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Five Essential Guidelines to Improve Brain Health for All

Since 2010, the Sharp­Brains Vir­tu­al Sum­mit has been bring­ing togeth­er neu­ro­sci­en­tists, entre­pre­neurs, and prac­ti­tion­ers with a mis­sion to improve men­tal health­care, brain per­for­mance and gen­er­al well-being.

As we get ready to host our next col­lec­tive brain­storm­ing next week, let us share some key themes from our last Sum­mit, since they helped shape the Agen­da for this one.

In 2017, the gathering’s tone was gen­er­al­ly optimistic–given the explo­sion of sci­en­tif­ic and tech­no­log­i­cal break­throughs, start-ups and investments–but impor­tant eth­i­cal con­cerns were also wide­ly dis­cussed.

1. The Need is Very Real, Very Large and Largely Unmet

Dr. Tom Insel, a well-known sci­en­tist turned pol­i­cy-mak­er turned entre­pre­neur, shared a deep dive into the land­scape of health­care inno­va­tion: We have seen $15 Bil­lion invest­ed in Health Tech since 2012, in over a thou­sand new com­pa­nies … yet men­tal health­care has not tru­ly evolved while brain and men­tal dis­or­ders remain among the costli­est con­di­tions in the US, with an annu­al bur­den esti­mat­ed at $200+ Bil­lion.

 

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Same thing regard­ing aging and brain health: the need is very real and very large, both in devel­oped and in emerg­ing coun­tries. At least there we see stronger signs of advo­cates and pol­i­cy­mak­ers begin­ning to take note. For exam­ple, Sarah Lenz Lock from AARP spoke about the need for improved dig­i­tal assess­ments that are evi­dence-based and per­son­al­ized, help­ing mil­lions of old­er adults self-mon­i­tor their brain health and delay cog­ni­tive and mem­o­ry prob­lems.

 

A num­ber of researchers shared pop­u­la­tion-lev­el ways to pro­mote life­long brain health. For exam­ple, Belén Guer­ra-Car­ril­lo at UC-Berke­ley dis­cussed how Big Data com­ing from new online and mobile plat­forms can inform pol­i­cy. Dr. David Bartrés-Faz from the Barcelona Brain Health Ini­tia­tive described how track­ing behaviors–that sus­tain neur­al func­tion­ing in advanced age—can help per­son­al­ize inter­ven­tions, and how they are mea­sur­ing lifestyle fac­tors in a large, 3,000-subject-strong, ran­dom­ized tri­al.

 

2. Solutions Start with Early Detection and Digital Phenotyping

A very inge­nious pre­sen­ta­tions came from Jan Samzelius of Neu­raMetrix, one of the win­ners of the Brain­no­va­tions Pitch Con­test. His team, with a back­ground in cyber­se­cu­ri­ty, dis­cov­ered a method of assess­ing typ­ing cadence which could enable ear­ly detec­tion of neu­rode­gen­er­a­tive dis­eases, from Alzheimer’s Dis­ease to Parkinson’s. The sys­tem can run silent­ly (yes, per­mis­sion and pri­va­cy will be issues to address) in the back­ground of a per­son­al com­put­er or smart­phone, inte­grat­ing hun­dreds of vari­ables in a per­sons’ key­board cadence and flag­ging unusu­al pat­terns.

Anoth­er great exam­ple came from Nan­cy Briefs of Dig­i­tal Cog­ni­tion Tech­nolo­gies, which has adapt­ed a tra­di­tion­al neu­ropsy­cho­log­i­cal test (the ‘Clock Draw­ing Task’) and com­bined it with machine learn­ing to pro­vide fast, afford­able, and scal­able detec­tion of cog­ni­tive changes.

Mind­strong Health has been at the fore­front of dig­i­tal phe­no­typ­ing. Dr. Tom Insel dis­cussed how ‘dig­i­tal exhaust’ –data tak­en from smart phones– can be used to pro­vide objec­tive, con­tin­u­ous, and proac­tive mark­ers of mood, cog­ni­tion, and behav­ior. The firm has found that vari­ables extract­ed through machine learn­ing are as good at pre­dict­ing cog­ni­tive func­tion as the test-retest reli­a­bil­i­ty of numer­ous cog­ni­tive tests, pre­sent­ing the oppor­tu­ni­ty for scal­able and non­in­va­sive solu­tions to detect men­tal health dis­or­ders.  Fur­ther, the infor­ma­tion gained from these meth­ods could be used by clin­i­cians and patients not only to enable ear­ly inter­ven­tion but also to mon­i­tor progress over time, some­thing that is rarely done today.

3. And continue with Lifestyle and Digital Health/ Medicine interventions

The upcom­ing ‘dig­i­tal cav­al­ry,’ as described by Dr. Oliv­er Har­ri­son from Tele­fon­i­ca Inno­va­tion, will be high­ly com­ple­men­tary to the ear­ly detec­tion and dig­i­tal phe­no­typ­ing ini­tia­tives out­lined above.

For exam­ple, Dr. Eddie Mar­tuc­ci of Akili Inter­ac­tive Labs shared find­ings from a recent­ly-pub­lished ran­dom­ized con­trolled tri­al (RCT) sup­port­ing the use of ‘pre­scrip­tion’ video games to tar­get symp­toms of atten­tion deficit hyper­ac­tiv­i­ty dis­or­der (ADHD), while rep­re­sen­ta­tives at Click Ther­a­peu­tics, Sin­cro­lab, and Myn­dY­ou out­lined a new wave of per­son­al­ized cog­ni­tive training/ ther­a­py pro­grams. Going fur­ther, researchers at Neu­roscape and UCSF pre­sent­ed vir­tu­al and aug­ment­ed real­i­ty plat­forms for mul­ti­modal bio-sens­ing, adap­tive eval­u­a­tion and brain-body train­ing, which could well help upgrade brain health­care and cog­ni­tive rehab in the near term.

 

 

Some of the ideas dis­cussed were sim­ple yet high­ly inspired. Dr. Albert Kwon and col­leagues at Aug­men­tX craft­ed an aug­ment­ed real­i­ty adap­ta­tion of mir­ror box ther­a­py to poten­tial­ly pro­vide home-based treat­ment for stroke vic­tims. Emma Yang, the youngest Speak­er being just 13-years old, unveiled Time­less — a dig­i­tal app using arti­fi­cial intel­li­gence to help per­sons with Alzheimer’s Dis­ease to remem­ber events, stay con­nect­ed, and engage with friends and fam­i­ly.

4. Open issues: data security, privacy, equity

While explor­ing the oppor­tu­ni­ties, Sum­mit par­tic­i­pants also detailed the con­cerns over data secu­ri­ty, pri­va­cy, equi­ty, and ethics.

Dr. Simone Schurle at ETH Zurich sur­veyed bio­med­ical sys­tems for neu­ro-mon­i­tor­ing and inter­ven­tion and issued a pow­er­ful call for respon­si­ble devel­op­ment: new plat­forms and devices can pro­duce great good in health care, but also have the capac­i­ty for mis­use and harm.

 

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Dr. Álvaro Pas­cual-Leone at Har­vard Med­ical School dis­cussed state-of-the-art neu­ro­mod­u­la­tion, which offers a sig­nif­i­cant and large­ly untapped oppor­tu­ni­ty, while Dr. Anna Wexler from Uni­ver­si­ty of Penn­syl­va­nia high­light­ed real-world issues expe­ri­enced by home-based users and cham­pi­oned the need for bet­ter eco­log­i­cal research and cus­tomer pro­tec­tion, giv­en the onrush of ‘do-it-your­self’ home devices and loose­ly reg­u­lat­ed prod­ucts.

Mul­ti­ple speak­ers dis­cussed major con­cerns regard­ing pri­va­cy and per­son­al auton­o­my raised by big data plat­forms, and poten­tials way for­ward.

5. The Time to Engage is Now

Giv­en every­thing dis­cussed above, now is the prime moment for change­mak­ers, investors, clin­i­cians and allied health­care pro­fes­sion­als to engage with the dig­i­tal brain health rev­o­lu­tion in ways that can ben­e­fit all.

Sig­nif­i­cant advances are com­ing, have come, and will con­tin­ue to come. Researchers, inno­va­tors and prac­ti­tion­ers should work togeth­er to direct the flow of the upcom­ing ‘dig­i­tal cav­al­ry’ and shape the Future of Brain Health – togeth­er we can bet­ter rec­og­nize needs, pro­vide feed­back on imple­men­ta­tion, and make sure that those who suf­fer receive actu­al ben­e­fits.

At the same time, we have a respon­si­bil­i­ty to iden­ti­fy and pre­empt eth­i­cal con­cerns and to guide respon­si­ble devel­op­ment and appro­pri­ate use. If users and pro­fes­sion­als pull back from these advances out of pro­pri­ety con­cerns, turf war, or feel­ings of threat, a great oppor­tu­ni­ty will be lost. Our brain/ men­tal health care prob­lems will only get worse, not bet­ter.

 

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Let’s, togeth­er, explore and dis­cuss how to use every avail­able tool in the toolk­it to address the very real and very unmet needs of 7+ bil­lion peo­ple in the 21st Cen­tu­ry.

Alvaro Fer­nan­dez is the CEO & Edi­tor-in-Chief of Sharp­Brains, and Bran­don Frank is a PhD can­di­date at Ford­ham Uni­ver­si­ty with a con­cen­tra­tion in Neu­ropsy­chol­o­gy.

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Learn More & Register:

2019 Sharp­Brains Vir­tu­al Sum­mit: The Future of Brain Health (May 7–9th)

 

Study: Practice effect due to repeated testing can delay detection of cognitive impairment and dementia

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Prac­tice Imper­fect: Repeat­ed Cog­ni­tive Test­ing Can Obscure Ear­ly Signs of Demen­tia (UC San Diego Health press release):

Alzheimer’s dis­ease (AD) is a pro­gres­sive, neu­rode­gen­er­a­tive con­di­tion that often begins with mild cog­ni­tive impair­ment or MCI, mak­ing ear­ly and repeat­ed assess­ments of cog­ni­tive change cru­cial to diag­no­sis and treat­ment.

But in a paper pub­lished online in the jour­nal Alzheimer’s & Demen­tia: Diag­no­sis, Assess­ment & Dis­ease Mon­i­tor­ing, a team of researchers led by sci­en­tists at the Uni­ver­si­ty of Cal­i­for­nia San Diego School of Med­i­cine found that repeat­ed test­ing of mid­dle-age men pro­duced a “prac­tice effect” which obscured true cog­ni­tive decline and Read the rest of this entry »

May 8th: How Neurotech Innovation Leads to New Healthcare Realities @ Horasis Global Meeting in Cascais, Portugal

Heads-up: the 2018 Hora­sis Glob­al Meet­ing will host a ses­sion on How Inno­va­tion Leads to New Health­care Real­i­ties, and our very own Alvaro Fer­nan­dez will dis­cuss the lat­est in neu­rotech­nol­o­gy, brain & men­tal health and also set the stage for the upcom­ing launch of the Por­tuguese edi­tionof The Sharp­Brains Guide to Brain Fit­ness: How to Opti­mize Brain Health and Per­for­mance at Any Age (also avail­able in Span­ish, Japan­ese and Pol­ish).

Descrip­tion: Inno­va­tion in health-care is advanc­ing glob­al­ly, offer­ing trans­for­ma­tive change. In an aging soci­ety we might con­sid­er bet­ter pal­lia­tive care most impor­tant – but are there oth­er areas that offer bet­ter prospects?  How may our plan­et and we become more resilient?

When: May 8th, 08.00–09.30

Read the rest of this entry »

The more hours you sit per day, the smaller your medial temporal lobe (MTL) seems to become, brain scans show

—– In the study, both (A) Total medi­al tem­po­ral lobe (MTL) and (B) parahip­pocam­pal thick­ness cor­re­lat­ed inverse­ly with hours of sitting/day, con­trol­ling for age. Ref­er­ence: Sid­darth P et al (2018), Seden­tary behav­ior asso­ci­at­ed with reduced medi­al tem­po­ral lobe thick­ness in mid­dle-aged and old­er adults. PLOS ONE 13(4): e0195549.

Sit­ting is bad for your brain — not just your metab­o­lism or heart (UCLA release):

UCLA researchers recruit­ed 35 peo­ple ages 45 to 75 and asked about their phys­i­cal activ­i­ty lev­els and the aver­age num­ber of hours per day they spent sit­ting over the pre­vi­ous week. Each per­son had a high-res­o­lu­tion MRI scan, which pro­vides a detailed look at the medi­al tem­po­ral lobe, or MTL, a brain region involved in the for­ma­tion of new mem­o­ries.

The researchers found that seden­tary behav­ior is a sig­nif­i­cant pre­dic­tor of thin­ning of the MTL and Read the rest of this entry »

Dr. Albert Kwon, CEO of Brainnovations Winner AUGMENTx, wants to harness Augmented Reality to significantly ease access to Neurological Rehabilitation Therapies

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Albert, what sur­prised you the most from the Judges’ ques­tions and feed­back dur­ing the Brain­no­va­tions Pitch Con­test?

It was a pleas­ant sur­prise to receive so many votes and such great feed­back, which solid­i­fied my con­vic­tion that there is a great need to cre­ate new ther­a­py options for stroke patients and oth­er neu­ro­log­i­cal injuries, espe­cial­ly giv­en our aging pop­u­la­tion.  Med­ical sys­tems world­wide will strug­gle to han­dle the grow­ing bur­den of chron­ic ill­ness­es unless we start act­ing soon.

In a nut­shell, what is the core idea behind AUG­MEN­Tx?

The core idea is to lever­age visu­al-cog­ni­tive and visu­al-motor/sen­so­ry con­nec­tions of the brain to enhance per­for­mance in dis­ease states.  For exam­ple, mir­ror ther­a­py takes advan­tage of the mir­ror neu­ron path­way to improve post-stroke motor recov­ery and to alle­vi­ate phan­tom limb pain in limb amputees.  And we believe that these ther­a­pies can be deliv­ered on dig­i­tized AR plat­forms, instead of being always con­fined to few spe­cial­ized phys­i­cal reha­bil­i­ta­tion cen­ters.  Why not have them be acces­si­ble from the patient’s home Read the rest of this entry »

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As seen in The New York Times, The Wall Street Journal, BBC News, CNN, Reuters and more, SharpBrains is an independent market research firm tracking health and performance applications of brain science.

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