, doctors writing Tuesday in a medical journal said an era of “cosmetic neurology” soon may be upon us.

“We live in an environment where there is a lot of pressure to excel,” said Anjan Chatterjee, an associate professor of neurology at the University of Pennsylvania. “I think it is absolutely likely that we are going to be seeing more of this.”

Drugs that are developed for treating disease could be prescribed for healthy people looking to enhance their cognitive or emotional performance, he said.

In a Views & Reviews article in the journal Neurology and an interview, Chatterjee offered several examples:

_Alzheimer’s drugs might be given to commercial airline pilots or others in highly skilled jobs to improve attention and memory. The drugs also might be used for healthy seniors to prevent normal forgetfulness.

_Amphetamines, which in small doses can improve motor learning and already, have been used in rehabilitation therapy for stroke patients. They might also be used to learn to play the piano or to swim.

_Transcranial magnetic stimulation, a treatment used to treat clinical depression, might be used to improve the mood of healthy people who are just having an off day.

_Newer, non-addictive drugs intended to treat attention deficit hyperactivity disorder could be used by college students to study for exams.

_Beta-blocking drugs, which can blunt the effects of emotionally traumatic events such as battle stress or a car accident, could be used to minimize memories formed during less-disturbing events such as a stressful family gathering.

Chatterjee said in the future it’s plausible that neurologists will become “quality of life consultants.”

But struggling with pain builds character. He warned that getting a boost without doing the work is cheating.

“A fundamental concern is that chemically changing the brain threatens our notion of personhood,” he wrote.

Bernd Remler, a professor of neurology at the Medical College of Wisconsin who practices at Froedtert Memorial Lutheran Hospital, said the article offers a glimpse of the future.

“Perhaps we have seen some of this already,” he said.

Remler said he knows of actors and individuals who had to give public speeches and who were given prescriptions for beta-blocking drugs to tone down the effects of their nervousness.

Remler noted that there may not even be sound science supporting the use of some neurological drugs on healthy people. Just the perception of a benefit might be enough to cause people to request the drugs.

In addition, pharmaceutical companies are advertising directly to consumers the wonders of new drugs such as those to treat social phobias, he said.

“There is a large gray area between normalcy and abnormalcy that exists in all of us,’’ Remler said. “That’s the soma of the Brave New World.”

Advances in neuroscience carry with them the likelihood that they will be used for medical applications beyond the goals of preventing, diagnosing and treating disease, wrote Stephen Hauser, a professor of neurology at the University of California, San Francisco, in an accompanying editorial.

“Individuals will go to considerable distances to seek advantages, even trivial ones, both for themselves and their children,” Hauser wrote.

New designer drugs will be developed to treat Alzheimer’s and stroke patients, but, eventually, there will be pressure to offer those drugs for off-label uses, Hauser said.

“Should we permit use of a safe memory enhancement drug for physicians who need to keep current with new developments in the field?” he wrote. “What about a single use indication for our kids as they cram for SAT exams?”

As doctors of the human nervous system, neurologists must shape the debate “about what it means to be fully human, healthy and normal and about how society might define the boundary between interventions used to promote and restore optimal health and those used for enhancement,” Hauser wrote.

And the slippery slope toward cosmetic neurology is not a certainty, Richard Dees, an associate professor in the department of philosophy and neurology at the University of Rochester, said in separate editorial.

Society does not have to surrender ethics to the government, market forces and the power of Wall Street, Dees writes.

“Because we can choose, we face deep moral questions that we must simply answer one by one,” he adds.