April 2016

I’ve decided it’s time to start writing a newsletter about the field of brain plasticity and cognitive training. You’re getting this email because I know you—or you have collaborated with Posit Science—and in one way or another I thought you might be interested, and I want to stay in touch.  If you don’t want to get this email every other month or so, just email me and I’ll take you off the list. We can still be friends.

There’s a lot going on in the science and application of brain plasticity and cognitive training.  My hope in writing this newsletter with my colleagues at Posit Science is to share information across the greater research community—about new trials, new publications, new developments—so we all get smarter together, build better tools, do better science, and could potentially help more people recover from various brain-related illnesses.

Without further ado, here are a few things that have interested me over the past month or two.


A large national study evaluating impacts of comprehensive brain health in an aging population…
The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial recently published their main results. The goal of FINGER was to assess a multi-domain approach for preventing cognitive decline in older adults. The intervention was a combination of nutrition (fruit and vegetables, whole grains, low-fat options dairy/dairy, fish 2x/week), physical exercise (strength and aerobic training based on the Dose-Responses to Exercise Training protocol), and cognitive training (targeting episodic & working memory, executive function, and speed), while the control group received “general health advice.” With 1,260 participants enrolled and followed for 2 years, results showed an 0.20 z-score change in the intervention group, significantly larger than the 0.16 z-score change seen in the control group.

I found the relatively small between-group effect size quite surprising. The IMPACT trial (with a set of auditory training exercises from Posit Science) showed a 0.30 between-groups effect size after 10 weeks of training, and substantially larger impacts for training completers. I suspect that had the cognitive training program in FINGER been more intensive, or if they had applied different exercises (there’s not much detail in exercise designs or schedules in their report), effects might have been even bigger. But I do think that’s it time we started to see these kinds of national level, integrated-brain-health trials. Their grand, understated conclusion: “(A) multi-domain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.”

An important erratum in the literature…
In one of the most widely cited reports about the effects of computerized brain training in adult populations, Cambridge University (now University of Western Ontario) scientist Adrian Owen led a team that documented cognitive training impacts in a large cohort participating in an open trial publicized on a BBC program. Owen’s team had created two programs specifically for evaluation in this loosely controlled trial.

Their computerized brain training failed the first test. Their study results, involving over 11,000 30-60 year-old trainees, documented improvements on all of the tasks they worked on – but no generalization and no clear benefits extending to impact their everyday lives. Owen and colleagues stated, in a rather astounding editorial comment in their study abstract, that “the widely held belief that commercially available computerized brain-training programs improve general cognitive function in the wider population… lacks empirical support.”

This publication got a huge amount of press coverage, with headlines like “Brain Exercises Don’t Improve Cognition.” But the results were obviously spurious, because we know that all brain training programs are not the same, in their designs or quality or neurological impacts. Some work. Some don’t work.  Spurious, because by 2010 there were already a large number of far better controlled trials that had shown, unequivocally, that brain programs can drive benefits that transfer to important real life abilities. Spurious, because nothing can be ‘proved’ by this kind of uncontrolled study in which the average trainee worked at computerized exercises for less than 2 hours, on individually sporadic and uncontrolled training schedules. At best, this team could have fairly concluded that they were unable to produce a form of cognitive training that, with this limited dosing and uncontrolled application, was effective in use.

But also spurious, because the primary broad conclusion of their study was just plain wrong. Now, five years later, the same team has reported that longer-term use of the same program in an older-aged (>60 year old) population shows very positive effects. Now, strong far-transfer impacts to instrumental activities of daily living, verbal learning, reasoning and other real-life abilities were recorded. Now, these clear benefits are shown to be (who’s surprised?) strongly dose dependent. And now, benefits equaled those that could be achieved using far less scalable personal training delivery strategies.

Alas, Nature is not going to publish this as an erratum. My guess is that given that the new publication is buried in the Journal of the American Medical Directors Association and not Nature, this correction shall not receive the same level of public attention as did the first paper.


Of the hundreds of studies using computer-delivered brain training programs that are now underway, we’d like to feature exemplary ongoing studies of potentially broad interest and societal value in each of our quarterly reports. Let me know about YOUR projects so that we can tell everyone in our research family about your work in future newsletters.

Cognitive Training and Huntington’s Disease
In a study supported by the New Zealand government, Dr. Melanie Cheung and colleagues are defining the behavioral and neurological impacts of intensive computerized training in individuals with Huntington’s Disease. Huntington’s is an inherited condition affecting about 50 million individuals worldwide. There is an especially high incidence in the Maori population in New Zealand. Individuals in this wonderfully generous native community have agreed to help Dr. Cheung’s research team determine whether or not intensive brain plasticity-based training can alter the inexorable progression of this illness to its catastrophic end-stage marked by progressive loss of physical and mental control paralleled by physical brain changes especially strongly affecting specific brainstem, thalamic, cortical and basal ganglia functioning.

Symptomatic HD patients are the focus of this trial. Once symptoms emerge, HD advances to mortality within 10-20 years. The randomized controlled trial model trains matched HD and non-HD individuals, and applies a duration-matched (casual computer-game) actively-controlled strategy for comparison in the HD cohort. All subjects undergo extensive cognitive and psychiatric assessment prior to and immediately following program completion. All subjects also undergo MRI assessments focusing on the physical, functional and connectional status of cortical, thalamic and basal ganglia structures known to be strongly impacted in the disease. Training is completed at home, with compliance and progress monitored remotely. All assessments are independently conducted by blinded evaluators. MRI analyses are being provided by a University of California, San Francisco team, again with evaluators blind to training/control cohort memberships.

The trial should be completed later in the fall of 2016.  Dr. Cheung’s team hopes to use outcomes from this initial trial to elaborate training for a larger international trial.


The FTC concludes actions against Carrot Neurotechology and Lumosity.
The Federal Trade Commission brought their actions against Aaron Seitz and his partners at Carrot Neurotechnology Incorporated (a small Riverside-based startup) to a close by choosing not to alter or amend their action against Carrot following public commentary. As those of you familiar with this case are aware of, Dr. Seitz is a UC Riverside psychologist who as a postdoctoral fellow and assistant professor had conducted several studies showing that aspects of visual perception were improved by particular forms of computerized training. The FTC’s core concern was that these studies were not randomized, controlled, blinded studies. Despite the fact that many scientists submitted comments to the FTC supporting Dr. Seitz, arguing that his work had met the generally accepted standards for research in the field, the FTC upheld its original judgment.

The FTC’s response to these comments contains helpful guidance for scientists considering the eventual broad use of their research in cognitive training. In particular, the FTC requires that data supporting health-related claims must be from randomized, controlled studies that are blinded to the extent feasible. The FTC specifically notes that it is generally feasible to have active controls/alternate activities in cognitive training studies, and although participants may know that a study involves two distinct activities, participants can be kept blind as which activity is believed to be superior by researchers. As an example from our own work, consent forms for trials organized at Posit Science typically describe trials as comparing two distinct forms of cognitive training, rather than describing trials as comparing a treatment and a placebo control.

In addition, The FTC also brought their action against Lumosity for deceptive advertising to a close, stating in blunt terms that companies must have adequate scientific data to support their claims. Of course, this is an obvious requirement. But it serves as a reminder to everyone involved in cognitive training (including us!) that clinical trials and published data have to come first.

The FTC imposed a financial penalty on both groups–$50 million for Lumosity, reduced to $2 million given their inability to pay, and $150k for Dr. Seitz and his partner at Carrot. Lumosity’s payment seems like it will have little impact on company operations or business reach (I still hear their ads on NPR), while Carrot’s will no doubt cause substantial personal hardship to Dr. Seitz. In my view, the FTC used a cannon to kill the fly, and a BB gun to sting the elephant.

A shared publication database

The scientific literature in our field is scattered across many journals. We try to keep up with it, and am committed to making our efforts public. We ask you to help us keep up with this fast-moving feast!  You can see our shared database of published randomized controlled trials in brain training online. It’s worth taking a look, as you might find something you weren’t aware of before that can be helpful for you.  As always, please email us any papers that you know about that you find to be missing from this compendium.