(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 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