Best practices to assess and enhance brain function via mobile devices and wearables

Best practices to assess and enhance brain
function via mobile devices and wearables

Source: The SharpBrains Guide to Brain Fitness (second edition)

Chaired by: Keith Epstein,
Senior Strategic Advisor at AARP
Corinna E. Lathan,
Founder and CEO of AnthroTronix
Eddie Martucci,
VP, R&D at Akili Interactive Labs
Alex Doman,
Co-founder of Sleep Genius
Joan Severson,
President of Digital Artefacts

AARP Research
• When AARP asked, members made it clear that
brain health is a top area of interest and concern
as they age.
• Younger consumers (age 34-49) are more inclined
to feel brain health is the most important
component to overall health (41% versus 34% of
consumers age 50-75).
• However, they are also more likely to believe
brain deterioration cannot be reversed.
AARP Research August 2014
Keith Epstein - Senior Strategic Advisor -
Strategic Intelligence Team - AARP -
October 24, 2014

Corinna Lathan, PhD
Founder and CEO of AnthroTronix

The Brain Vital: Why do we ignore our brain?
www.danabrainvital.com
Human Inspired. Technology Driven.
8

Existing options for brain health
Imaging (MRI, CT)
• Expensive
• Not portable
• Not always available
Physiological (EEG)
• Hard to interpret
• Difficult to administer
• Not widely available
Behavioral (Forms & Interviews)
• Limits of self-reporting
• Time pressures in clinic
Human Inspired. Technology Driven. 9

The DANA™ Brain Vital
DANA is an FDA-cleared mobile reaction time testing
system that reinvents the way patients are monitored for
signs of neurocognitive impairment.
10

History of DANA
 Developed for the Department of Navy Bureau of
Medicine and Surgery (BUMED)
 A mobile software application to assist in the
detection of neurocognitive impairment from any
cause
 To help the far forward medic to more accurately
detect impairment as soon as possible
 To assist the psychologist or healthcare professional
with supportive diagnostic tools to aid in their
diagnosis

DANA Requirements
 Portability
 Leverage best practices in computerized cognitive
testing
 Both standardized cognitive and psychological tests
 Easy of use for all types of providers – 3 levels of
testing
 Embedded tests of effort determine malingering vs real
 FDA Compliance

Scaleable Software
Human Inspired. Technology Driven. 13

FDA Cleared IFU
DANA provides clinicians with objective measurements of reaction time
(speed and accuracy) to aid in the assessment of an individual’s
medical or psychological state.
Factors that may affect the measurement of reaction time include, but are
not limited to concussion, head injury, insomnia, post traumatic stress
disorder (PTSD), depression, attention deficit hyperactivity disorder
(ADHD), memory impairment, dementia, delirium, prescription and
non-prescription medication, some nutritional supplements, as well as
a variety of psychological states (e.g. fatigue and stress).
DANA also delivers and scores standardized psychological
questionnaires. DANA results should be interpreted only by qualified
professionals.
14

FDA Lessons Learned
• Context matters
• Dialogue
• Find the right people
• Persistence
15

Thank You!
clathan@atinc.com
www.atinc.com
www.DANABrainVital.com
NDA Only: Confidential
& Proprietary 16

Eddie Martucci,
VP, R&D at Akili Interactive Labs

Akili
A new class of medical products

What if...
more data points
real-world data
time/cost-effective
broader patient selection
MOBILE

What if...
more data points
many
IN YOUR POCKET
time/cost-effective
increased compliance
real-world data

What if...
many more data points
increased compliance and then some
FUN
WAY
time/cost-effective
real-world data
higher signal-to-noise than traditional assessments

Akili’s Platform
Medicine you actually enjoy

Akili’s Platform
Personalized cognitive engine
Proprietary
Adaptive
Algorithms
Custom difficulty automatically
personalized to the patient
Proprietary
Cognitive
Mechanics
Software-based Assessment
of Executive Function

Findings from First Clinical Study
confidential
Game metrics show ability to
be sensitive cognitive marker
0%
-10%
-20%
-30%
-40%
-50%
-60%
-70%
At-home training leads to measura
ble physiological brain changes
**
EEG – Theta Band Amplitude
Time-Locked to Stimulus
p < 0.05
Multitasking training
Single task training
No-contact control
-80%
10s 20s 30s 40s 50s 60s 70s
Interference Cost
Assessment of Interference Processing Ability
Mean ± SEM
*
*
*
*
*
*
†
†
†
‡
‡
‡
Mean ± SEM
*
*
*
*
*
*
†
†
†
‡
‡
‡
Mean + SEM
Source: Anguera et al, Nature, 2013

Akili’s Perspective
+
12 ongoing/completed clinical studies
In various populations with same game platform

What We’ve Found Industry
Wants
Data, data, data
Theoretical underpinning
Intellectual Property
Scientific culture
Diversity in background

Lessons from Clinical Studies
Don’t assume you know who loves technology
Small pilot studies add value
Specific populations matter
Reward cycles work…if you get it right

Alex Doman,
Co-founder of Sleep Genius

Track and Treat: The
Future of Wearables
Alex Doman
Co-Founder
alex@sleepgenius.com

Self Actualization
“What a man can be,
he must be.”
-Abraham Maslow

The Measured Life
• Sensory Technology
• Wearables
• Sensor Technology
• Data Visualization
• Big Data

Sleep Genius
Personalized Sleep Reporting

TRACKING
1.6 million
AGGREGATED
TRACKING
8 million
2013 2014
• Consumer Adoption
gains momentum
• High Drop-off rates
• Dozens of
wearables
• Apple Health
Book/Google Fit
TREATING
23 million
2015
• Corporate wellness
adoption
• Health Solutions
PERSONALIZED
COACHING
45 million
2017
• Data usefulness
• Personalized
coaching
WEARABLES
GROWTH PHASES
TRACKING
200,000
# Wearable Devices

Thank You!
Alex Doman
Sleep Genius
alex@sleepgenius.com
sleepgenius.com

Joan Severson,
President of Digital Artefacts

Joan Severson
201 East Washington Street
Suite 1302
Iowa City, IA 52240
Phone: (319) 431-3278
Email: joan@digitalartefacts.com
October 29, 2014
BrainBaseline
http://www.brainbaseline.com
Copyright Digital Artefacts 2014

BrainBaseline
Why are we building the BrainBaselineTM platform
“If you could give people information and tools that would delay the onset of cognitive
impairment by a few years, you would be doing much to improve individuals’ quality of life
as
well as improving society.”
Debra Cherry, PhD
Alzheimer’s Association

BrainBaseline
BrainBaseline’s Broad Objectives
• Develop a global platform that integrates cognitive performance measures with lifestyle
and biometric information to track brain health over time
• Provide consumers, clinicians, pharmaceutical companies, and health care and
wellness communities a better understanding of brain health and function across the
lifespan.
• Inform and educate consumers on evidence-based behavioral interventions to provide
life-long cognitive health and wellness.
• Accelerate discovery and reduce the cost of research, clinical trials, and clinical
interventions.

BrainBaseline
How many of you know your
current weight? Blood pressure?
How many of you
know how well
your brain is
working
(objectively)?

The BrainBaseline platform provides
any individual with a mobile device
tools to measure, track and
understand their own brain and
cognitive functioning.
BrainBaseline

BrainBaseline
BrainBaseline Platform
BrainBaselineTM is designed as a modular platform that aggregates health and
behavioral measures through embedded content and third party API integration. The
cornerstone of the application is our suite of over 40 cognitive tasks, which allow us to
determine the relationship between cognitive performance and other aspects of an
individual’s behavior or physical health. We present this information to users in a way that
is appealing and easy to understand; effectively, BrainBaseline is an education and
research platform that provides users with an engaging means of understanding, testing,
and improving their cognitive health.

BrainBaseline
BrainBaseline 2.0 Platform Overview
Lifestyle Activity Brain Drive Biometrics
What makes BrainBaselineTM 2.0 unique is the ability to combine these measures to
provide holistic snapshots of an individual’s psychological, physical and cognitive health,
providing this information to users in a way that allows them to better understand how their
brain health is linked to their behavior.

BrainBaseline
Components of BrainBaseline 2.0
User Dashboard:
The user dashboard acts as a hub that provides users with an overall
snapshot of their current behavioral, cognitive, and lifestyle status in
the form of summary scores and performance trend lines. The data
are populated dynamically and can be adjusted instantly to provide
social motivation, with users being allowed to see how their status in
each domain compares to other anonymous users of the application
in, e.g., their age group or location, as well as connecting with friends
or family to compare scores against others in their social network.

BrainBaseline

BrainBaseline
User Information: (lifestyle, demographics)
In the user information module, users answer a series of demographic
questions, including, age, gender, income level, education, and
geographic location, in addition to questions related to their preferred
leisure activities, overall level of activity. Other specific questionnaires or
self-report measures can be integrated on the basis of project-specific
requirements.

BrainBaseline
Cognitive Testing:
The cognitive testing module is the cornerstone of the BrainBaseline
application. The tests are mapped to specific cognitive domains, are brief
(individual tests take between 1 and 4 minutes), and are diverse in order to
maximize both user engagement and data quality. Furthermore, the diversity
and wide-ranging nature of BrainBaseline’s tests provide added sensitivity to
cognitive change, allowing more accurate detection of decrements or
improvements in cognition.

BrainBaseline
Activity:
The activity module is a hub for users to monitor and aggregate
information about their level of activity and sleep, and allows them to set
activity and sleep goals that let them visualize and incentivize lifestyle
changes that lead to optimal physical and cognitive health. Current
functionality allows users to either self-report activity and sleep data, or
integrate directly with their FitBit, Jawbone UP, and Body Media trackers
for automated aggregation of these data.

BrainBaseline
Biometrics:
The Biometrics module allows users to aggregate biometric information
such as weight, blood pressure, heart rate, or blood-glucose level over
time. Users are able to set specific goals related to target levels of specific
biometric variables (e.g., blood pressure) as well as trend this information
over time.

BrainBaseline
Medication tracking :
Future development is planned to support integration of medication
reminders, as well as tracking of prescription/over the counter
pharmaceutical use and dosage over time.

BrainBaseline
1 Million self administered consumer based tests by 2015

BrainBaseline
Developing models for assessing and classifying change over time
BrainBaseline allows for classification of an individual’s cognitive performance relative to
their own peer group or population sub-group.
We are developing models to classify the predicted or average slope of change across
multiple testing sessions for each population sub-group
Population sub-groups are determined by factors that are likely to stay stable over time
(e.g., race, income level, education, birth year, etc.)
This predicted slope of change classifies what is the “expected” performance for a given
individual meeting a population characteristics

BrainBaseline
Developing models for assessing and classifying change over time
Predicted slope of change also allows for classification of people who display aberrant
(e.g., outlier) performance for their population group
E.g., people who’s slope of change is increasing or decreasing at a different rate than their
population sub-group.
This measure may provide an index of people who are outliers for their own population
sub-group, and may provide a nuanced, stable index of people who are at risk for early
cognitive decline.

BrainBaseline
Subgroup classification to behavior, lifestyle, and biometrics assessment
Analysis of full dataset will be independently performed by research collaborators at the
University of Illinois at Urbana-Champaign.
Analysis of relationship between survey based report of physical activity and cognitive
function
Analysis of relationship between wearable sensor based physical activity sensor data and
cognitive function
Analysis of relationship between survey based reporting of biometrics, heart rate, BP,
glucose measures, and cognitive function
Analysis of relationship between consumer sensor based reporting of biometrics, heart
rate, BP, glucose measures, and cognitive function

BrainBaseline
BrainBaseline 2.0 Platform Overview
BrainBaseline 2.0 is a scalable platform capable of integrating data from many varying
systems, developed both internally and externally, into cognitive profiles for varying
populations ranging from individual users up to groups based on activity, biometrics,
demographics and other factors. The platform itself focuses on data security, reliability and
extensibility.
BrainBaseline integration with Apple HealthKit and Electronic Health Records
Electronic
Health
Records

In conjunction with UCSD department of psychiatry we
have received NIH funding to develop an iPad-based
screening measure for HIV-associated neurocognitive
disorders.
• Screening takes 10 minutes to complete
• Self administered in clinic waiting room
• Automated scoring and reporting
• Aggregated data
• HIPPA compliant infrastructure
• Multiple language support, native iOS development
• Global Research sties
• US, Japan, South Africa
BrainBaseline
Clinical Screening Instruments

 To learn more, visit SharpBrains.com

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