neuroprotection

On the limits of Citicoline and the need for comprehensive brain injury rehabilitation

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Citi­co­l­ine does not improve func­tion­al, cog­ni­tive sta­tus in patients with trau­mat­ic brain injury (Out­come Magazine):

“Although approved for use for treat­ing trau­mat­ic brain injury (TBI) in near­ly 60 coun­tries, use of citi­co­l­ine in a ran­dom­ized tri­al that includ­ed more than 1,200 par­tic­i­pants with TBI did not result in improve­ment in func­tion­al and cog­ni­tive sta­tus, accord­ing to a study appear­ing in the Novem­ber 21 issue of JAMA.

“Despite con­sid­er­able advances in emer­gency and crit­i­cal care man­age­ment of TBI as well as decades of research on poten­tial agents for neu­ro­pro­tec­tion or enhanced recov­ery, no effec­tive phar­ma­cother­a­py has yet been iden­ti­fied [Read more…] about On the lim­its of Citi­co­l­ine and the need for com­pre­hen­sive brain injury rehabilitation

Brain Fitness/ Training Report Finds Market Growth, Potential, and Confusion

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After many many months of men­tal stim­u­la­tion, phys­i­cal exer­cise and the cer­tain need for stress man­age­ment… we have just announced the release of the The State of the Brain Fit­ness Soft­ware Mar­ket 2009 report, our sec­ond annu­al com­pre­hen­sive mar­ket analy­sis of the US mar­ket for com­put­er­ized cog­ni­tive assess­ment and train­ing tools. In this report we esti­mate the size of the US brain fit­ness soft­ware mar­ket at $265M in 2008, up from $225M in 2007 (18% annu­al growth), and from $100m in 2005. Two seg­ments fuelled the mar­ket growth from 2007 to 2008: con­sumers (grew from $80m to $95m) and health­care & insur­ance providers (grew from $65m to $80m).

The 150-page report finds promis­ing research and ini­tia­tives to dri­ve sig­nif­i­cant growth, com­bined with increased con­sumer con­fu­sion giv­en aggres­sive mar­ket­ing claims and lack of edu­ca­tion and stan­dards. The report includes:
— The com­plete results of an exclu­sive Jan­u­ary 2009 Sur­vey with 2,000+ respondents
— A pro­pri­etary Mar­ket & Research Momen­tum Matrix to cat­e­go­rize 21 key ven­dors into four categories
— 10 Research Exec­u­tive Briefs writ­ten by lead­ing sci­en­tists at promi­nent research labs
— An analy­sis of the lev­el of clin­i­cal val­i­da­tion per prod­uct and cog­ni­tive domain

Top 10 High­lights from the report:

1) Con­sumers, seniors, com­mu­ni­ties and insur­ance providers drove year on year sus­tained growth, from $225m in 2007 to $265m in 2008. Rev­enues may reach between $1 bil­lion to $5 bil­lion by 2015, depend­ing on how impor­tant prob­lems (Pub­lic Aware­ness, Nav­i­gat­ing Claims, Research, Health Cul­ture, Lack of Assess­ment) are addressed.

2) Increased inter­est and con­fu­sion: 61% of respon­dents Strong­ly Agree with the state­ment Address­ing cog­ni­tive and brain health should be a health­care pri­or­i­ty. But, 65% Agree/Strongly Agree. I don’t real­ly know what to expect from prod­ucts mak­ing brain claims.

3) Invest­ment in R&D seeds future growth: Land­mark invest­ments by insur­ance providers and gov­ern­ment-fund­ed research insti­tutes test­ing new brain fit­ness appli­ca­tions plant­ed new seeds for future growth.

4) Becom­ing stan­dard in res­i­den­tial facil­i­ties: Over 700 res­i­den­tial facil­i­ties most­ly Inde­pen­dent and Assist­ed Liv­ing facil­i­ties and CCRCs have installed com­put­er­ized cog­ni­tive train­ing programs.

5) Cus­tomer sat­is­fac­tion: Con­sumers seem more sat­is­fied with com­put­er-based prod­ucts than paper-based options. But, sat­is­fac­tion dif­fers by prod­uct. When asked I got real val­ue for my mon­ey, results were as fol­lows: Lumosity.com (65% Agree), Puz­zle Books (60%), Posit Sci­ence (52%), Nin­ten­do (51%) agreed. Posit Sci­ence (53% Agree) and Lumosity.com (51%) do bet­ter than Puz­zle Books (39%) and Nin­ten­do (38%) at I have seen the results I wanted.

6) Assess­ments: Increas­ing adop­tion of com­put­er-based cog­ni­tive assess­ments to base­line and track cog­ni­tive func­tions over time in mil­i­tary, sports, and clin­i­cal con­texts. The Alzheimer’s Foun­da­tion of Amer­i­ca now advo­cates for wide­spread cog­ni­tive screen­ings after 65–75.

7) Spe­cif­ic com­put­er­ized cog­ni­tive train­ing and videogames have been shown to improve brain func­tions, but the key ques­tions are, Which ones, and Who needs what when?

8) Aggres­sive mar­ket­ing claims are cre­at­ing con­fu­sion and skep­ti­cism, result­ing in a dis­tract­ing con­tro­ver­sy between two mis­lead­ing extremes: (a) buy­ing prod­uct XYZ can reju­ve­nate your brain Y years or (b) those prod­ucts don’t work; just do one more cross­word puz­zle. The upcom­ing book The Sharp­Brains Guide to Brain Fit­ness aims to help con­sumers nav­i­gate these claims.

9) Devel­op­ers can be clas­si­fied into four groups, based on a pro­pri­etary Mar­ket and Research Momen­tum Matrix: Sharp­Brains finds 4 Lead­ers, 8 High Poten­tials, 3 Cross­words 2.0, and 6 Wait & See companies.

10) Increased dif­fer­en­ti­a­tion: Lead­ing com­pa­nies are bet­ter defin­ing their val­ue propo­si­tion and dis­tri­b­u­tion chan­nels to reach spe­cif­ic seg­ments such as retire­ment com­mu­ni­ties, schools, or health­care providers.

Lead­ing researchers pre­pared 10 Research Exec­u­tive Briefs:
- Dr. Joshua Stein­er­man (Ein­stein-Mon­te­o­re): Neu­ro­pro­tec­tion via cog­ni­tive activities
— Dr. Jer­ri Edwards (South Flori­da): Assess­ments of dri­ving fitness
— Dr. Susanne Jaeg­gi and Dr. Mar­tin Buschkuehl (Bern, Michi­gan): Work­ing mem­o­ry train­ing and  intelligence
— Dr. Torkel Kling­berg (Karolin­s­ka): Work­ing mem­o­ry train­ing, dopamine, and math
— Dr. Liz Zelin­s­ki (UC Davis): Audi­to­ry pro­cess­ing training
— Dr. David Vance (UAB): Speed-of-pro­cess­ing training
— Dr. Jer­ri Edwards (South Flori­da): Cog­ni­tive train­ing for healthy aging
— Dr. Daphne Bave­li­er & Dr. Shawn Green (Rochester): Action videogames and atten­tion­al skills
— Dr. Arthur Kramer (Illi­nois): Strat­e­gy videogames and exec­u­tive functions
— Dr. Yaakov Stern (Colum­bia): The cog­ni­tive reserve and neuroimaging
— Dr. David Rabin­er (Duke): Objec­tive assess­ments for ADHD

Table of Contents 

Edi­to­r­i­al
Exec­u­tive Summary
Chap­ter 1. Bird-Eye View of the Grow­ing Field
Chap­ter 2. Mar­ket Sur­vey on Beliefs, Atti­tudes, Pur­chase Habits
Chap­ter 3. The Emerg­ing Com­pet­i­tive Landscape
Chap­ter 4. The Sci­ence for Brain Fit­ness and Cog­ni­tive Health
Chap­ter 5. Con­sumers  Adopt­ing Cross­words 2.0?
Chap­ter 6: Health­care and Insur­ance Providers — A Cul­ture of Cog­ni­tive Health
Chap­ter 7: K12 School Sys­tems- Ready for Change?
Chap­ter 8: Mil­i­tary, Sports Teams, Com­pa­nies,  Brain-Per­for­mance Link
Chap­ter 9: Future Direc­tions‚ Pro­jec­tions and Bottlenecks

Com­pa­nies pro­filed include: Advanced Brain Tech­nolo­gies, Applied Cog­ni­tive Engi­neer­ing, Brain Cen­ter Amer­i­ca, Brain Resource, CNS Vital Signs, Cogmed, Cogstate, Cog­niFit, Cog­ni­tive Drug Research, Dakim, Houghton Mif­flin, Learn­ing Enhance­ment Cor­po­ra­tion, Learn­ingRx, Lumos Labs, Mar­bles: The Brain Store, Nin­ten­do, NovaV­i­sion, Posit Sci­ence, Sci­en­tif­ic Brain Train­ing, Sci­en­tif­ic Learn­ing, Trans­An­a­lyt­ics, vibrant­Brains, Vig­or­ous Mind, Viv­i­ty Labs.

More on the report by click­ing on The State of the Brain Fit­ness Soft­ware Mar­ket 2009.

Education builds Cognitive Reserve for Alzheimers Disease Protection

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Giv­en the grow­ing media cov­er­age men­tion­ing the terms Cog­ni­tive Reserve and Brain Reserve, you may be ask­ing your­self, “What exact­ly is my Cog­ni­tive (or Brain) Reserve?”

The cog­ni­tive reserve hypoth­e­sis, test­ed in mul­ti­ple stud­ies, states that indi­vid­u­als with more cog­ni­tive reserve can expe­ri­ence more Alzheimer’s dis­ease pathol­o­gy in the brain (more plaques and tan­gles) with­out devel­op­ing Alzheimer’s dis­ease symptoms.

How does that work? Sci­en­tists are not sure but two pos­si­bil­i­ties are considered.
1. One is that more cog­ni­tive reserve means more brain reserve, that is more neu­rons and con­nec­tions (synaps­es) between neu­rons. Indi­vid­u­als with more synaps­es would then have more synaps­es to lose before the crit­i­cal thresh­old for Alzheimer’s Dis­ease is reached.
2. Anoth­er pos­si­bil­i­ty is that more cog­ni­tive reserve means more com­pen­sato­ry process­es. The brain of indi­vid­u­als with more cog­ni­tive reserve would use more alter­na­tive net­works to com­pen­sate for the dam­ages caused by the pathol­o­gy in pre­vi­ous­ly used networks.

In a new­ly pub­lished study, Roe and col­leagues brain fitness event from Wash­ing­ton Uni­ver­si­ty in St. Louis, used the num­ber of years of edu­ca­tion as a mea­sure of cog­ni­tive reserve. Why years of edu­ca­tion? Because pre­vi­ous stud­ies have shown that peo­ple who have more edu­ca­tion also exhib­it a greater resis­tance to Alzheimer’s symp­toms, even while patho­log­i­cal changes are occur­ring in the brain (see Ben­nett el al., 2003 or Roe, Xiong, et al., 2008).

Roe and her col­leagues stud­ied 198 indi­vid­u­als whose mean age was 67. Out of these 198 indi­vid­u­als, 161 were non­de­ment­ed and 37 were diag­nosed with Alzheimer’s Disease.

All the par­tic­i­pants in the study took a [Read more…] about Edu­ca­tion builds Cog­ni­tive Reserve for Alzheimers Dis­ease Protection

Bilingual brains stay sharp longer

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In study, Bilin­gual brains stay sharp longer

We have seen a num­ber of stud­ies on why and how speak­ing more than one lan­guage may help build a Cog­ni­tive Reserve (inter­view with Yaakov Stern) that pro­tects us against cog­ni­tive decline. This arti­cle does a good job at explain­ing what may be going on (bold added by me):

- Bia­lystok, who began study­ing bilin­gual kids decades ago, believes one key to their spe­cial brain­pow­er lies in the way they must con­stant­ly decide which lan­guage to use and which to sup­press.

- For peo­ple who use two lan­guages dai­ly, “every time you want to speak one lan­guage, the oth­er lan­guage is acti­vat­ed” in the brain as well, she said. “That means you need a mech­a­nism so that you’re only draw­ing from the right pool (of words). It’s going be a mech­a­nism that works extreme­ly fast … while you’re pro­duc­ing sen­tences. It’s way below your radar for detect­ing what’s happening.”

- So bilin­guals get far more prac­tice than mono­lin­guals in using the part of the brain that focus­es our atten­tion, help­ing us sort through con­flict­ing infor­ma­tion and ignore dis­trac­tions. Using two lan­guages seems to bol­ster rapid deci­sion-mak­ing, mul­ti-task­ing and per­haps memory.

In short: learn­ing and speak­ing a for­eign lan­guage pro­vides con­stant brain exer­cise to the frontal lobes (see basic brain anato­my), the area of the brain right behind your fore­head that focus­es our atten­tion, helps us ignore dis­trac­tions, and make decisions.

Have a nice East­er time.