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A Call to Action: Improv­ing brain & men­tal health via dig­i­tal plat­forms, neu­ro­plas­tic­ity research and the White House BRAIN initiative

(Session held at the 2014 SharpBrains Virtual Summit; October 28-30th, 2014)

8:15–9:45am. A Call to Action: Improv­ing brain & men­tal health via dig­i­tal plat­forms, neu­ro­plas­tic­ity research and the White House BRAIN initiative
- Dr. Thomas Insel, Direc­tor of the National Insti­tute of Men­tal Health (NIMH)
- Dr. Adam Gaz­za­ley, Direc­tor of UCSF Neu­ro­science Imag­ing Cen­ter and Co-founder of Akili Inter­ac­tive Labs
- Dr. Daphne Bave­lier, Head of the Brain & Learn­ing Lab at the Uni­ver­sity of Geneva & U. of Rochester
- Jack Young, Head of Qual­comm Life Fund
- Chair: Alvaro Fer­nan­dez, CEO of SharpBrains

Learn more here:
http://sharpbrains.com/summit-2014/agenda/

A Call to Action: Improv­ing brain & men­tal health via dig­i­tal plat­forms, neu­ro­plas­tic­ity research and the White House BRAIN initiative

  1. 1. A Call to Action: Improving brain & mental health via digital platforms and neuroplasticity research
  2. 2. Sponsors Welcome!
  3. 3. 215 Participants in 17 Countries
  4. 4. Source: The SharpBrains Guide to Brain Fitness: How to Optimize Brain Health and Performance at Any Age
  5. 5. A Call to Action: Improving brain & mental health via digital platforms, neuroplasticity research and the White House BRAIN initiative Chaired by: Alvaro Fernandez, CEO of SharpBrains Dr. Thomas Insel, Director of the National Institute of Mental Health Dr. Adam Gazzaley, Director of UCSF Neuroscience Imaging Center and Co-founder of Akili Interactive Labs Dr. Daphne Bavelier, Head of the Brain & Learning Lab at the University of Geneva & U. of Rochester Jack Young, Head of Qualcomm Life Fund
  6. 6. A Call to Action: Improving brain & mental health via digital platforms, neuroplasticity research and the White House BRAIN initiative Dr. Thomas Insel, Director of the National Institute of Mental Health
  7. 7. October 28, 2014 SharpBrains Summit Improving Brain Health: A Call to Action Thomas R. Insel, MD Director, NIMH Public Filer Nothing to Disclose
  8. 8. Brain health and Brain training – In the News Emily Underwood Oct 22, 2014
  9. 9. Frame of Reference
  10. 10. U.S. Burden of Diseases: 291 diseases and injuries 11 Leading Categories of DALYs 2010 5.1 6.5 8.0 11.8 15.1 16.8 0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0 16.0 18.0 20.0 1. Neuropsychiatric Disorders 2. Cardiovascular and Circulatory Diseases 3. Neoplasms 4. Musculoskeletal Disorders 5. Diabetes, Urogenital, Blood, and Endocrine Diseases 6. Chronic Respiratory Diseases 7. Other Non-communicable Diseases Percent of Total U.S. DALYs 18.7 Neurological Disorders 5.1 Mental and Behavioral Disorders 13.6 US Burden of Disease Collaborators, JAMA, 2013.
  11. 11. Neurons to Neighborhoods: Our Toolbox Molecules Cells Systems Individual Social “ New directions in science are launched by new tools much more often than by new concepts. The effect of a concept-driven revolution is to explain old things in new ways. The effect of a tool-driven revolution is to discover new things that have to be explained. ” Freeman Dyson (1997) Imagined Worlds Harvard University Press, Cambridge, MA
  12. 12. The Human Connectome Project Functional Connectivity Structural Connectivity Molecular Imaging Multimodal Integration New Molecular Imaging Temporal Connectivity Wash U U Minn MGH
  13. 13. “The Next Great American Project” “So there is this enormous mystery waiting to be unlocked, and the BRAIN Initiative will change that by giving scientists the tools they need to get a dynamic picture of the brain in action and better understand how we think and how we learn and how we remember. And that knowledge could be – will be – transformative.” ~President Obama, April 2, 2013
  14. 14. The NIH BRAIN Scientific Plan To map the circuits of the brain, measure the fluctuating patterns of electrical and chemical activity flowing within those circuits, and understand how their interplay creates our unique cognitive and behavioral capabilities.
  15. 15. Bending the curve with clinical neuroscience Transforming diagnostics From behavioral disorders to brain disorders: Diagnosis rooted in biology and behavior Transforming therapeutics From chemical imbalance to circuit dysfunction Treatments for circuit tuning Transforming the culture of science From “these data are mine” to “mine these data” Open science as a new model for discovery
  16. 16. Bending the curve with clinical neuroscience Transforming diagnostics From behavioral disorders to brain disorders: Diagnosis rooted in biology and behavior Transforming therapeutics From chemical imbalance to circuit dysfunction Treatments for circuit tuning Transforming the culture of science From “these data are mine” to “mine these data” Open science as a new model for discovery
  17. 17. Defining mental illnesses as circuit disorders OCD PTSD Depression Insel. Sci Am, 2010
  18. 18. RDoC: Precision Medicine for Psychiatry 19 Rare variants for etiology, common variants for risk iPSCs for pathways analysis Imaging biomarkers Cognitive testing Information Sensors Commons
  19. 19. Bending the curve with clinical neuroscience Transforming diagnostics From behavioral disorders to brain disorders: Diagnosis rooted in biology and behavior Transforming therapeutics From chemical imbalance to circuit dysfunction Treatments for circuit tuning Transforming the culture of science From “these data are mine” to “mine these data” Open science as a new model for discovery
  20. 20. Treating mental illnesses as circuit disorders Sci Transl Med 2012 Nat Rev Drug Dev, 2013
  21. 21. Depression as a Brain Circuit Syndrome PF9/46 PM6 Par40 oF11 pACC24 mF9/10 MCC PCC sACC25 amg mb-vta a-ins hth bstem hc na-vst thal Salience Motivation Mood state Self-awareness insight Cognition (attention-appraisal-action) Interoception (drive-autonomic-circadian) P F P MEDS Cg25 PCC BS CBT PF MF MCC DBS Br Med Bul 65:193-207, 2003 Arch Gen Psych 61:34-41-2004 Helen Mayberg Emory University
  22. 22. Networked Psychiatric Treatments 23 Protective LOF mutations, Pathway targets, epigenetics Cell replacement Rx, Plasticity agents Circuit based Rx, rTMS, DBS Cognitive training mHealth, Social networks Network Solutions
  23. 23. Bending the curve with clinical neuroscience Transforming diagnostics From behavioral disorders to brain disorders: Diagnosis rooted in biology and behavior Transforming therapeutics From chemical imbalance to circuit dysfunction Treatments for circuit tuning Transforming the culture of science From “these data are mine” to “mine these data” Open science as a new model for discovery
  24. 24. Transforming the Culture Academia Standardization Integration Data/Reagent/Tissue Sharing Industry Foundations Government
  25. 25. Summary Thoughts  Hype/hope usually drive new technologies (e.g. gene therapy) including those that ultimately prove effective.  For complex problems, magic bullets (e.g. drugs or cognitive training) are unlikely to be effective alone.  There is no short-cut to rigorous science – unbiased RCTs looking at effect size, generalization, durability are essential to demonstrate value.
  26. 26. “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten.” --Bill Gates Jr. Finally
  27. 27. Thank you ! Paving the Way for Prevention, Recovery, and Cure www.nimh.nih.gov Research = Hope
  28. 28. A Call to Action: Improving brain & mental health via digital platforms, neuroplasticity research and the White House BRAIN initiative Dr. Adam Gazzaley, Director of UCSF Neuroscience Imaging Center and Co-founder of Akili Interactive Labs
  29. 29. A Vision of the Future of Medicine Adam Gazzaley, MD PhD Professor - Neurology, Physiology and Psychiatry Director - Neuroscience Imaging Center University of California, San Francisco
  30. 30. Challenge Develop effective approaches to enhance cognition in both healthy and impaired individuals
  31. 31. Current Approach 60 year old with mild cognitive impairment • Poor characterization • Poor targeting • Non-personalized • Unimodal • Open Loop This is just not good enough
  32. 32. Create a New Approach closed-loop targeted personalized multimodal
  33. 33. Video Games
  34. 34. Video Game Training ★ Adaptive training of interference processing drives enhancements of cognitive control in older adults. ★ Task improvements are associated with changes in engagement of prefrontal cortex networks. Anguera et al. Nature 2013
  35. 35. Move to the Real World Akili Interactive Labs Co-founder and Chief Science Advisor Patent-pending: “Enhancing Cognition in the Presence of Distraction and/or Interruption”
  36. 36. Bridging the Gap Between Technology and Neuroscience Neuroscapelab.com
  37. 37. New Technology Mobile / Wireless
  38. 38. New Technology Virtual Reality Motion Capture
  39. 39. Enhance the Effects Neuromodulation Neurofeedback Video Games
  40. 40. Glass Brain
  41. 41. Thanks for your attention
  42. 42. Many thanks Associates Students • Omar Alhashimi • Alan Legitt • Benjamin Dorn • Cammie Rolle • Jacki Janowich • Roger Anguera • Rajat Jain Fellows • David Ziegler • Morgan Hough • WanYu Hsu • Yixuan Ku • Martine Schouwenburg Faculty • Ted Zanto • Judy Pa • Jyoti Mishra • Peter Wais • Joaquin Anguera GlassBrain • Tim Mullen • Christian Kothe • Oleg Konigs • John Fesenko Financial Support www.gazzlab.com Game Development • Matt Omernick • Dmitri Ellingson • Eric Johnson • Noah Fahlstein Hardware • Apple • NVIDIA • National Institute on Aging • National Institute of Mental Health • American Federation of Aging Research • Robert Wood Johnson Foundation • Zynga.org Foundation • Center 17 Foundation • Ellison Medical Foundation • James Gates Family Foundation • Sandler Foundation • Rose Family Foundation • Feldman Family Foundation • Grammy Foundation • Biggelsworth Foundation • UCSF CTSI • Posit Science • Pfizer / Eisai • Tim Ferriss • Tully and Elise Friedman • Sara and Evan Williams Foundation • Oculus VR • Ty Clark • Matt Whitman • Mike Gonzales • Mickey Hart • to Gazzlab alumni, collaborators, research and industry partners ... • Myers Sound
  43. 43. A Call to Action: Improving brain & mental health via digital platforms, neuroplasticity research and the White House BRAIN initiative Dr. Daphne Bavelier, Head of the Brain & Learning Lab at the University of Geneva & U. of Rochester
  44. 44. Action video games as exemplary learning tools Daphne Bavelier Disclosure • Advisory Board, Co-founder, Akili, PureTech Venture • Product Partner, E-line Media • Patent on Method and System for Treating Amblyopia (US Pat. Appln. No. 61/403,585) • Patent on Method and System for Training ‘Number Sense‘ (US Pat. Appln. No. 13/301,392)
  45. 45. Enhancing learning and facilitating transfer is possible In young adults, action-packed fast paced games appear to have an edge
  46. 46. Better vision
  47. 47. ACTION SOCIAL Medal of Honor UT Call of Duty Tetris the Sims Restaurant Empire
  48. 48. Before After
  49. 49. Green & Bavelier, 2007, Psych. Science Li, Polat, Makous & Bavelier, 2009, Nat. Neuro Li, Polat, Scalzo & Bavelier, 2009, J. of Vision
  50. 50. Better Mental Rotation
  51. 51. 1 2 3 4 Feng, Pratt, Spence, 2007, Psych Science
  52. 52. Action-Games: FPS Pretesting Post-testing Training 10 hours of in labs training Feng, Pratt, Spence, 2007, Psych Science
  53. 53. Surprisingly broad transfer Contrast sensitivity/Crowding Acuity/Backward masking: Green & Bavelier, 2007; Li et al., 2009; Li et al. 2010; Mental Rotation: Feng et al, 2007; Boot et al, 2008; Cherney, 2008; Task-switching: Colzato, et al., 2010, 2013; Boot, et al., 2008; Andrews & Murphy, 2006; Karle, Watter, & Shedden, 2010; Cain, Landau, Shimamura, 2012; Green et al., 2012; Strobach, Frensch, Schubert, 2012; Chiappe et al. 2013; Attentional Blink/Temporal masking: Green & Bavelier, 2003, 2006; Dye & Bavelier, 2010; Li et al., 2010; Cohen et al., 2009; UFOV/Goldman Perimetry: Green & Bavelier, 2003, 2006; Feng et al, 2007; Spence et al, 2009; Buckley et al, 2010 ; Visual Search: Castel et al, 2005; Hubert-Wallander et al, 2011; West et al, 2008; Bavelier et al., 2012; Clark, Fleck & Mitroff, 2011; vSTM/Object Memory: Boot et al, 2008; Sungur & Boduroglu, 2012; McDermott, Green & Bavelier, 2014; Blacker & Curby, 2013; Multiple Object Tracking: Trick et al, 2005; Green & Bavelier, 2006; Boot et al, 2008; Cohen, Green & Bavelier, 2009; Dye & Bavelier, 2010 Decision Making: Green et al., 2010; Dye et al., 2009; Time estimation: Donohue et al, 2010 Change Detection/Redirecting of attention/Distractor Suppression: Clark et al, 2011; Chisholm et al. 2010, 2011; Mishra et al., 2011; Krishman et al., 2012; Oei & Patterson, 2013; META–ANALYSIS of action games vs. other video games - MEDIUM EFFECT SIZE (0.45 - 0.6)
  54. 54. Not all games are created equal Action games in young adults and children have that effect Social Games, Tetris not so much
  55. 55. Enhancing learning and facilitating transfer to new tasks is possible with some video games: action-packed, fast paced games This holds in young adults – in older adults or patients, action games are ill-adapted Need adaptive training, video games or other experiences, that will enhance attentional control
  56. 56. Action video game play results in enhanced attentional control Test of Variables of Attention (T.O.V.A.®)
  57. 57. http://www.tovatest.com/ - Target Frequent - Target Infrequent Dye, Green and Bavelier (2009) Current Directions in Psych. Science
  58. 58. Sustained Impulsivity Sustained Impulsivity Gamers are faster but no less accurate No issue with impulsivity or sustained attention Dye, Green & Bavelier (2009). Current Dirs. Psych. Sci.
  59. 59. Enhanced Attentional Control • Test of Variables of Attention (T.O.V.A.®) • Selective Attention in Space, in Time or to Objects • More efficient suppression of distractors • Major changes in fronto-parietal attentional control network Green, C.S. and Bavelier, D. (2003) Nature Green, C.S. and Bavelier, D. (2012) Current Biology Bavelier, Achtman, Mani, Fockert (2012) Vis. Research Mishra, Zinni, Bavelier & Hillyard (2011). J. of Neuroscience C. Shawn Green Enhanced attentional control allows for faster learning of task statistics, and thus greater adaptability and broader transfer
  60. 60. Summary • Broad transfer to perception, attention and cognition after action game play • Not all video games are created equal – for young adults and skills studied so far action packed video games have an edge BUT action video games too challenging for older adults or low vision patients… • Evaluating key game play components and how they may be best adapted to induce learning and transfer as a function of the population studied
  61. 61. A Call to Action: Improving brain & mental health via digital platforms, neuroplasticity research and the White House BRAIN initiative Jack Young, Head of Qualcomm Life Fund
  62. 62.  To learn more, visit SharpBrains.com

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