Chapter 31

Programs for Brain Rejuvenation or Brain Recovery Features of computer-controlled, Internet-delivered neuroscience-based programs designed to grow, rejuvenate or recover – then sustain – your brain health

1. The principles guiding the designs and strategies for delivery of these brain-health-targeted training programs have been well-described in a number of published reviews. See, e.g., Merzenich MM et al (1998) Some neurological principles relevant to the origins of—and the cortical plasticity based remediation of—language learning impairments. IN: Neuroplasticity: Building a Bridge from the Laboratory to the Clinic. Springer-Verlag, New York; HW et al (2006) Brain plasticity and functional losses in the aged: scientific bases for a novel intervention. Prog Brain Res 147:81; Mahncke HW et al (2006) Memory enhancement in healthy older adults using a brain plasticity-based training program: a randomized, controlled study. PNAS 103:12523.My colleagues (Drs. Mor Nahum and Tom Van Vleet) and I have recently edited a Progress in Brain Research volume “Changing Brains — Applying Brain Plasticity to Advance and Recover Human Ability” in which neuroscience-based training strategies is the general subject at hand, contributed to by about 20 scientific authors. In that volume, scientists on my own team summarize the history of studies of brain plasticity and it relates to improving human performance ability, and describe how we apply it in our own therapeutic program development. See Nahum M, Lee H and Merzenich M (2013) Principles of neuroplasticity-based rehabilitation (in that volume).Of course the science cited in the references for preceding chapters that describe the principles of brain plasticity, and the capacities to drive changes in brains via training in ALL of the aspects described in this current chapter (especially, the references after Chapter 28) applies here.
2. For more information about training program designs, and still further annotation, also go to www.brainhq.com or www.positscience.com
3. A large body of research supports our approaches for addressing specific general targets in training; the following references provide an introduction to that extensive background literature.
   1. Alertness and focus. Our general goal is to assure that noradrenaline, acetylcholine and serotonin expressions are ‘under control’, i.e., up-regulated if the baseline level of alertness is low (as it is in the great majority of individuals who come to our brain gym door), but in some cases down-regulated in ways that induce a reduction in ongoing anxiety. The nuclei controlling production and release of these neurotransmitters are all metabolically sustained by trophic factors that are themselves produced and released as a function of their functional levels of engagement. Our first goal is to excite these nuclei in many controlled learning cycles through the course of each training epoch—engaging these crucial modulatory control nuclei under near-ideal conditions of engagement. We have used animal studies documenting the ‘rules of engagement’ of these nuclei in learning as a primary basis for optimizing positive plasticity in these key limbic system sites. See, as a starting point, the references cited in www.soft-wired.com/ref/ch10 (rules 1 & 2) and www.soft-wired.com/ref/ch28
   2. Positive mood. See Schultz W (2007) Multiple dopamine functions at different time courses. Ann Rev Neurosci 30:259; Altieri SC et al (2013) Rethinking 5HT1A receptors: emerging models of inhibitory feedback of relevance to emotion-related behavior. ACS Chem Neurosci 4:72; De Boer A et al (2011) Love is more than just a kiss: a neurobiological perspective on love and affection. Neuroscience 201:114.
   3. Learning and remembering. Many studies have shown that learning rates can be accelerated by specific forms of behavioral training. My colleague Tom Van Vleet has completed a study in which he has doubled learning rates by coupling exercises designed to up-regulate noradrenaline and acetylcholine-based learning-enabling processes with progressive training regimes; a report summarizing these outcomes shall be published in early 2014. Many studies have shown that memory can be enhanced by training, including virtually all of the outcomes studies listed in the randomized control trials recorded below (where measures of immediate and delayed recall and ‘working memory’ were almost always on the post- vs pre-training assessment list).
   4. Accuracy. Thousands of perceptual, cognitive, executive control and movement control studies have shown that the accuracy (refined responding coming from more-refined neurological representation) can be achieved via progressive training. See www.soft-wired.com/ref/ch28 for examples from our own research. We directly document improvements in the resolving capacities of the brain in virtually EVERY task that we apply in training. Progress in that training EQUATES with improvements in neurological representational and performance accuracy.
   5. Brain speed. When the brain is trained under conditions in which it reliably (more than 70% of the time) ‘gets the answer right’, it slowly speeds up. As related earlier, those improvements in processing speed are recorded behaviorally AND neurologically. We add to those impacts by ‘speed challenging’ trainees, in the majority of our exercises. Our goal is to increase ‘decision times’ in the brain without compromising performance success. Hundreds of published reports document the capacity to drive improvement in these abilities in animal and human training; this capacity is directly confirmed in the training progressions of millions of children and adults who have been engaged by these progressive speed-challenged training program strategies. Speed of processing (recognition speed; fluency; time for completion of “everyday tasks”) is also routinely measured in almost every RCT outcomes studies cited below; in general, speed changes are highly significant each time they have been measured — more than doubling, as a rule, in aging populations.
4. The AARP brain gym: http://www.brain.aarp.org For Easter Seals, it’s http://www.brainhq.easterseals.com
5. One frustrating aspect of our science is the confusion in the training program landscape contributed by the emergence of many ‘brain games’ produced by relatively young companies that focus in their marketing on arguing that they are ‘neuroscience based’ or ‘brain plasticity based’ and ‘scientifically proven’ when they may be none of those things. The reader of this book is very strongly urged to look into the extents, nature, and quality of the science supporting such claims. They would quickly discover that even for some of the highest-visibility players in this commercial arena, there is usually little support in confirmed outcomes trials behind all that marketing. An equally distressing problem is the confusion of ‘brain games’ or ‘cognitive training’ with neuroscience-based brain exercises. That confusion has resulted in destructive, negative claims about brain training efficacy that frustrate many people from getting available brain-training assistance that could really help them. A study led by the Cambridge University scientist Adrian Owen is a case in point. (See Owen AM et al (2010) Putting brain training to the test. Nature 465:775.) Owen is a notable iconoclast who talked the BBC into producing a program in which he discussed ‘brain training games’ with the viewing audience, then offered a program of training via the Internet to anyone who volunteered to participate in his internet-delivered outcomes trial. The training program applied in this ‘trial’ was designed by Dr. Owen’s team. The result was a uncontrolled mess of a trial using those custom programs, conducted with more than 16,000 participants. On the face of it, this was an impressive undertaking. Less impressive: 1) The training was ill-conceived. 2) The average participant spent about 2 hours at it, i.e., too little time to assure much good effect, given what Professor Owen had them doing. 3) Owen and colleagues DID record some positive changes, but chose not to emphasize those benefits, preferring to emphasize what did NOT change. And, perhaps most importantly, 4) the ‘study’ met NONE of the scientific criteria that would qualify it as a valid outcomes study. Owens actually proved two things. First, this team had little understanding about how to make a ‘cognitive training program’ that was effective. And second, they had a very poor concept of how to set up an Internet-based trial to determine whether or not it DID (or did not) work.Owen and colleagues used this interpretation of their internet trial results to trumpet loudly that “brain training does not work.” No references were made in their report to any studies (a number of which had been earlier published) that showed that the right kind of training DOES work. Either Dr. Owen’s team was not aware of them, or they again cherry-picked scientific precedents for the benefit of iconoclastic impact. In either case, this behavior, for professional, does not meet a high standard.Rather shockingly, this work was published in the prestigious journal Nature—which magnified its destructive impacts. Its publication was clearly at odds with Nature’s usual impeccable editorial standards. Rather destructively, the public press and bloggers reported this outcome with the oft-repeated message “Brain training doesn’t work.” Stating their results in these fraudulent terms bears a substantial societal cost: Some people who could benefit from this science were undoubtedly discouraged from finding their way to it. There is a word for this, in the world. The word is “irresponsible.”There are several other clear examples of the costs, to the public and to science, of confusing ‘brain games’ with scientifically-validated brain exercises. A scientifically serious report conducted by Borness C et al (2013) Putting brain training to the test in the workplace: A randomized, blinded, multisite, active-controlled trial. PLoS One 8:e59982 provides another example. Here, scientists evaluated the impacts of use of a “cognitive training” program suite marketed by HappyNeuron. Not surprisingly, given the nature of its design, Happy Neuron’s training games were not effective. HOWEVER, the message of the authors and the message picked up by the press in response to this report was that “Brain games (brain training) do not work.” The authors and the press are very confused about something every serious scientist in these subdisciplines of psychology and neuroscience DO understand: Different brain training programs are designed on different principles, and have been validated at very different levels of proof. SOME DON’T WORK. SOME DO WORK. It is rather important, journalistically, to separate the wheat from the chaff!My third example of an unfair criticism of brain game efficacy comes primarily from scientists who have evaluated whether or not there is ‘far transfer’ from working memory training to ‘flexible intelligence’ or to ‘executive control.’ Consider a particularly egregious journalistic example. A flawed report by another rather notable British iconoclast (see Melby-Lervag M (2013) Is working memory training effective? A meta-analytic review. Dev Psychol. 49:270) argued that the working memory training marketed by CogMed was ineffective, and in any event did not generalize to ‘real world benefits.’ This article stimulated a caustic blog by a Pulitzer Prize-winning science journalist, Gareth Cook titled “Brain Games Are Bogus.” http://www.newyorker.com/online/blogs/elements/2013/04/brain-games-are-bogus.html Cook was wrong in this article, twice. First, he gave the authors far more credit for their analysis than they were due. Second, he painted all science-based brain training with the same broad, ignorant brush.

   At the same time, it SHOULD be pointed out that there IS only limited near and far transfer from (for example) working memory training or executive skills training to other abilities that might apply to a better brain operating in real life. Many examples of studies challenging the extents of that transfer (and others showing that significant transfer CAN occur) could be cited. For example, see Chacko A et al (2013) Working memory training for youth with ADHD: A closer examination of efficacy utilizing evidence-based criteria. J Clin Child Adolesc Psychol (epub ahead of print); Gray SA et al Effects of a computerized working memory training program on working memory, attention, and academics in adolescents with severe LD and comorbid ADHD: A randomized controlled trial. J Child Psychol Psychiatry 53:1277; or Shipstead Z et al (2010) Does working memory training generalize? [to make you smarter] Psychol Belgica 50:245. My point in raising these issues: Some training DOES generalize to ‘real life’. Some does not. Validating that generalization of training to related (near transfer) or more distant (far transfer) abilities is a core part of every outcomes study that we have conducted to date. Some training DOES NOT generalize. They deserve a level of disdain, re their practical values. Scientists and journalists should keep these differences in mind, as you design and report on scientific studies, or as you inform the broader public about whether or not THIS or THAT form of brain training might actually help improve a life or save someone’s bacon.

6. OUTCOMES STUDIES ON BRAINHQ PROGRAMS IN THE NORMAL-AGING POPULATION:
   MANY “gold standard” controlled studies have shown that the training programs delivered at BrainHQ enduringly benefit trainees, and positively alter (rejuvenate) their neurology. For example:Mahncke HW et al (2006) Memory enhancement in healthy older adults using a brain plasticity–based training program: a randomized control study. PNAS 103:12523. This large controlled trial showed that brain training focusing on aural speech listening very significantly improves memory and other cognitive abilities, and results in substantial improvement recorded by brain speed and accuracy. Outcomes were independent of age, and were achieved with subjects completing this training with no direct monitoring or guidance on their home computers.Smith GE et al (2009) A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity-based Adaptive Cognitive Training (IMPACT) study. J Am Geriatr Soc 57:594; Zelinski EM et al (2011) Improvement in memory with plasticity-based adaptive cognitive training (IMPACT): results of the 3-month follow-up. J Am Geriatr Soc 59:258. Again, this large (about 300 subject) randomized controlled trial, conducted by independent scientists at the Mayo Clinic in Rochester and at the Andress Aging Center at the University of Southern California demonstrated highly significant gains documenting by a long series of memory and cognition assessments. Overall gains in cognition translated to a gain in ‘cognitive age’ of about 11 years in this “intent-to-treat” trial. If data from the 15% of non-completers in the trial was not included in the analysis, average gains in ‘cognitive age’ translates to nearly 14 years. Put in simple terms, that means that a person whose overall cognitive indices are appropriate for their age — say 70 — after training their cognitive abilities would match those of a typical 56-year-old. Note that a number of near- and far-transfer gains from training were documented in this study, including significant advances in measured indices of quality of life.Wolinsky FD et al (2011) A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults. PLoS One 8:361624. This randomized controlled trial (conducted with 670 trained individuals) was noteworthy because it documented benefits of only ten hours of visual training, using just one of the visual training modules at BrainHQ.com. It also assessed outcomes as a function of a) age, b) whether training impacts were stronger in a clinical ‘class’, or when training sessions were all completed ‘at home’; and c) their endurance in following years, with and without a 2-hour ‘booster’. Controlled subjects worked for the same period on progressively more challenging computer-delivered crossword puzzles. The outcome: a) Large scale gains in brain speed, memory, and a variety of other clinical indices richly documenting near- and far-transfer of benefits. b) Results were just as strong if you completed your exercises at home as in the clinic. c) Outcomes were independent of age. D) MOST IMPORTANTLY, gains on all measures were long-enduring; gains over the pre-training baseline were estimated to be sustained for from 1.7 to more than 6 years after training completion. e) The short booster did not significantly impact those gains; it probably occurred to early after initial training to make much difference.Berry AS et al (2010) The influence of perceptual training on working memory in older adults. PLoS One 5:311537. Here, the scientists used another of the visual training exercises mounted at BrainHQ.com, again training over about a 10-hour period. Again, highly significant gains were recorded in this controlled study on non-trained (far-transfer) measures — in this case, for un-trained indices of memory for visual (and visual motion) stimuli). Importantly, parallel brain recording studies documented physical and function brain changes accounting for these substantial improvements.

   Ball K et al (2002) Effects of cognitive training interventions with older adults: A randomized contolled trial. JAMA 288:2271; Willis SL ET AL 92006) Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA 296:2805; Wolinsky FD et al (2006) The effects of the ACTIVE cognitive training trial on clinically relevant declines in health-related quality of life. J Gerontol B Psychol Sci Soc Sci 62:S281; Edwards JD et al (2002) Transfer of a speed of processing intervention to near and far cognitive functions. Gerontology 48:329 These reports summarize positive outcomes, again, of 10 hours of training on a single visual training task, documenting sharp increases in brain speed, and demonstrating significant far-transfer to QOL indices attributable to this very brief training epoch. This large trial (ACTIVE) was conducted in more than 3,000 subjects.

   Edwards JD et al (2005) The impact of speed of processing training on cognitive and everyday performance. Aging & Mental Health 9:262. In another trial, the same 10-hour-long program was applied in several hundred subjects in a controlled trial further documenting both cognitive gains AND (importantly) far-transfer gains on TIADLs (timed completion of everyday tasks). After speeding up their neurological processes through this brief epoch of training, subjects completed everyday tasks (like looking up a number in the phone book) in about half the time. Effects were sustained for more than 2 years after training.

   Wolinsky FD et al (2006) The ACTIVE cognitive training trial and health-related quality of life: protection that lasts for 5 years. J Gerontol A Biol Sci Med Sci 61:1324; Wolinsky FD et al (2010) Speed of processing training protects self-rated health in older adults: enduring effects observed in the multi-site ACTIVE randomized controlled trial. Int Psychogeriatr 22:470; Wolinsky FD et al (2009) The effect of speed of processing raining on depressive symptoms in ACTIVE. J Gerontol A Biol Sci Med Sci 64:468; Wolinsky FD et al (2009) Does cognitive training improve internal locus of control among older adults? J Gerontol B Psychol Sci Soc Sci. (http://www.ncbi.nlm.nih.go/pubmed/20008028.

   These studies are among a dozen positive reports by Fredric Wolinsky and colleagues (University of Iowa) on the impacts of completing a standard visual module of BrainHQ. The two main points of these studies: 1) Subjects get better at measured indices of performance abilities, and are medially healthier, after training. 2) EFFECTS ENDURE, in these (and other reported cases) for at least 5 years. Thus, complete a brief epoch of brain training, and five years later there are STILL fewer individuals from the large training cohort in a >3000 subject trial developing clinical depression (for example). One important outcomes: Trained subjects are more strongly ‘in control’ in their lives over this epoch, in ways that assure greater likelihood of sustained independence.

   Scalf PE et al (2007) The neural correlates of an expanded functional field of view. J Gerontol B Psychol Sci Soc Sci 62:32. Here, neurological changes resulting from a 10 hour training epoch are documented. They reveal, to a first level of understanding, how brain change accounts for behavioral gains.

   Rosen AC et al (2011) Cognitive training changes hippocampal function in mild cognitive impairment: a pilot study. J Alzheimers Dis 26:349. Here, some of the neurological changes arising from listening training are documented, in subjects engaged in a memory acquisition task. These ‘mildly cognitively impaired’ individuals also had a series of positive gains recorded in parallel PET- (positron emission tomography) recording studies, documenting positive changes in their ‘default network’ that are the sites of early large-scale Alzheimer’s pathology.

7. Many more studies could be cited. Note that: 1) Most of these studies documented near and far transfer training effects, i.e., improvements that translated to improved performance on other different-related tasks (near transfer), and on every day-tasks never subject to training in these evaluated computer-delivered programs, indicating a generalized growth in “brainpower”. That real-life improvement is the REAL target of any valid brain-health program. 2) Most of these studies documented highly significant improvements in processing speed and accuracy, as noted above. 3) Studies repeatedly show that impacts of training are enduring over a period of many months to years after an epoch of 10 or 20 or 30 or 40 hours of training.
8. One of the best-established far-transfer impacts of the training that that has been recorded for training exercises provided at BrainHQ.com has been documented by the research of Drs. Karlene Ball (University of Alabama at Birmingham), Daniel Roenker (University of Western Kentucky) and Jerri Edwards (University of South Florida), who first demonstrated the strong relationship between a speed-related divided attention ability in vision (the individual’s “Useful Field of View”, UFOV) and their driving accident rate THEN showed that UFOV was highly trainable, and that training resulted in far safer driving AND enabled older individuals to sustain driving (keep their driver’s licenses; drive more competently, frequently, confidently, far longer in life) and sustain their independence much more effectively.For an entry into the several dozen reports relating your high-speed, wide-field vision to safe driving, see Friedman C et al (2013) Association between higher-order visual processing abilities and a history of motor vehicle collision involvement by drivers ages 70 and over. Invest Ophthalmol Vis Sci 54:778; Ball K, Edwards JD, Ross LA, McGwin G Jr. (2010) J Am Geriatr Soc 58:2107; O’Connor ML, Edwards JD, Wadley VG, Crowe M (2010) Changes in mobility among older adults with psychometrically defined mild cognitive impairment. J Gerontol B Psychol Sci Soc Sci 65:306; Edwards JD, Delahunt Pb, Mahncke HW (2009) Cognitive speed of processing training delays driving cessation. J Gerontol A Biol Sci Med Sci; Edwards JD, Myers C, Ross LA, Roenker DL, Cissel GM, McLaughlin AM, Ball KK (2009) The longitudinal impact of cognitive speed of processing training on driving mobility. Gerontologist 49:485-94; Roenker DL, Cissel GM, Ball KK, Wadley VG, Edwards JD (2003) Speed of processing and driving simulator training resut in improved driving performance. Hum Factors 45:218.
9. Other important controlled trials using BrainHQ programs have recorded positive outcomes in patients suffering from a variety of clinical conditions. The most complete series has been conducted with chronic and first-onset schizophrenics, and in individuals at risk for schizophrenia onset. To begin reviewing these findings, begin with an editorial in the American Journal of Psychiatry describing the results of recent research with Posit (BrainHQ) programs, calling for this approach to be evaluated and thought of as a new form of therapeutic for people with schizophrenia. See Green MF (2009) New possibilities in cognition enhancement for schizophrenia. Amer J Psychiat 166:749.People with schizophrenia show statistically significant improvements in untrained measures of generalized cognitive function following Posit (BrainHQ) cognitive remediation in a randomized controlled double-blind trial; our training programs improved generalized measures cognitive function more than did ordinary computer games used as an active control. See Fisher M et al (2009) Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. Am J Psychiatry 166:805.
   Generalized cognitive function improvements following Posit cognitive remediation were maintained six months after the completion of the program, but effect sizes had begun to wane, indicating that some further—or maintenance—training might be called for. See Fisher M et al (2010) Neuroplasticity-based cognitive training in schizophrenia: an interim report on the effects 6 months later. Schizophr Bull 36:869.Generalized cognitive function improvements following BrainHQ cognitive remediation were accompanied by gains in the level of Brain Derived Neurotrophic Factor (BDNF), a growth factor supporting neuronal health that is sharply down-regulated in schizophrenics. Gains returned BDNF expression to normal levels. Levels were well-sustained long after training series completion.See Vinogradov S et al (2009) Is serum brain-derived neurotrophic factor a biomarker for cognitive enhancement in schizophrenia? BiologicalPsychiatry 66:549.People with schizophrenia can have high levels of serum anti-cholinergicity, which can be a side-effect of certain medications. That drug impact moderately but significantly weakens patient gains achieved through Posit (BrainHQ) cognitive remediation. See Vinogradov S (2009) The cognitive cost of anticholinergic burden: Decreased response to cognitive training in schizophrenia. Amer J Psychiat 166:1055.A multi-site randomized controlled trial designed to replicate the above studies demonstrated training impacts from Posit/BrainHQ cognitive remediation on generalized cognitive function in people with schizophrenia—again showing superiority compared to ordinary computer games. These studies indicate that the benefits of this training can be delivered in a clinical setting via the Internet out to the millions of individuals that it can help. See Keefe RSE et al (2012) Feasibility and pilot efficacy results from the multisite cognitive remediation in the schizophrenia trials network (CRSTN) randomized controlled trial. J Clin Psychiatry 73:1016. This study added further evidence supporting the initiation of an FDA trial, now being conducted at 11 national (American) sites.

   People with schizophrenia who used Posit (BrainHQ) cognitive remediation and received standardized supported employment services show improved executive function skills that contributed to better employment outcomes, compared to those receiving supported employment services alone. See Greig TC et al (2007) Improved Cognitive Function in Schizophrenia After One Year of Cognitive Training and Vocational Services. Schizophr Res 96:156.

   People with schizophrenia who use BrainHq cognitive remediation and received standardized supported employment services showed improved employment outcomes compared to those receiving supported employment services alone; in the year following the completion of program use and supported employment, users worked significantly more hours and were significantly more likely to retain employed positions. See Bell MD et al (2008) Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophren Res 105:18.
   A review of the results from a single large randomized controlled trial of Posit cognitive remediation in schizophrenia provided new analyses documenting that people progressing to the most challenging levels of the program show the largest gains in generalized cognitive function. See Adcock RA et al (2009) When top-down meets bottom-up: auditory training enhances verbal memory in schizophrenia. Schizophr Bull 35:1132.

   BrainHQ (Posit) training resulted in a renormalization of a key neurological index of schizophrenia (sensory gating) in a controlled German study. See Popov T et al (2010) Specific cognitive training normalizes auditory sensory gating in schizophrenia: A randomized trial. Biological Psychiatry 68:322; and Popov T et al (2012) Adjusting Brain Dynamics in Schizophrenia by Means of Perceptual and Cognitive Training. PloS one 7:e39051.

   By adding social cognition training modules to our perceptual/cognitive training program suite, there were strong positive renormalizing changes recorded in the anterior lateral frontal cortex and amygdala and a sharp improvement in quality of life measures. See Sachs S et al (2013) Combining computerized social cognitive training with neuroplasticity-based auditory training in schizophrenia. Clin Schizopohr Relat Psychoses 30:1.

   Training has strong impacts in first-onset patients, and has a strong prophylactic impact in patients at risk for disease onset. See Fisher M et al (2013) Cognitive interventions targeting brain plasticity in the prodromal and early phases of schizophrenia. Ann Rev Clin Psychol 9:435. We believe that with this resilience training, schizophrenia is likely preventable in a large proportion of at-risk individuals.

   Some genetic factors contribute to aspects of training outcomes in schizophrenia patients. See Pannizzutti R et al (2013) Genetic correlate of cognitive training response in schizophrenia. Neuropharmacology 65:264. The better we understand those genetic factors, the better we can shape training to work for different schizophrenia patient sub-populations.

   Adding social cognition training programs like those mounted at BrainHQ and being applied in our FDA trial resulted in a renormalization of the patterns of response in the emotion recognition machinery in the brain. See Hooker CI et al (2012) Neural activity during emotion recognition after combined cognitive plus social cognitive training in schizophrenia. Schizophr Res 139:53.

   Finally, training resulted in a restoration of the ability to keep track of who does what—which is a fundamental problem for the schizophrenia patient. In parallel, the patient’s neurology was restored to normalcy (or nearly so). See Subramaniam K et al (2012) Computerized cognitive training restores neural activity within the reality monitoring network in schizophrenia. Neuron 73:842.

10. OTHER CLINICAL INDICATIONS.
    We have generated similarly positive outcomes data for many other clinical indications. For references to that data, see www.brainhq.com and review the “Brain Training Courses” at that site. There, links will lead to references to the clinical conditions that are the subjects of Brainhq course training. Some are now up at the site; others shall appear there through the course of 2013 an 2014. Targets of our research for which we have developed “Brain Training Courses” include: a) tinnitus; b) traumatic brain injury; c) cognitive losses attributable to brain infections (HIV/AIDS; Lyme Disease; West Nile Virus; et alia); d) optimizing hearing with a new hearing aid; f) improving sleep regulation; g) cognitive losses attributable to oxygen deprivation; h) cognitive losses attributable to heavy metal and organic poisons; i) mild depressive symptoms; j) mild anxiety symptoms; k) prosopagnosia and related social cognition problems; l) psychopathy and other conduct disorders; m) cognitive losses attributable to a history of neglect or abuse; n) hemispatial neglect syndrome; o) cognitive losses attributed to multiple sclerosis; p) resilience against Alzheimers onset; q) resilience against Parkinsons onset; r) among others. In all of these conditions, scientists and clinicians have generated evidence that our strategies for strengthening neurological abilities can contribute to growing functionality and to weakening—and in some cases pretty completely overcoming—the expressions of these chronic conditions. [I shall load these arguments and references at this site related to all of these clinical conditions by early-to-mid 2014].