Cognitive Training and Brain Fitness Computer Programs: Interview with Dr. Elkhonon Goldberg

December 8, 2006/Alvaro Fernandez/

Dr. Elkhonon Gold­berg is a clin­i­cal pro­fes­sor of neu­rol­o­gy at New York Uni­ver­si­ty School of Med­i­cine, and author of over 50 peer-reviewed papers. His areas of exper­tise include exec­u­tive func­tions, mem­o­ry, atten­tion deficit dis­or­der, demen­tia, trau­mat­ic brain injury, and oth­ers. Dr. Gold­berg was a stu­dent and close asso­ciate of the great neu­ropsy­chol­o­gist Alexan­der Luria. His book The Exec­u­tive Brain: Frontal Lobes and the Civ­i­lized Mind (Oxford Uni­ver­si­ty Press, 2001) has received crit­i­cal acclaim and has been pub­lished in 12 lan­guages. His recent book The Wis­dom Para­dox: How Your Mind Can Grow Stronger As Your Brain Grows Old­er (Gotham Books, Pen­guin, 2005) offers an inno­v­a­tive under­stand­ing of cog­ni­tive aging and what can be done to fore­stall cog­ni­tive decline. It has been, or is in the process of being, pub­lished in 13 languages.

We are for­tu­nate that Dr. Gold­berg is Sharp­Brains Co-Founder and Chief Sci­en­tif­ic Advi­sor. His book The Wis­dom Para­dox inspired me to embark in this path, and has been a key sound­ing board in the devel­op­ment of what we are doing.

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Key take-aways

- “Use It and Get More of It” reflects real­i­ty bet­ter than “Use It or Lose It”.

- Let’s demys­ti­fy cog­ni­tion and the brain. Every­one needs to have a basic under­stand­ing of the brain-and how to cul­ti­vate it.

- Well-direct­ed men­tal exer­cise is a must for cog­ni­tive enhance­ment and healthy aging.

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Roots: Vygot­sky and Luria

Alvaro Fer­nan­dez (AF): Elkhonon, maybe we could start with Vygot­sky. At one of my Stan­ford class­es, I became fas­ci­nat­ed by his the­o­ry of learn­ing. Which links into mod­ern neu­ropsy­chol­o­gy.

Dr. Elkhonon Gold­berg (EG): Vygot­sky pro­posed that learn­ing requires inter­nal­iza­tion. And that inter­nal­iza­tion equals, lit­er­al­ly, a change in the brain of the learn­er. Of course there weren advanced neu­roimag­ing tech­niques those days, so sci­en­tists could only spec­u­late about what hap­pened in healthy brains. But they could care­ful­ly ana­lyze what hap­pened with patients who had suf­fered any kind of seri­ous brain prob­lem, from strokes to trau­mat­ic brain injury. And this is how neu­ropsy­chol­o­gy was born: Alexan­der Luria, Vygot­sky dis­ci­ple, and my own men­tor, was com­mis­sioned to help reha­bil­i­tate Russ­ian sol­diers with brain injuries dur­ing WWII. This pro­vid­ed invalu­able clin­i­cal mate­r­i­al for under­stand­ing the mech­a­nisms of the healthy brain. Much of mod­ern cog­ni­tive neu­ro­science rests its foun­da­tion in Luri­a’s work.

Neu­roimag­ing

AF: and now we have new neu­roimag­ing techniques.

EG: Pre­cise­ly. It is often said that new neu­roimag­ing meth­ods have changed neu­ro­science in the same way that the tele­scope changed astron­o­my. We use MRI, PET, SPECT, fMRI and MEG both in neu­ro­science research and in clin­i­cal prac­tice. None of these tech­niques is per­fect, but used prop­er­ly they pro­vide us with a much bet­ter under­stand­ing than we had only 30 years ago.

Research and work

AF: please tell us about your main research and prac­ti­cal inter­ests.

EG: As you can see in my papers and books, I will cat­e­go­rize them in 3 areas‑a) com­put­er-based cog­ni­tive training/ Brain Fit­ness over­all, b) healthy cog­ni­tive aging, and c) frontal lobes and exec­u­tive func­tions. I am also inter­est­ed in mem­o­ry, hemi­spher­ic inter­ac­tion, and in a gen­er­al the­o­ry of cor­ti­cal func­tion­al orga­ni­za­tion, but we will leave this for anoth­er occa­sion and focus today on those three areas.

First, Cog­ni­tive Training/ Brain Fit­ness. Rig­or­ous and tar­get­ed cog­ni­tive train­ing has been used in clin­i­cal prac­tice for many years. It can help improve mem­o­ry, atten­tion, con­fi­dence and com­pe­tence, rea­son­ing skills, even how to reduce anx­i­ety and deal with uncom­fort­able situations.

Sec­ond, healthy cog­ni­tive aging. The brain evolves as we age. Some areas, such as pat­tern recog­ni­tion, get bet­ter with age. Some require extra-work­outs in order to reduce “chinks in the armor” and increase neu­ro­pro­tec­tion through the Cog­ni­tive (or Brain) Reserve). Hence, the need for tar­get­ed cog­ni­tive training.

Third, the Frontal lobes and exec­u­tive func­tions, which per­me­ate seem­ing­ly very dif­fer­ent prob­lems such as ADHD and Alzheimer’s, are crit­i­cal for our iden­ti­ty and suc­cess­ful dai­ly func­tion­ing so they require extra attention.

Frontal Lobes and exec­u­tive functions

AF: Please tell us more about what the Frontal Lobes are

EG: We researchers typ­i­cal­ly call them the Exec­u­tive Brain. The pre­frontal cor­tex is young by evo­lu­tion­ary terms, and is the brain area crit­i­cal to adapt to new sit­u­a­tions, plan for the future, and self-reg­u­late our actions in order to achieve long-term objec­tives. We could say that that part of the brain, right behind our fore­head, acts as the con­duc­tor of an orches­tra, direct­ing and inte­grat­ing the work of oth­er parts of the brain.

I pro­vide a good exam­ple in The Exec­u­tive Brain book, where I explain how I was able to orga­nize my escape from Rus­sia into the US.

Sig­nif­i­cant­ly, the path­ways that con­nect the frontal lobes with the rest of the brain are slow to mature, reach­ing full oper­a­tional state between ages 18 and 30, or maybe even lat­er. And, giv­en that they are not as hard-wired as oth­er parts of the brain, they are typ­i­cal­ly the first areas to decline.

Cog­ni­tive Train­ing and Brain Fit­ness

AF: And is that one of the areas where cog­ni­tive training/ Brain Fit­ness Pro­grams can help

EG: Yes. Most pro­grams I have seen so far are bet­ter at train­ing oth­er brain areas, which are also very impor­tant, but we are get­ting there, with exam­ples such as work­ing mem­o­ry train­ing, emo­tion­al self-reg­u­la­tion and domain-spe­cif­ic deci­sion-mak­ing. Some of the spec­tac­u­lar research and clin­i­cal find­ings of the last 20 years that remain to be dis­cov­ered by the pop­u­la­tion at large are that we enjoy life­long brain plas­tic­i­ty and neu­ro­ge­n­e­sis, that the rate of devel­op­ment of new neu­rons can be influ­enced by cog­ni­tive activ­i­ties, and that intense men­tal chal­lenges pro­vide extra resis­tance to aging.

Exer­cis­ing our brains sys­tem­at­i­cal­ly ways is as impor­tant as exer­cis­ing our bod­ies. In my expe­ri­ence, “Use it or lose it” should real­ly be “Use it and get more of it”. And com­put­er-based pro­grams are prov­ing to be a great vehi­cle for that.

Emo­tions and Art

AF: We have been talk­ing most­ly about cog­ni­tion or “think­ing”. What about the role of emo­tions, as shown by the great research by Dama­sio?

EG: Great ques­tion. Until recent­ly, emo­tions were sim­ply not rel­e­vant for many cog­ni­tive neu­ro­sci­en­tists. That is chang­ing, and there is more and more research look­ing into what makes us “unique­ly human”: attrib­ut­es like moti­va­tion, judg­ment, empa­thy, insight into oth­ers, emo­tion­al self-regulation.

AF: how does that link into the role of art? Can we con­sid­er art cre­ation and appre­ci­a­tion as brain exer­cise?

EG: Indeed, and a great one. This is still open ter­ri­to­ry, but my per­son­al opin­ion is that art’s main pur­pose is in fact exer­cis­ing brains. As I men­tion in The Wis­dom Para­dox, I would­n’t be sur­prised if piano lessons were shown to improve over­all sharp­ness and lucid­i­ty. Any activ­i­ty changes the brain, and sys­tem­at­ic pro­grams can be designed to lead that change in a bet­ter way than ran­dom dai­ly activ­i­ties. Learn­ing a com­plex skill such as learn­ing the piano helps train and devel­op some parts of the brain. Well-designed com­put­er-pro­grams help train and devel­op oth­er parts.

Key Mes­sages

AF: if we had to sum­ma­rize your key mes­sages to the pub­lic, based on your research and clin­i­cal career, what would you say?

EG: first, I would say, “For­get about Use It or Lose It”. It is “Use It and Get More of It!”. Sec­ond, I would like to con­tribute to demys­ti­fy cog­ni­tion and the brain, enabling peo­ple to increase their self-aware­ness, their knowl­edge of the brain and how to cul­ti­vate it through­out life. Final­ly, I would high­light the impor­tance of well-direct­ed men­tal exer­cise, on one hand, and of sup­port­ive social net­works, on the oth­er. I am enthused about the oppor­tu­ni­ty to work with you and Sharp­Brains and get the word out.

AF: so are we. It is a plea­sure to col­lab­o­rate on such an endeav­or. Which I am sure will pro­vide us with plen­ty of brain exercise.

EG: as long as you don’t stress out, that’s good! Good night, Alvaro.

AF: Good night, Elkhonon.

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- Cog­ni­tive Neu­ro­science and Psy­chol­o­gy Inter­view Series: in-depth inter­views with 11 sci­en­tists and experts in cog­ni­tive train­ing and brain fitness.

- Books on neu­ro­plas­tic­i­ty and mem­o­ry train­ing: reviews of Train Your Brain, Change Your Mind, by Sharon Beg­ley, and The Brain That Changes Itself, by Nor­man Doidge. Both books are fas­ci­nat­ing and pow­er­ful; each would have mer­it­ed appear­ing in the 2007 New York Times List of 100 Notable Books.

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16 Comments

  1. Andy on December 13, 2006 at 11:18

    His work pro­vides extra moti­va­tion (for me per­son­al­ly, at least) to keep my mind active and chal­lenged. There’s a time and a place for inten­tion­al “down time” but not the men­tal (to some­times accom­pa­ny phys­i­cal) lazi­ness that seems to be fair­ly com­mon today. I enjoy life more when I’m intel­lec­tu­al­ly stimulated.



  2. Alvaro on December 14, 2006 at 8:38

    Andy, thanks for your nice com­ment. Yes, men­tal stim­u­la­tion is impor­tant “food” for our brains. Yes, “inten­tion­al “down time”” is also need­ed to man­age stress.

    Keep enjoy­ing life



  3. Marie Matthews on December 30, 2006 at 5:28

    1) I just read ” The Wis­dom Paradox”. I live in LA and I am a teacher, thus not very rich. I am 63 years old. Does Dr. Gol­berg offer soft­ware for peo­ple like me to use on my own com­put­er and enhance my brain as I tran­si­tion into old age?
    If not, are there decent alternatives?

    2) I teach “at risk students” in an alter­na­tive school in the inner city. My stu­dents are char­ac­ter­ized by a total or par­tial lack of the “executive” abil­i­ties of the frontal lobes ( plan­ning, empa­thy. prob­lem solv­ing etc…). Many also exhib­it symp­toms of Dislex­ia, ADD, Depres­sion …. Com­ing from poor socio-eco­nom­ic back­ground where decent health­care is rare they tend to self-med­icate with drugs (main­ly mar­i­jana) and alco­hol and in the process seem to wors­en their problems.
    Intu­itive­ly I have based my teach­ing on devel­op­ing brain skills to help with the traits they are miss­ing. Thus my inter­est in brain research. But my efforts have been hap­haz­ard and not sys­tem­at­ic because I obvi­ous­ly lack the nec­es­sary knowl­edge. Is there any­thing that can help me (from books to sofware) to cre­ate a more effec­tive program?

    I would be so grate­ful if you could help me. Thank you.

    Marie Matthews, San Pedro (LA) California



  4. Alvaro on December 30, 2006 at 5:48

    Dear Marie,

    First of all, thanks for con­tact­ing us. We are very hap­py that you read The Wis­dom Paradox.

    1) The pro­grams that Dr. Gold­berg uses in his clin­i­cal prac­tice would not nec­es­sar­i­ly be appro­pri­ate for a healthy per­son, such as your­self. (And in this web­site we do not offer clin­i­cal advice). From we pro­grams we offer now, the one that we would rec­om­mend for you is Mind­Fit Com­pre­hen­sive Work­out Pro­gram. You can read more infor­ma­tion in our Get Start­ed section

    2) Great ques­tion regard­ing pro­gram for exec­u­tive func­tion devel­op­ment in teenagers. This is a new field, and we have not found a tool we rec­om­mend for over­all frontal lobe train­ing for teenagers. We also do not pro­vide med­ical advice for peo­ple with spe­cif­ic con­di­tions-that would be a role for an school psy­chol­o­gist, prob­a­bly you have resources avail­able at the dis­trict level. 

    The one pro­gram avail­able that could help a good num­ber of your stu­dents (and staff) is Freeze-Framer Stress Man­age­ment Pro­gram, men­tioned in this Tech­nol­o­gy & Learn­ing arti­cle http://www.techlearning.com/showArticle.php?articleID=193700663. It is the best pro­gram we have found for emo­tion­al self-reg­u­la­tion (anx­i­ety reduc­tion, anger man­age­ment, reduc­tion of impul­siv­i­ty) and has both good sci­ence and good school-based tes­ti­mo­ni­als to sup­port its val­ue for teach­ers, school admin­is­tra­tors and stu­dents. Your school could start by get­ting one copy, for the prin­ci­pal or school psy­chol­o­gist office, that can be shared by as many peo­ple as you want (there are sep­a­rate log-ins). Some schools apply for grants to be able to install the pro­gram in sev­er­al com­put­ers in their labs. You can learn more in our Get Start­ed Sec­tion, or in the Solu­tions one, under Schools.

    Will be hap­py to talk next week, and pro­vide more con­text and address your questions. 

    Regards, and hap­py 2007



  5. karen landers on March 13, 2007 at 5:01

    am inter­est­ed in pur­chas­ing the sharp brain com­put­er soft­wear pro­gram. recent­ly had my mom diag­nosed with alzheimers.any help with where to pur­chase would be appreciated.



  6. Alvaro on March 14, 2007 at 12:41

    Dear Karen,

    Sor­ry to hear about your mom. None of the pro­grams we have is aimed at peo­ple with Alzheimer’s (we focus on pre­ven­tion and cog­ni­tive improve­ment for healthy indi­vid­u­als), in prin­ci­ple. Your mom’s doc­tor should see if our com­pre­hen­sive men­tal work­out (in the Get Start­ed sec­tion) might be help­ful for her, based on her sit­u­a­tion and priorities. 

    The Alzheimer’s Foun­da­tion has a num­ber of books and resources-they may also know of com­put­er-pro­grams more help­ful for your mom.

    Regards



  7. Rusty Rosenberger on September 30, 2007 at 1:55

    Let me train you twice per week for a month, and your phys­i­cal fit­ness will improve,
    relieve stress, build an unbe­liev­able self con­fi­dence, tone and tight­en all mus­cles, while learn­ing a fan­tas­tic self defense, all fore men­tioned ben­e­fits accom­plished train­ing only a total of one hour weekly.



  8. Alvaro on September 30, 2007 at 3:23

    Hel­lo Rusty, we are on the same boat, with com­ple­men­tary focus. Your expe­ri­ence is in phys­i­cal train­ing, which we often say is one of the key pil­lars of brain health. Now, the point is that is not the only pil­lar; if you want to exer­cise spe­cif­ic brain areas, or “men­tal mus­cles”, a well-designed men­tal work­out may be more effi­cient and direct. Please spend some more time on the site, and let us know how to make this point more clear.



  9. Sean Pedersen on December 28, 2007 at 4:48

    A local pri­vate school is sug­gest­ing a brain based com­put­er pro­gram they call the SMaRts pro­gram in order to teach our daugh­ter to learn audi­to­ry recep­tive skills to devel­op her learn­ing and lan­guage and rea­son­ing. Our daugh­ter is 9 years old and we believe she can ben­e­fit great­ly from this pro­gram but we can­not find this pro­gram any­where. Appar­ent­ly there are dif­fer­ent lev­els to com­plete based on accu­ra­cy, then speed, then speed and accu­ra­cy. Once a stu­dent com­pletes a lev­el fire­works go off on the com­put­er screen and they are con­grat­u­lat­ed! Do you have any insight as to the name of this pro­gram, who sells it or where it can be found? Thanks, Sean



  10. Alvaro on December 28, 2007 at 7:24

    Hel­lo Sean, 

    I have nev­er heard of “SMaRts pro­gram”. Which is sur­pris­ing, because we are quite up to speed with all cog­ni­tive train­ing lit­er­a­ture. The clos­est I can think of is that the school is using Sci­en­tif­ic Learn­ing’s Fast For­Word, and for sone rea­son decid­ed to rename it. But you should ask for the real name and spe­cif­ic peer-reviewed stud­ies on its valid­i­ty. Some oth­er tips to eval­u­ate com­put­er-based programs:
    https://sharpbrains.com/blog/2007/08/16/brain-training-games-and-games/



  11. Ellen Nash on June 29, 2008 at 12:23

    Do you have online cours­es avail­able? I am a Spe­cial Edu­ca­tion teacher and want to learn more about work­ing with dis­abil­i­ties and how the brain can be trained using “games”.



  12. Alvaro on June 30, 2008 at 2:12

    Hel­lo Ellen,

    We offered some online webi­na­rs last month, and may be offer­ing them again. Please sub­scribe to our newslet­ter to be notified.

    Now, the best resource for your school may be our Mar­ket Report, which pro­vides an overview of the whole field. We offer dis­counts to schools and aca­d­e­m­ic institutions.

    Regards



  13. Dr. Chris Wolf on July 9, 2008 at 3:23

    Dr. Gold­berg is a for­mer pro­fes­sor of mine. He is a vir­tu­al ency­clo­pe­dia of neu­ro­science. I high­ly rec­om­mend his books which are a joy to read.



  14. Alvaro on July 9, 2008 at 8:04

    Chris, thank you for vsit­ing us and your com­ment. I couldn´t agree more!



  15. Robert Forsythe MD on November 23, 2008 at 4:53

    I would like any infor­ma­tion on treat­ment of anox­ic brain injury. Includ­ing ery­thro­po­et­in, cog­ni­tive exer­cis­es ie com­put­er games, phys­i­cal exer­cise, vit B sup­ple­ments, omega 3, return to work, or oth­er treat­ments to short­en recov­ery or to improve out­come at one year.
    Thank you Robert Forsythe MD



  16. Alvaro Fernandez on November 25, 2008 at 10:16

    Dear Robert, we don’t offer clin­i­cal advice via this blog, I sug­gest you con­sult with a neu­ropsy­chol­o­gist to help direct the rehab of your patient. Regards



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