(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 »

(Editor’s note: this article belongs to the excellent May 2009 special issue on Augmenting Cognition of scientific journal Frontiers in Neuroscience, Volume 3, Issue 1. You can order this issue, for 50 euros, here. Highly recommended for scientists and technical readers interested in the science. This article, an industry overview, is reproduced here with authorization by the Frontiers Research Foundation).

Preparing Society for the Cognitive Age

- By Alvaro Fernandez

Groundbreaking cognitive neuroscience research has occurred over the last 20 years – without parallel growth of consumer awareness and appropriate professional dissemination. “Cognition” remains an elusive concept with unclear implications outside the research community.

Earlier this year, I presented a talk to health care professionals at the New York Academy of Medicine, titled “Brain Fitness Software: Helping Consumers Separate Hope from Hype”. I explained what computerized cognitive assessment and training tools can do (assess/enhance specific cognitive functions), what they cannot do (reduce one’s “brain age”) and the current uncertainties about what they can do (i.e., delay Alzheimer’s symptoms). At the same symposium, Dr. Gary Kennedy, Director of Geriatric Psychiatry at Montefiore Medical Center, provided guidance on why and how to screen for executive function deficits in the context of dementia.

I could perceive two emerging trends at the event: 1) “Augmenting Cognition” research is most commonly framed as a healthcare, often pharmacological topic, with the traditional cognitive bias in medicine of focusing on detection and treatment of disease, 2) In addition, there is a growing interest in non-invasive enhancement options and overall lifestyle issues. Research findings in Augmenting Cognition are only just beginning to reach the mainstream marketplace, mostly through healthcare channels. The opportunity is immense, but we will need to ensure the marketplace matures in a rational and sustainable manner, both through healthcare and non-healthcare channels.

In January 2009, we polled the 21,000 subscribers of SharpBrains’ market research eNewsletter to identify attitudes and behaviors towards the “brain fitness” field (a term we chose in 2006 based on a number of consumer surveys and focus groups to connect with a wider audience). Over 2,000 decision-makers and early adopters responded to the survey.

One of the key questions we asked was, “What is the most important problem you see in the brain fitness field and how do you think it can be solved?”. Some examples of the survey free text answers are quoted here, together with my suggestions.

Most important problems in the brain fitness field

• Public awareness (39%): “To get people to understand that heredity alone does not decide brain functioning”. We need to ramp up efforts to build public awareness and enthusiasm about brain research, including establishing clear links to daily living. We can collaborate with initiatives such as the Dana Foundation’s Brain Awareness Week and use the recent “Neuroscience Core Concepts” materials developed by the Society for Neuroscience to give talks at schools, libraries and workplaces.

• Claims (21%): “The lack of standards and clear definitions is very confusing, and Read the rest of this entry »

Games for Health and SharpBrains have partnered to bring you the first Cognitive Health Track in a Games for Health Conference, June 11-12th in Boston. If you are interested, in attending the conference, you can learn more and register Here.

To get a 15% off registration fees ($379), you can use discount code: sharp09, when you register Here.

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Cognitive Health Track, Powered by SharpBrains

Thursday, June 11th

10.20 (50m) Bird’s Eye View of Cognitive Health Innovation
Speaker(s): Alvaro Fernandez, SharpBrains

Scientific, technological and demographic trends have converged to create a new $265m market in the US alone: serious games, software and online applications that can help people of all ages assess and train cognitive abilities. Alvaro Fernandez will provide a Bird’s Eye View of the science, market segments and trends, competitive landscape, and main challenges ahead, based on The State of the Brain Fitness Software Market 2009 report released in May, which included Research Executive Briefs prepared by 12 leading scientists and a survey of 2,000+ decision-makers and early adopters.

61% of respondents to the survey Strongly Agreed with the statement “Addressing cognitive and brain health should be a healthcare priority.” But, 65% Agreed/Strongly Agreed with “I don’t really know what to expect from products making brain claims.” In this session, Alvaro will publicly unveil the new book The SharpBrains Guide to Brain Fitness: 18 Interviews with Scientists, Practical Advice, and Product Reviews, To Keep Your Brain Sharp, co-authored by neuropsychologist Dr. Elkhonon Goldberg and himself, aimed at helping consumers and professionals understand and navigate this growing field.

11.20 (30m) The Allstate-Posit Science Partnership: Cognitive Training for Safer Driving
Speaker(s): Tom Warden, Allstate; Henry Mahncke, Posit Science

Evidence-based cognitive training programs have been available in retirement communities for several years. Now, they are reaching a younger population including Boomers through innovative partnerships, like insurers.

In October 2008 auto insurance company Allstate and brain fitness software developer Posit Science announced a research collaboration that could lead to “potentially the next big breakthrough in automobile safety”. The purpose of this session is to review novel ways of getting the science of cognitive training into the real world where it can help people. Representatives from Allstate and Posit Science will discuss why these partnerships work for insurers, developers, and end users. They will also provide a thorough review of the evaluation process a major partner goes through when selecting a cognitive training company.

12.00 (30m) What Consumers Buy and Why
Speaker(s): Lindsay Gaskins, Marbles: The Brain Store

Launched in October 2008, Marbles: The Brain Store is a retail store that Read the rest of this entry »

This is a press release that went through the wire earlier today. If you are interested, in attending the conference, you can learn more and register Here

Note that below you can find 5 out of the 12 sessions – we will announce the full track tomorrow. To get a 15% off registration fees, you can use discount code: sharp09, when you register.

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The Games for Health Project, organizers of the 5th Annual Games for Health Conference, today announced its first Cognitive Health Track powered by SharpBrains, a leading market research company focused on the brain fitness and the cognitive health market.

The Cognitive Health track builds upon previous year’s sampling of sessions looking at cognitive health and fitness, expanding to a full two-day track at The Games for Health Conference, June 11-12, Boston, MA. The Conference features the largest gathering of organizations interested in the intersection between videogames, health and healthcare.

“There is already a very active cognitive health videogames industry and field of research,” said Ben Sawyer, co-founder of the Games for Health Conference. “We partnered with SharpBrains to bring their expertise in this field our conference planning. Together we have for the first time created a powerful set of sessions and a much needed conversation with researchers, thought-leaders and industry pioneers who will attend the event in June.”

The track features a dozen sessions covering research findings and partnerships, implementation in insurance, consumer and clinical settings, and special sessions looking at innovative areas such as driver safety, healthy aging, attention deficits, stroke/traumatic brain injury, schizophrenia and multiple sclerosis.

“The convergence of interactive media such as videogames with cognitive science opens the door to innovative and scalable approaches to Read the rest of this entry »

There’s such a flood of very significant research studies, educational resources and articles related to brain health, it’s hard to keep track – even for us!

Let me introduce and quote some of the top Brain Health Studies, Articles and Resources published in March:

1) Cognitive Decline Begins In Late 20s, Study Suggests (Science Daily)

- “These patterns suggest that some types of mental flexibility decrease relatively early in adulthood, but that how much knowledge one has, and the effectiveness of integrating it with one’s abilities, may increase throughout all of adulthood if there are no pathological diseases,” Salthouse said.

- However, Salthouse points out that there is a great deal of variance from person to person

2) Cerebrum 2009: Emerging Ideas in Brain Science – new book by the Dana Foundation that “explores the cutting edge of brain research and its implications in our everyday lives, in language understandable to the general reader.”

A couple of excellent chapters of direct relevance to everyone’s brain health are:
- Chapter 4: A Road Paved by Reason, by Elizabeth Norton Lasley

- Chapter 10: Neural Health: Is It Facilitated by Work Force Participation?, by Denise Park, Ph.D

3) Staying Sharp DVD Program: “Dr. Jordan Grafman, chief of the Cognitive Neuroscience Section at the National Institute of Neurological Disorders and Stroke outside of Washington, DC, and a member of the Dana Alliance for Brain Initiatives, is your guide as we cover what to expect from the aging brain and what we can do to ’stay sharp.’

For a free DVD of this program you can contact stayingsharp@dana.org. (they say free in their website, I don’t know if that includes shipping & handling)

4) Drivers to be tested on cognitive ability starting at age 75 (Japan Times)

The outline of a cognitive test that drivers aged 75 or over will be required to take from June when renewing their licenses was released Thursday…The test is intended to reduce the number of traffic accidents involving elderly drivers by measuring their cognitive level.

5) Physical Fitness Improves Spatial Memory, Increases Size Of Brain Structure (Science Daily)

- “Now researchers have found that elderly adults who are more physically fit tend to have bigger hippocampi and better spatial memory than those who are less fit.”

6) Brain Trainers: A Workout for the Mind (Scientific American Mind)

“I recently tried out eight of the latest brain fitness programs, training with each for a week. The programs ranged widely in focus, quality and how fun they were to use. “Like physical exercise equipment, a brain exercise program doesn’t do you any good if you don’t use it,” says Andrew J. Carle, director of the Program in Assisted Living/Senior Housing Administration at George Mason University. And people tend not to use boring equipment. “I remember when NordicTrack was the biggest thing out there. Everyone ran out and bought one, and 90 percent of them ended up as a clothes rack in the back of your bedroom.”

The reporter used: Posit Science’s Brain Fitness Program Classic, HappyNeuron, Nintendo BrainAge, CogniFit’s MindFit/ CogniFit Personal Coach, Lumosity, MyBrainTrainer, BrainTwister, Cogmed Working Memory Training.

7) The Latest in Mental Health: Working Out at the ‘Brain Gym’ (Wall Street Journal)

- “Marshall Kahn, an 82-year-old family doctor in Fullerton, Calif., says he got such a boost from brain exercises he started doing at a “Nifty after Fifty” club that he decided to start seeing patients again part-time. “Doing all the mental exercise,” he says, “I realized I’ve still got it.”

Debate Over Drugs For ADHD Reignites (Washington Post)

- “New data from a large federal study have reignited a debate over the effectiveness of long-term drug treatment of children with hyperactivity or attention-deficit disorder, and have drawn accusations that some members of the research team have sought to play down evidence that medications do little good beyond 24 months.”

- “The study also indicated that long-term use of the drugs can stunt children’s growth.”

Adaptive training leads to sustained enhancement of poor working memory in children (Developmental Science)

Abstract: Working memory plays a crucial role in supporting learning, with poor progress in reading and mathematics characterizing children with low memory skills. This study investigated whether these problems can be overcome by a training program designed to boost working memory. Children with low working memory skills were assessed on measures of working memory, IQ and academic attainment before and after training on either adaptive or non-adaptive versions of the program. Adaptive training that taxed working memory to its limits was associated with substantial and sustained gains in working memory, with age-appropriate levels achieved by the majority of children. Mathematical ability also improved significantly 6 months following adaptive training. These findings indicate that common impairments in working memory and associated learning difficulties may be overcome with this behavioral treatment.

9) Brain cortex thinning linked to inherited depression (Los Angeles Times)

- “On average, people with a family history of depression appear to have brains that are 28% thinner in the right cortex — the outermost layer of the brain — than those with no known family history of the disease. That cortical thinning, said the researchers, is on a scale similar to that seen in patients with Alzheimer’s disease or schizophrenia.”

Welcome to Encephalon´s 50th edition, where you will find another superb collection of blog posts on all things Brain and Mind.

Enjoy these contributions:

Science & Technology

Mind Hacks reports that Facebook ate my psychiatrist. We can learn about the benefits of social networking sites like Facebook, bringing great perspective to recent and misguided media speculation (fuelled by a recent talk at the Royal College of Psychiatrists). Vaughan, will you please report on the benefits of participating (and, better, hosting) Encephalon?.

Dungeons And Dragons – Or Mazes And Monsters?: PodBlack Cat offers a thought-provoking review of the therapy (including self-therapy) applications of role-playing games such as the classic Dungeons And Dragons and the more recent massively multiplayer online games.

Cognitive Daily covers another type of game. Read the rest of this entry »

After many months of work (and we hope many new neurons and stronger synapses in our brains), we have just released our inaugural report on the emerging Brain Fitness Software Market, the first to define the brain fitness and training software market and analyze the size and trends of its four customer segments. We estimate the size of the US brain fitness software market at $225M in2007, up from $100m in 2005 (50% CAGR). The two segments that fueled the market growth: consumers (grew from $5m to $80m, 300% CAGR) and healthcare & insurance providers (grew from $36m to $65m, 35% CAGR).

Highlights from The State of the Brain Fitness Software Market 2008 report include:

1) 2007 was a seminal year for the US Brain Fitness software market, which reached $225 million in revenues – up from an estimated $100 million in 2005.

2) Over 20 companies are offering tools to assess and train cognitive skills to four customer segments: consumers; healthcare and insurance providers; K12 school systems; and Fortune 1000 companies, the military, and sports teams.

3) The Nintendo Brain Age/ Brain Training phenomenon has driven much of the growth. The consumer segment grew from a few million in 2005 to an estimated $80 million in 2007.

4) There is major confusion in the market, so education will be key. Users and buyers need help to navigate the maze of products and claims.

Read the rest of this entry »

The CDC has reported a joint initiative with the Alzheimer’s Association to create the Healthy Brain Initiative: A National Public Health Roadmap for Cognitive Health. Some quotes from their announcement:

• “In order to maintain and improve the cognitive performance of all adults, the Centers for Disease Control and Prevention (CDC) and the Alzheimer’s Association today released the first-ever National Public Health Road Map to Maintaining Cognitive Health (Road Map) at the 2nd Alzheimer’s Association International Conference on Prevention of Dementia in Washington, DC.”
• “The Road Map highlights the importance of maintaining and improving cognitive health to the overall health of the nation. The Road Map is both a call to action and a guide for implementing a coordinated approach to raising the public’s awareness about cognitive health and increasing the nation’s commitment to understanding both the risks for cognitive decline and ways of maintaining brain health.”
• “Efforts to maintain and improve public health have focused mostly
  ‘below the neck,’ addressing diseases and conditions affecting the heart
  and other bodily organs,” said Harry Johns, Alzheimer’s Association
  President and CEO. “The National Public Health Road Map to Maintaining
  Cognitive Health shifts the focus ‘above the neck’ to draw attention to
  maintaining the health of our brains, which arguably is the most important
  organ in our bodies.”

We hope the message gets well-heard!

Related posts:

• The Dana Guide to Brain Health book review
• Easy Steps to Improve Your Brain Health Now