Dr. Elkhonon Goldberg  is a clinical professor of neurology  at New York University School of Medicine, and author of over 50 peer-reviewed papers. His areas of expertise include executive functions, memory, attention deficit disorder, dementia, traumatic brain injury, and others. Dr. Goldberg was a student and close associate of the great neuropsychologist Alexander Luria . His book The Executive Brain: Frontal Lobes and the Civilized Mind  (Oxford University Press, 2001) has received critical acclaim and has been published in 12 languages. His recent book The Wisdom Paradox: How Your Mind Can Grow Stronger As Your Brain Grows Older  (Gotham Books, Penguin, 2005) offers an innovative understanding of cognitive aging and what can be done to forestall cognitive decline. It has been, or is in the process of being, published in 13 languages.
We are fortunate that Dr. Goldberg is SharpBrains Co-Founder and Chief Scientific Advisor. His book The Wisdom Paradox inspired me to embark in this path, and has been a key sounding board in the development of what we are doing.
- “Use It and Get More of It” reflects reality better than “Use It or Lose It”.
- Let’s demystify cognition and the brain. Everyone needs to have a basic understanding of the brain-and how to cultivate it.
- Well-directed mental exercise is a must for cognitive enhancement and healthy aging.
Roots: Vygotsky and Luria
Alvaro Fernandez (AF): Elkhonon, maybe we could start with Vygotsky . At one of my Stanford classes, I became fascinated by his theory of learning. Which links into modern neuropsychology .
Dr. Elkhonon Goldberg (EG): Vygotsky proposed that learning requires internalization. And that internalization equals, literally, a change in the brain of the learner. Of course there weren advanced neuroimaging techniques those days, so scientists could only speculate about what happened in healthy brains. But they could carefully analyze what happened with patients who had suffered any kind of serious brain problem, from strokes to traumatic brain injury. And this is how neuropsychology was born: Alexander Luria , Vygotsky disciple, and my own mentor, was commissioned to help rehabilitate Russian soldiers with brain injuries during WWII. This provided invaluable clinical material for understanding the mechanisms of the healthy brain. Much of modern cognitive neuroscience rests its foundation in Luria’s work.
AF: and now we have new neuroimaging techniques.
EG: Precisely. It is often said that new neuroimaging methods have changed neuroscience in the same way that the telescope changed astronomy. We use MRI, PET, SPECT, fMRI and MEG both in neuroscience research and in clinical practice. None of these techniques is perfect, but used properly they provide us with a much better understanding than we had only 30 years ago.
Research and work
AF: please tell us about your main research and practical interests.
EG: As you can see in my papers and books, I will categorize them in 3 areas-a) computer-based cognitive training/ Brain Fitness overall, b) healthy cognitive aging, and c) frontal lobes and executive functions. I am also interested in memory, hemispheric interaction , and in a general theory of cortical functional organization, but we will leave this for another occasion and focus today on those three areas.
First, Cognitive Training/ Brain Fitness. Rigorous and targeted cognitive training has been used in clinical practice for many years. It can help improve memory, attention, confidence and competence, reasoning skills, even how to reduce anxiety and deal with uncomfortable situations.
Second, healthy cognitive aging. The brain evolves as we age. Some areas, such as pattern recognition, get better with age. Some require extra-workouts in order to reduce “chinks in the armor” and increase neuroprotection through the Cognitive (or Brain) Reserve). Hence, the need for targeted cognitive training.
Third, the Frontal lobes and executive functions, which permeate seemingly very different problems such as ADHD and Alzheimer’s, are critical for our identity and successful daily functioning so they require extra attention.
Frontal Lobes  and executive functions
AF: Please tell us more about what the Frontal Lobes are
EG: We researchers typically call them the Executive Brain. The prefrontal cortex is young by evolutionary terms, and is the brain area critical to adapt to new situations, plan for the future, and self-regulate our actions in order to achieve long-term objectives. We could say that that part of the brain, right behind our forehead, acts as the conductor of an orchestra, directing and integrating the work of other parts of the brain.
I provide a good example in The Executive Brain book, where I explain how I was able to organize my escape from Russia into the US.
Significantly, the pathways that connect the frontal lobes with the rest of the brain are slow to mature, reaching full operational state between ages 18 and 30, or maybe even later. And, given that they are not as hard-wired as other parts of the brain, they are typically the first areas to decline.
Cognitive Training and Brain Fitness 
AF: And is that one of the areas where cognitive training/ Brain Fitness Programs can help
EG: Yes. Most programs I have seen so far are better at training other brain areas, which are also very important, but we are getting there, with examples such as working memory training, emotional self-regulation and domain-specific decision-making. Some of the spectacular research and clinical findings of the last 20 years that remain to be discovered by the population at large are that we enjoy lifelong brain plasticity and neurogenesis , that the rate of development of new neurons can be influenced by cognitive activities, and that intense mental challenges provide extra resistance to aging.
Exercising our brains systematically ways is as important as exercising our bodies. In my experience, “Use it or lose it” should really be “Use it and get more of it”. And computer-based programs are proving to be a great vehicle for that.
Emotions and Art
AF: We have been talking mostly about cognition or “thinking”. What about the role of emotions, as shown by the great research by Damasio ?
EG: Great question. Until recently, emotions were simply not relevant for many cognitive neuroscientists. That is changing, and there is more and more research looking into what makes us “uniquely human”: attributes like motivation, judgment, empathy, insight into others, emotional self-regulation.
AF: how does that link into the role of art? Can we consider art creation and appreciation as brain exercise?
EG: Indeed, and a great one. This is still open territory, but my personal opinion is that art’s main purpose is in fact exercising brains. As I mention in The Wisdom Paradox, I wouldn’t be surprised if piano lessons were shown to improve overall sharpness and lucidity. Any activity changes the brain, and systematic programs can be designed to lead that change in a better way than random daily activities. Learning a complex skill such as learning the piano helps train and develop some parts of the brain. Well-designed computer-programs help train and develop other parts.
AF: if we had to summarize your key messages to the public, based on your research and clinical career, what would you say?
EG: first, I would say, “Forget about Use It or Lose It”. It is “Use It and Get More of It!”. Second, I would like to contribute to demystify cognition and the brain, enabling people to increase their self-awareness, their knowledge of the brain and how to cultivate it throughout life. Finally, I would highlight the importance of well-directed mental exercise, on one hand, and of supportive social networks, on the other. I am enthused about the opportunity to work with you and SharpBrains and get the word out.
AF: so are we. It is a pleasure to collaborate on such an endeavor. Which I am sure will provide us with plenty of brain exercise.
EG: as long as you don’t stress out, that’s good! Good night, Alvaro.
AF: Good night, Elkhonon.
- Cognitive Neuroscience and Psychology Interview Series : in-depth interviews with 11 scientists and experts in cognitive training and brain fitness.
- Books on neuroplasticity and memory training : reviews of Train Your Brain, Change Your Mind, by Sharon Begley, and The Brain That Changes Itself, by Norman Doidge. Both books are fascinating and powerful; each would have merited appearing in the 2007 New York Times List of 100 Notable Books.