Drugs, games, and devices for enhancing cognition: implications for work and society.

As work environments change, the demands on working people change. Cognitive abilities in particular are becoming progressively more important for work performance and successful competition in a global environment. However, work-related stress, performance over long hours, lack of sleep, shift work, and jet lag affect cognitive functions. Therefore, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as noninvasive brain stimulation, to maintain or improve work performance. This review summarizes research on pharmacological and technical methods as well as cognitive training, including game apps for the brain, in healthy people. In neuropsychiatric disorders, impairments in cognitive functions can drastically reduce the chances of returning to work; therefore, this review also summarizes findings from pharmacological and cognitive-training studies in neuropsychiatric disorders.All cited psychopharmacological work from Professor Sahakian laboratory was funded by a Wellcome Trust Grant (089589/Z/09/Z) awarded to T.W. Robbins, B.J. Everitt, A.C. Roberts, J.W. Dalley, and B.J. Sahakian, and it was conducted at the Behavioural and Clinical Neuroscience Institute, which is supported by a joint award from the Medical Research Council and Wellcome Trust (G00001354). ABB was supported by a grant from the The Wallitt Foundation.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1111/nyas.1304

Drugs, games, and devices for enhancing cognition: implications for work and society

As work environments change, the demands on working people change. Cognitive abilities in particular are becoming progressively more important for work performance and successful competition in a global environment. However, work-related stress, performance over long hours, lack of sleep, shift work, and jet lag affect cognitive functions. Therefore, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as noninvasive brain stimulation, to maintain or improve work performance. This review summarizes research on pharmacological and technical methods as well as cognitive training, including game apps for the brain, in healthy people. In neuropsychiatric disorders, impairments in cognitive functions can drastically reduce the chances of returning to work; therefore, this review also summarizes findings from pharmacological and cognitive-training studies in neuropsychiatric disorders.All cited psychopharmacological work from Professor Sahakian laboratory was funded by a Wellcome Trust Grant (089589/Z/09/Z) awarded to T.W. Robbins, B.J. Everitt, A.C. Roberts, J.W. Dalley, and B.J. Sahakian, and it was conducted at the Behavioural and Clinical Neuroscience Institute, which is supported by a joint award from the Medical Research Council and Wellcome Trust (G00001354). ABB was supported by a grant from the The Wallitt Foundation.This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1111/nyas.1304

Hybridizing 3-dimensional multiple object tracking with neurofeedback to enhance preparation, performance, and learning

Le vaste domaine de l’amélioration cognitive traverse les applications comportementales, biochimiques et physiques. Aussi nombreuses sont les techniques que les limites de ces premières : des études de pauvre méthodologie, des pratiques éthiquement ambiguës, de faibles effets positifs, des effets secondaires significatifs, des couts financiers importants, un investissement de temps significatif, une accessibilité inégale, et encore un manque de transfert. L’objectif de cette thèse est de proposer une méthode novatrice d’intégration de l’une de ces techniques, le neurofeedback, directement dans un paradigme d’apprentissage afin d’améliorer la performance cognitive et l’apprentissage. Cette thèse propose les modalités, les fondements empiriques et des données à l’appui de ce paradigme efficace d’apprentissage ‘bouclé’. En manipulant la difficulté dans une tâche en fonction de l’activité cérébrale en temps réel, il est démontré que dans un paradigme d’apprentissage traditionnel (3-dimentional multiple object tracking), la vitesse et le degré d’apprentissage peuvent être améliorés de manière significative lorsque comparés au paradigme traditionnel ou encore à un groupe de contrôle actif. La performance améliorée demeure observée même avec un retrait du signal de rétroaction, ce qui suggère que les effets de l’entrainement amélioré sont consolidés et ne dépendent pas d’une rétroaction continue. Ensuite, cette thèse révèle comment de tels effets se produisent, en examinant les corrélés neuronaux des états de préparation et de performance à travers les conditions d’état de base et pendant la tâche, de plus qu’en fonction du résultat (réussite/échec) et de la difficulté (basse/moyenne/haute vitesse). La préparation, la performance et la charge cognitive sont mesurées via des liens robustement établis dans un contexte d’activité cérébrale fonctionnelle mesurée par l’électroencéphalographie quantitative. Il est démontré que l’ajout d’une assistance- à-la-tâche apportée par la fréquence alpha dominante est non seulement appropriée aux conditions de ce paradigme, mais influence la charge cognitive afin de favoriser un maintien du sujet dans sa zone de développement proximale, ce qui facilite l’apprentissage et améliore la performance. Ce type de paradigme d’apprentissage peut contribuer à surmonter, au minimum, un des limites fondamentales du neurofeedback et des autres techniques d’amélioration cognitive : le manque de transfert, en utilisant une méthode pouvant être intégrée directement dans le contexte dans lequel l’amélioration de la performance est souhaitée.The domain of cognitive enhancement is vast, spanning behavioral, biochemical and physical applications. The techniques are as numerous as are the limitations: poorly conducted studies, ethically ambiguous practices, limited positive effects, significant side-effects, high financial costs, significant time investment, unequal accessibility, and lack of transfer. The purpose of this thesis is to propose a novel way of integrating one of these techniques, neurofeedback, directly into a learning context in order to enhance cognitive performance and learning. This thesis provides the framework, empirical foundations, and supporting evidence for a highly efficient ‘closed-loop’ learning paradigm. By manipulating task difficulty based on a measure of cognitive load within a classic learning scenario (3-dimentional multiple object tracking) using real-time brain activity, results demonstrate that over 10 sessions, speed and degree of learning can be substantially improved compared with a classic learning system or an active sham-control group. Superior performance persists even once the feedback signal is removed, which suggests that the effects of enhanced training are consolidated and do not rely on continued feedback. Next, this thesis examines how these effects occur, exploring the neural correlates of the states of preparedness and performance across baseline and task conditions, further examining correlates related to trial results (correct/incorrect) and task difficulty (slow/medium/fast speeds). Cognitive preparedness, performance and load are measured using well-established relationships between real-time quantified brain activity as measured by quantitative electroencephalography. It is shown that the addition of neurofeedback-based task assistance based on peak alpha frequency is appropriate to task conditions and manages to influence cognitive load, keeping the subject in the zone of proximal development more often, facilitating learning and improving performance. This type of learning paradigm could contribute to overcoming at least one of the fundamental limitations of neurofeedback and other cognitive enhancement techniques : a lack of observable transfer effects, by utilizing a method that can be directly integrated into the context in which improved performance is sought

Genetic influences on neural plasticity.

Neural plasticity refers to the capability of the brain to alter function or structure in response to a range of events and is a crucial component of both functional recovery after injury and skill learning in healthy individuals. A number of factors influence neural plasticity and recovery of function after brain injury. The current review considers the impact of genetic factors. Polymorphisms in the human genes coding for brain-derived neurotrophic factor and apolipoprotein E have been studied in the context of plasticity and stroke recovery and are discussed here in detail. Several processes involved in plasticity and stroke recovery, such as depression or pharmacotherapy effects, are modulated by other genetic polymorphisms and are also discussed. Finally, new genetic polymorphisms that have not been studied in the context of stroke are proposed as new directions for study. A better understanding of genetic influences on recovery and response to therapy might allow improved treatment after a number of forms of central nervous system injury

Physical exercise in attention deficit hyperactivity disorder:evidence and implications for the treatment of borderline personality disorder

A growing body of literature indicates a potential role for physical exercise in the treatment of attention deficit hyperactivity disorder (ADHD). Suggested effects include the reduction of ADHD core symptoms as well as improvements in executive functions. In the current review, we provide a short overview on the neurophysiological mechanisms assumed to underlie the beneficial effects of exercise. Further, we review the current evidence from experimental studies regarding both acute exercise and long-term interventions in ADHD. While the positive effects observed after acute aerobic exercise are promising, very few well-designed long-term intervention studies have been conducted yet. Moreover, although exercise effects have not yet been studied in borderline personality disorder (BPD), in the end of this paper we derive hypotheses why exercise could also be beneficial for this patient population

An Access theory of self-control: Essays on self-control, ADHD, and stimulant medication

This dissertation consists of four articles and an introductory essay, the overarching aim of which is to investigate the nature of self-control and its implications. I defend a value-deflationist definition of self-control, according to which self-control is that which is enacted to align one’s behaviour with intention in the face of competing motivation. This radical revision of the concept of self-control, which under its received denotation is associated with motivational hierarchies under various guises, allows for a conception of self-control that is consistent even in the absence of clear value hierarchies. For my account, self-control is defined by its behavioural function, not by its reliance on any specific cognitive or neural process. As a result, self-control can be realized by a large range of functionally equivalent processes. Some such processes are intrapsychic, such as inhibition, rehearsal of reasons, and construal. Others are situational, such as environmental selection and modification as well as social processes of self-control. Not all self-control processes are equally available for all agents, however. Some processes that are heavily reliant on executive functioning, such as inhibition and rehearsal of reasons, are unavailable for agents with executive dysfunction. For other self-control processes, social and economic constraints delimit their availability. It then becomes of utmost importance that agents are aware of such means of self-control that are a good fit for the agent and her situation. In this dissertation I analyse individual differences in self-control in terms of differences in access to self-control behaviours, articulating criteria for access to self-control and demonstrating how epistemic and practical constraints contingently modulate access to self-control in a manner that results in aggravated individual differences in self-control. I also discuss various implications of the access theory of self-control. implications span assessments of responsibility for failures of self-control; accounting for individual differences in self-control, including when these differences are connected to diagnoses such as Attention Deficit /Hyperactivity Disorder; and the prospects of self-control neuroenhancement

Do informal caregivers of people with dementia mirror the cognitive deficits of their demented patients?:A pilot study

Recent research suggests that informal caregivers of people with dementia (ICs) experience more cognitive deficits than noncaregivers. The reason for this is not yet clear. Objective: to test the hypothesis that ICs ‘mirror' the cognitive deficits of the demented people they care for. Participants and methods: 105 adult ICs were asked to complete three neuropsychological tests: letter fluency, category fluency, and the logical memory test from the WMS-III. The ICs were grouped according to the diagnosis of their demented patients. One-sample ttests were conducted to investigate if the standardized mean scores (t-scores) of the ICs were different from normative data. A Bonferroni correction was used to correct for multiple comparisons. Results: 82 ICs cared for people with Alzheimer's dementia and 23 ICs cared for people with vascular dementia. Mean letter fluency score of the ICs of people with Alzheimer's dementia was significantly lower than the normative mean letter fluency score, p = .002. The other tests yielded no significant results. Conclusion: our data shows that ICs of Alzheimer patients have cognitive deficits on the letter fluency test. This test primarily measures executive functioning and it has been found to be sensitive to mild cognitive impairment in recent research. Our data tentatively suggests that ICs who care for Alzheimer patients also show signs of cognitive impairment but that it is too early to tell if this is cause for concern or not

Bop, look, and listen: a playful sensorimotor approach to address attention-deficit/hyperactivity disorder-like symptoms among young children

Bop, Look, and Listen (BLL): A Playful Sensorimotor Approach to Address Attention-Deficit/Hyperactivity Disorder-Like Symptoms Among Young Children is an evidence-based and theory-driven treatment method that aims to support child development and learning within preschool classrooms. There has been a substantial increase in the prevalence of attention-deficit/hyperactivity disorder (ADHD), as well as other developmental disabilities, since the turn of the century. Given that ADHD-like symptoms most frequently emerge during preschool and are associated with future maladaptive functioning, there is an imperative need for effective and optimal intervention at this life stage. Due to the controversy surrounding the act of diagnosing a child at such a young age, BLL has been created to address “ADHD-like symptoms”, regardless of diagnosis, or lack thereof. BLL was developed by an occupational therapist and may be considered: 1) an intervention that uses the meaningful childhood occupation of play to target multiple potential neurological underpinnings of ADHD-like symptoms; 2) a health promotion program that educates school-related professionals and parents about the relationship between sensorimotor play, child development, and learning; and 3) a prevention program that aims prevent or alter the trajectory of ADHD-like symptoms in preschoolers. A BLL storybook is used to guide children through specific playful sensorimotor activities, which are based on techniques that research has shown to be effective in reducing ADHD-like symptoms. Secondarily, evidence-based behavioral strategies that maintain the integrity of key concepts from Sensory Integration Theory are woven throughout the program to support participation. In addition, educational materials are provided to school-related professionals and parents. The evidence-based literature regarding the effectiveness of sensorimotor-based interventions for addressing ADHD-like symptoms is scarce, yet promising. Dissemination efforts for program expansion and the future application of an evaluative study of BLL will address this practice gap. BLL has the potential to decrease ADHD-like symptoms and positively impact children’s participation in meaningful occupations and roles within preschool classrooms and beyond

A review and framework for designing interactive technologies for emotion regulation training

Emotion regulation is foundational to mental health and well-being. In the last ten years there has been an increasing focus on the use of interactive technologies to support emotion regulation training in a variety of contexts. However, research has been done in diverse fields, and no cohesive framework exists that explicates what features of such system are important to consider, guidance on how to design these features, and what remains unknown, which should be explored in future design research. To address this gap, this thesis presents the results of a descriptive review of 54 peer-reviewed papers. Through qualitative and frequency analysis I analyzed previous technologies, reviewed their theoretical foundations, the opportunities where they appear to provide unique benefits, and their conceptual and usability challenges. Based on the findings I synthesized a design framework that presents the main concepts and design considerations that researchers and designers may find useful in designing future technologies in the context of emotion regulation training

Eye quietness and quiet eye in expert and novice golf performance: an electrooculographic analysis

Quiet eye (QE) is the final ocular fixation on the target of an action (e.g., the ball in golf putting). Camerabased eye-tracking studies have consistently found longer QE durations in experts than novices; however, mechanisms underlying QE are not known. To offer a new perspective we examined the feasibility of measuring the QE using electrooculography (EOG) and developed an index to assess ocular activity across time: eye quietness (EQ). Ten expert and ten novice golfers putted 60 balls to a 2.4 m distant hole. Horizontal EOG (2ms resolution) was recorded from two electrodes placed on the outer sides of the eyes. QE duration was measured using a EOG voltage threshold and comprised the sum of the pre-movement and post-movement initiation components. EQ was computed as the standard deviation of the EOG in 0.5 s bins from –4 to +2 s, relative to backswing initiation: lower values indicate less movement of the eyes, hence greater quietness. Finally, we measured club-ball address and swing durations. T-tests showed that total QE did not differ between groups (p = .31); however, experts had marginally shorter pre-movement QE (p = .08) and longer post-movement QE (p < .001) than novices. A group × time ANOVA revealed that experts had less EQ before backswing initiation and greater EQ after backswing initiation (p = .002). QE durations were inversely correlated with EQ from –1.5 to 1 s (rs = –.48 - –.90, ps = .03 - .001). Experts had longer swing durations than novices (p = .01) and, importantly, swing durations correlated positively with post-movement QE (r = .52, p = .02) and negatively with EQ from 0.5 to 1s (r = –.63, p = .003). This study demonstrates the feasibility of measuring ocular activity using EOG and validates EQ as an index of ocular activity. Its findings challenge the dominant perspective on QE and provide new evidence that expert-novice differences in ocular activity may reflect differences in the kinematics of how experts and novices execute skills