(Editor’s Note: given the growing media attention to three apparently separate worlds -cognitive enhancement via drugs, brain fitness training software, computerized neurocognitive assessments-, I found it refreshing to see our co-founder Elkhonon Goldberg introduce the topic of cognotropic drugs with an integrative perspective in the much updated new edition of his classic book, now titled The New Executive Brain: Frontal Lobes In A Complex World. Below goes an excerpt).

For many neuropsychologists, like myself, science is a labor of love, but seeing patients is bread and butter. Traditionally, the clinical contribution of neuropsychology has been mostly diagnostic, with precious little to offer patients by way of treatment. Neuropsychology is not the only clinical discipline for years consigned to helpless voyeurism. Every discipline concerned with cognition shares this humbling predicament. A psychiatrist treating a schizophrenic patient or a depressed patient finds him- or herself in a similar position. There are ample pharmacological tools to treat the patient’s psychosis or mood, but very few to treat the patient’s cognition. Even though psychiatrists increasingly recognize that cognitive impairment is often more debilitating in their patients than psychosis or mood disorder, traditionally, very little direct effort has been aimed at improving cognition.

A neurologist treating a patient recovering from the effects of head injury does not fare much better. There are adequate means to control the patient’s seizures but not his or her cognitive changes, despite the fact that cognitive impairment is usually far more debilitating than an occasional seizure. Society has been so preoccupied with saving lives, treating hallucinations, controlling seizures, and lifting depression that cognition (memory, attention, planning, problem solving) has been largely ignored. Granted, various neuroleptics, anticonvulsants, antidepressants, sedatives, and stimulants do have an effect on cognition, but it is an ancillary effect of a drug designed to treat something else.

Alzheimer’s disease and other dementias have been society’s wake-up call. Here, in the most affluent country in the most affluent of times, human minds were succumbing to decay before human bodies, a sharp challenge to the tacit popular belief that the “body is frail but soul is forever.” This provided an impetus for the development of an entirely new class of drugs, which can be termed familially as “cognotropic.” Their primary and explicit purpose is to improve cognition.

Since medical and public preoccupation with dementia focuses on memory, most of the pharmacological efforts have been directed at improving memory. At the time of this writing, a handful of drugs known as “Alzheimer’s drugs” or “memory enhancers” have been approved by the U.S. Food and Drug Administration (FDA). In reality, both designations are somewhat misleading. The drugs in question are Read the rest of this entry »

Just saw a very interesting press release regarding computer-based neurocognitive assessments – a critical part of the brain fitness puzzle. How long will it take before consumers can have access to a reliable and credible annual “mental check-up”/ cognitive baseline?

HeadMinder Cognitive Stability Index: Computerized Neurocognitive … (Press release)

- “The HeadMinder web-based Cognitive Stability Index (CSI) has proven more useful for blast-concussion detection than the ANAM computerized test battery the DoD currently employs. The CSI provides an immediate solution to clear the backlog of 400,000 IED-exposed service members in less than two years.”

- “The CSI is a 30-minute, Internet-based, computerized test that provides automated, objective measures of attention, memory, response speed, and processing speed for initial evaluation of cognitive functioning. The CSI produces standardized reports that enable triage and decision-making appropriate to a user’s qualifications – from medic to neuropsychologist to neurologist and other treatment team members.”

We covered this emerging type of assessments in the article Computerized Cognitive Assessments: opportunities and concerns

- “In fact, one of the Read the rest of this entry »

Where does our “Feeling of Knowing” come from? Have you ever felt certain that you knew an answer even though you couldn’t think of it right off? Where does that “feeling of knowing” come from? The answer to this question is the focus of neurologist Robert Burton’s new book On Being Certain: Believing You Are Right Even When You’re Not.

I recently reviewed Dr. Burton’s book on the Brain Science Podcast and last week I had the opportunity to interview him for the show. He explained that one of the origins for his book was his experience with patients with conditions like Cotard’s syndrome (where the patient thinks he is dead or does not exist). What Dr. Burton calls the “feeling of knowing” is so strong that people consistently trust it even when their beliefs contradict the evidence. At first it might seem surprising that this feeling is generated at an unconscious level in our brain, yet the same sort of processing creates the world we see and hear. It is well-known that what we see is not what enters our eyes, but Read the rest of this entry »