Racing to restoring cognitive function

Wisdom may come with age, but so too does an inexorable decline in cognitive abilities. Whether it is speed of processing, working or long-term memory, it all starts to go downhill as people move into their 30s, and continues as they enter their 40s and beyond (click on the figure for the details). What to do? Some people do crossword puzzles.Mostly they just worry. A few sign up for one of the many brain fitness software suites out there, but do they really work? The answer has mostly been maybe. Until now.

Before getting to the breakthrough, let’s briefly see what the state of affairs were last week. Many studies have shown improvements with brain training, but the gain is mainly in the game; overall, cognitive function is usually not affected. Getting better at a game is all well and good, but that is not what people are after.

One study was a clear exception. In 2008, Jaeggi et al. published a paper in PNAS which showed that one particular game – the N-back task – improved not just task performance but also fluid intelligence. This was met with a great deal of excitement, and you can find many N-back tasks on the internet. But the N-back is hard. It’s also pretty boring. I suppose that is why I have struggled with maintaining a regular practice of N-back training. While no one has disputed Jaeggi et al’s findings, the field was rocked on its heels in 2010 when Adrian Owen and his colleagues at Cambridge published a paper in Nature in which they tested 11,430 people (!!) in Britain. What they reported was that “in every one of the cognitive tasks that were trained, no evidence was found for transfer effects to untrained tasks, even when those tasks were cognitively closely related.” [Notably, the N-back task was not included in the study.]  At the time I wrote that more than anything, Owen’s results were likely to spur further investigation.

And so they have.  In a very thoughtfully designed set of experiments published this past week in Nature, Adam Gazzaley’s group at UCSF report that they have developed a new game called Neuroracer that not only improves the ability of older adults to multitask, but it also improves cognitive control, working memory, and attention; all of these are cognitive domains that are known to degrade in normal aging.  The experiments are exceedingly carefully carried out – there is both an active control group who had a slightly different task and a no-contact control group; neither showed any benefit. [It is not clear whether the game would have a similar effect in younger adults, but you can be sure that those data, and more, are in the pipeline.] What is remarkable is the degree to which the Neuroracer was able to restore cognitive function.

I have not played the Neuroracer game myself, but I know from discussions with Adam that his objective was to solve not just the efficacy side of the equation, but also to make the game interesting. Although it was not discussed in the article, if Neuroracer satisfies this criterion as well, it represents a doubly important advance in the field.

Adam visited us in November 2011 and I had a chance to sit down to talk with him about the degradation of attention that accompanies multitasking in the modern world. The video can be found below.

Cognitive training as a bona fide therapeutic

The New Scientist reports that Brain Plasticity, Inc. a developer of cognitive training games, has entered into discussions with the FDA to market one of its brain training software packages as a bona fide therapeutic. The issue is of interest on many accounts, and the New Scientist article covers many of the obvious ones that were discussed at the Entertainment Software and Cognitive Neurotherapeutics Society meeting held last week in San Francisco.  Noteworthy among them are the hope that FDA approval will bring validity to a field that has both serious practitioners and charlatans others who cut corners, as well as the concern that FDA approval might slow down progress, as the approval process is likely to be glacial compared to the pace of change in software development.

But if we unpack this a bit, we find that there are deeper levels of significance, and at least one of these are is worthy of further discussion. Continue reading

2011 Sharp Brains Summit

Registration is now open for the 2011 Sharp Brains Summit (full disclosure – I am a speaker this year). Sharp Brains is an organization that follows the business of brain fitness software and is primarily dedicated to promoting the business model of selling software.  At the same time, Alvaro and his team are quite serious about highlighting the best ways that we can improve our brains (non-pharmacologically, that is), and the information that Sharp Brains provides is not only intriguing but often practical. If you are at all interested in the latest and greatest in this rapidly growing field, by all means attend.

Even better, you don’t have to go anywhere!!  This is a virtual conference, so all that you need is a computer (you need to be  able to run Flash, but if you can watch YouTube videos, you are all set) to attend from the comfort of your own home or office.  I attended the 2010 Summit, and it was remarkably effective – not only did it save travel expenses and time for me (not to mention that it was environmentally responsible), but it turned out that the virtual conference had an advantage over in-person conferences in one way. Most people have had the experience that some of the most valuable discussions at conferences occur not from the podium but in the hallway. The virtual conference software allows for hallway conversations, but the bulk of that conversation occurs as a public comment stream. Getting to hear what many people are saying in the ‘hallway’ is much better than hearing only one person, and if you like what they say, you can send them a note and continue your conversation as a private one.

For the full list of speakers, go here.

For a brief intro to virtual conferences, go here.

Massive study finds no support for generalizability of benefit from brain training software

In a powerhouse of a publication, Adrian Owen and his colleagues have taken a broadside at the field of brain fitness software.  Together with the BBC popular science program Bang Goes the Test, they recruited 11,430 people who completed an average of twenty-four 10 minute training sessions over the six weeks that the experiment was run.  All of these individuals underwent cognitive testing before and after brain training, and the results were pretty clear: brain training provided no benefit other than improvement on the task that people trained with.  In their words:

In our view these results provide no evidence to support the widely held belief that the regular use of computerized brain trainers improves general cognitive functioning in healthy participants beyond those tasks that are actually being trained.

There will be much debate about this study in the days and weeks to come, much of it focused on the details, which, as we all know, is where the devil habitually resides.   In particular, it will be very important for experts to examine the specific tests being employed and compare them to what has been previously published, especially for those brain training regimes that have reported improvements in fluid intelligence.  One thing is clear: the numbers of participants make it difficult to refute Owen et al.’s findings, and certain make replication a challenge.

Personally, I see Owen et al.’s study as a healthy development, indicating that the field is moving from adolescence into early adulthood.  Indeed, with pharmaceuticals of all stripes we are quite accustomed to optimistic early results only to find in later, larger trials (especially after the drugs are released into use by the general population) that a subtle effect is seen which was not observed in earlier clinical trials.  Moreover, it is likely to spur further investigation, which again can only be healthy. The results, and our interpretation of those results, are likely to change over time.

I will admit to being among those who had hoped that brain training would produce impressive effects.  But in the end, I am a slave to data.   Anything less would be wishful thinking.

For more about the study, see the following video from the Nature Video.

Image source: Nature Publishing Group and Rex Features

Hat tip to Sofia Lombera for alerting me to the video

Neuroscientists: neither angels nor devils be

John Horgan, a science writer of some repute, has a new post up at Scientific American in which he takes neuroscientists to task for selling out (actually, his title is even more inflammatory, but that’s just journalism for you).

John begins by commenting upon a trend that has been going on for some time: the military has begun to reach out to neuroscience for innovation.  He particularly excoriates high profile neuroscientists who composed the Committee on Opportunities in Neuroscience for Future Army Applications for the National Research Council and the report that they produced entitled “Opportunities in Neuroscience for Future Army Applications“.  The report is free to download, and having read it when it was first released and then revisiting it after seeing John’s post, I am scratching my head, wondering what John is going on about.  Rather than promoting the sorts of nightmare scenarios that one might imagine Dr. Strangelove drooling over, the report makes a series of sensible recommendations that generally deal with capitalizing upon advances in neuroscience to improve training, reduce stress, treat PTSD, and other applications of neuroscience to military personnel. To this reader, this all seems rather humane. [I would only hope that other militaries as well as innocent civilians who suffer from what has euphemistically been called 'collateral damage' could benefit from these advances as well.] Continue reading

Sahakian on ‘Smart drugs’ at the Royal Institution

Photo: Murdo Macleod in the Guardian

Barbara Sahakian gave a talk at  the Royal Institution the other day on ‘Smart Drugs’.  You can listen to the talk here.   The talk received quite a bit of media attention, most notably in an article in the Guardian entitled, “A Pandora’s box full of smart drugs“.

Personally, I think that the data that methylphenidate and modafinil are bona fide cognitive enhancers is not as strong as many suggest, but there is little question that the pharmaceutical industry is gearing up to produce drugs that will satisfy this market (I hesitate to say need) in the years to come.  I was reassured that Barbara pointed out to the audience that exercise, both physical and mental, can provide effects that are comparable to what these drugs can offer.  Whether the audience heard that or not remains to be seen.

Someone who attended the lecture reported that, “She is disquietingly relaxed about it all; I wasn’t certain that she realises the power of what she is helping to unleash.”   This reminded me of the comment that David Healy made at the Brain Matters conference in Halifax in September 2009, where he opined that one of the problematic consequences of neuroethicists talking about cognitive enhancement is that it educates the populace that these compounds exist, and thereby might encourage their use.  Indeed, in the comments section of the Guardian article, someone calling themselves the ‘Rabid Racoon’ wrote,

I had no idea these drugs existed, thanks for informing me so I can go buy some.

p.s. slightly disapointed that the ‘ads by google’ which are putatibvely (sic) based on the content of the page you are looking at aren’t for online pharmacies Continue reading

Brain Fitness Software update

I have just returned from attending the two day Sharp Brains Summit.  Well, returned is not really the right word as the conference was held entirely online. So attending this conference involved sitting in my office and turning on my computer. The conference was both an information session on the emerging field of brain fitness software and, to be truthful, a marketing opportunity for the companies that are developing these programs.  Several observations from the conference are of relevance to the ongoing discussion about the the neuroethics of cognitive enhancement.

First of all, I was pleasantly surprised at the breadth of cognitive domains that are being targeted by brain fitness software.  Working memory, attention, and even emotional regulation are all fair game for this burgeoning field (improving driving skills, which ultimately makes everyone on the road safer, was highlighted). Secondly, I was impressed with the science.  It became clear as the presentations went on that some companies were offering software that was backed up by solid, peer-reviewed research.  They were able to state unequivocally that their software was able to demonstrate improvements as measured by good science.  Equally obvious was the fact that other company offerings were not (or at least not obviously) backed by solid science, and to me their pitch less compelling.  It seems that in this field, good science will be a marketing strength and this is a boon to the consumer as it is an antidote to hucksterism. Continue reading