How to promote brain health at scale: Examples in the workplace, K12 education and consumer tech

How to promote brain health at scale:
Examples in the workplace, K12 education and
consumer tech
Chaired by: Alvaro
Fernandez, CEO and
Editor-in-Chief
at SharpBrains
Dr. Gregory Rose, Director of
the Center for Integrated
Research in Cognitive and
Neural Sciences at SIU Med
Ariel Garten, Founder and
Chief Evangelism Officer
of InteraXon
Louis Gagnon, CEO
of Total Brain

How to Promote
Brain Health at Scale…
…in the Workplace
Louis Gagnon, CEO, Total Brain • 7 May 2019

INTRODUCTION
Over the last 25 years, I founded or led teams that:
1. Helped avert ‘00,000 of AIDS transmissions in Africa/Asia
2. Helped 50 millions people find jobs in 52 countries
3. Helped 50K US SMBs convert from YP to digital marketing
4. Helped 15M people discover audiobooks in 7 countries
In 2018, our team recapitalized and re-built an 18-year old company called
MyBrainSolutions and we launched Total Brain in October 2018. We are the
first and only company to approach mental health through brain capacities as
opposed to through psychological symptoms.
5
THE crisis of the day = mental health… and I signed-up to help
Cause–driven entrepreneur / business executive
Louis Gagnon
CEO Total Brain

Mental Health
and Fitness
Platform
INTRODUCTION TO TOTAL BRAIN
Founded in 2000 by leading
neuroscientist, Dr. Evian Gordon,
MD, PhD.
Mental Health is a Continuum. On one end, illness impairs brain capacities.
On the other, fitness improves capacities. Total Brain assesses and trains
brain capacities, in illness, fitness and anywhere in between => removing
stigma and ensuring continuity of care – a first!
Leading consumer groups and Fortune 500 companies benefit from strategic insights,
better outputs, more productivity and less healthcare cost
6
TOTAL BRAIN = UNPRECEDENTED RESULTS
MENTAL HEALTH ≠ ILLNESS
MENTAL HEALTH CRISIS = ATTENTION NEEDED
80% of US employees are at-risk of having a mental condition
20% have a condition - 50% undiagnosed and untreated
* Costing employees quality of life at-home and at-work
* Costing employers quality of outputs, productivity and $$$

Neuroscientific Definition of Mental Health
Mental Health is powered by 12 interdependent Brain Capacities
SELF- CONTROL
Social Connectivity
Resilience
Conscious Bias
COGNITIVE
Memory
Focus
Planning
FEELING
Anxiety Control
Stress Control
Depression Control
EMOTIONAL
Emo. Awareness
Unconscious Bias
Default Emotion
All Brain Capacities can be impaired by Mental Conditions
(Depression, Anxiety, PTSD, ADHD, Addiction, Sleep Apnea, Social Anxiety, etc.)
Our Emotions greatly influence all other Brain Capacities

The Problem of Continuity of Care
GOOD HEALTH
FULL-CAPACITY
– no risk, at-peak –
AT-RISK
UNDER-CAPACITY
– subclinical condition –
LOW HEALTH
INCAPACITY
– clinical condition–
8
Mental health is continuously changing
By focusing on illness and ignoring fitness, we miss what’s in-between: the Risk
AS A RESULT, WE INTERVENE TOO LATE, INCREASE COSTS AND CREATE STIGMA
Sources:
1. NIMH https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
2. NCBI, 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852925/
3. American Heart Association CEO Roundtable: Mental Health – A Workforce Crisis: https://goo.gl/torfyd
Five times per second, life events trigger non-conscious Emotions that impact the Capacities that
define our Mental Health. That’s why Mental Health is a Continuum, and not a State:

The Problem of Stigmatization
9
Misery is often normalized by our education (tough it up butter cup!)
We do not feel the need to screen and if we do, the illness context is extremely stigmatizing
AS A RESULT, 50% OF ALL CONDITIONS ARE UNDIAGNOSED AND UNTREATED2
Sources:
1. NIMH https://www.nimh.nih.gov/health/statistics/mental-illness.shtml
2. NCBI, 2007, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852925/
19% of the US population
reports “excellent health”3
18% of US population
has a clinical condition1
76% of US employees
declare having an issue3
GOOD HEALTH
FULL-CAPACITY
– no risk, at-peak –
AT-RISK
UNDER-CAPACITY
– subclinical condition –
LOW HEALTH
INCAPACITY
– clinical condition–
Five times per second, life events trigger non-conscious Emotions that impact the Capacities that
define our Mental Health. That’s why Mental Health is a Continuum, and not a State:

Devastating Health and Productivity Costs
2010: $2.5 T1
2030: $6.1 T1
$17,241
per employee peryear²
10
GLOBAL YOUR
SCALE COMPANY
Sources:
1. World Economic Forum: https://goo.gl/zZQ8eV

Prevalence of Mental Conditions in Employed Populations
11Sources:
1. Internal book of business data
of employees who took the Total Brain assessment screened at risk for at
least 1 mental condition1
screened at risk for ADHD1
61%
33%
screened at risk for PTSD1
14%
screened at risk for Anxiety1
14%
screened at risk for Social Anxiety1
14%
screened at risk for Depression1
11%
screened at risk for Sleep Apnea1
5%

The Total Brain Solution
MEASURE TOTAL
BRAIN (MONTHLY)
BECOME
AWARE
12 Brain Capacities
7 Mental Conditions
20 minutes
Strengths and
Weaknesses
Risk Explanations
Digital Brain Exercises
Breathing and Meditation
Science and Wisdom
Symptom Validation by Users
Call to EAP Initiated by Users
OPTIONAL EMPLOYER FEATURE
UNDERSTAND ONE’S MENTAL HEALTH
RISK (CONDITIONS) AND TAKE ACTION
ENGAGE WITH CUSTOM
MENTAL FITNESS PROGRAM
12

Solving for Continuity of Care and Destigmatization
13
BRAIN DATA SUPPORTS DIAGNOSTIC,
TREATMENT EFFECTIVENESS AND
RECOVERY TRACKING
CUSTOM TRAINING DRIVES SELF-
IMPROVEMENT AND ADJUNCTIVE
TREATMENT WHEN APPLICABLE
BACK-END SCREENING DRIVES DE-
STIGMATIZATION, PREVENTION AND
COMPLIANCE FOR THOSE AT-RISK
CONTINUOUSLY DRIVE AWARENESS WITH HEALTH MONITORING AND CAPACITY TRAINING

Benefits for Employees and Their Companies
MENTAL HEALTH
IMPROVEMENT
MENTAL HEALTH
INSIGHTS
MENTAL CONDITION
SCREENING
SELF AWARENESS
Strengths, weaknesses, conditions Emotion
Feeling
Thinking
Self Control
+15%
+15%
+9%
+11
IMPROVED PERFORMANCE1
EFFECTIVENESS MONITORING
Mental fitness programs and treatment
POPULATION ANALYTICS
Brain performance, mental condition
prevalence
PERFORMANCE ANALYSIS
By service provider, function and
geography
CONFIDENTIALLY SCREEN
7 common mental conditions
TAKE ACTION
EAP or other health service
HEALTH COST REDUCTION
55% of registered users screen and 66% are
at risk.. $6,390 in savings per year for each
successful treatment2.
MENTAL HEALTH CLAIMS
REDUCTION
38% reduction for the
25% most vulnerable population3
INCREASED PRODUCTIVITY
7.15% productivity gains on average4
SIGNIFICANT ROI
Average of over 7x ROI from productivity
gains5
Sources:
1. Improvements in brain performance correlated with average of three hours of training. 2017 internal book of business data; N = 3,275; Users who
assessed+ trained at least twice
2. $6,390 in healthcare cost according to BCBS, The Health of America, “Major Depression: The Impact on Overall Health”, May 2018
3. A group analysis in a major U.S. technology company showed that, for its 24% most vulnerable population (those employees with the poorest
sustained attention), brain training corresponded with a 38% reduction in pharmaceutical medical claims: $600 in annual savings per employee, if
we assume constant trainingor long lasting effect of 2-monthtraining.
4. Improvements in brain performance correlated with average of three hours of training. 2017 internal book of business data; N = 3,275; Users who
assessed+ trained at least twice
5. Based on 2017 internal book of business data
14

Benefits of Cognitive Training on Brain Connectivity
and Neuropsychological Measures in Adolescents
with Learning Disabilities
Gregory Rose, Ph.D.1
Audreyana Jagger, Ph.D.2
1Departments of Anatomy and Physiology, School of Medicine
2Department of Psychology
Southern Illinois University
Carbondale, IL USA

Goal and Approach of Our Work
Goal
• Explore the utility of Arrowsmith brain training for improving academic
performance in students with learning disabilities
Research Approach
• Define differences in brain function between students enrolled in the
Arrowsmith program and their typically developing counterparts using
• Functional magnetic resonance imaging (fMRI)
• Neuropsychological testing
• Determine whether there are changes in fMRI or neuropsychological measures
as a function of Arrowsmith training

What is Arrowsmith Training?
• Arrowsmith is a set of exercises developed to improve brain function in
students with complex learning disabilities.
• See www.arrowsmithschool.org for details.
• After assessment in up to 19 different functional areas, each student is
given a customized learning program.
• Students progress through sets of exercises of increasingly difficulty to
address their specific deficit areas, and must meet milestones in order
to progress.
• The goal of Arrowsmith training is to permanently improve cognitive
performance.

Using fMRI to Measure Connectivity Between Brain Regions
The Discovery of Resting State Networks
• The brain is ~2% of the body by weight, but it
uses about 20% of the body’s oxygen supply,
even at “rest”.
• Task-based MRI studies typically see signal
changes of only 1-5%.
• How to explain these seeming discrepancies?
• Biswal et al. (1995) were the first to describe
coordinated low-frequency (0.01 – 0.1 Hz)
oscillations in fMRI signals between distinct brain
regions under task-free conditions.
Raichle, Brain Connect. 2011
The Brain is Always Active:

Many Resting State Networks Identified
At least a dozen separate resting
state networks have been found
Raichle, Brain Connect., 2011
Distinct brain regions show both
correlated and anti-correlated activity
Fox et al., PNAS, 2005

Why Focus on Resting State Networks?
• Relatively easy acquire information
• MRI scanner needed, but no additional equipment
• Rapid procedure that is easily standardized
• Minimal demands on subjects
• Can assess multiple networks simultaneously
• Well suited for repeated assessments
• Predictive power
R e la tiv e R e s tin g D M N C o n n e c tiv ity
Memory(%Correct)
0 2 4 6 8
7 0
8 0
9 0
1 0 0
1 1 0
r
2
= 0 .6 0
p = 0 .0 1 4
Hampson et al., J. Neurosci., 2006 Seeley et al., J. Neurosci., 2007

Four Networks We Are Focusing On
Default Mode Dorsal Attention Salience
Fronto-Parietal
(Executive) Control
We are interested in the strength of connections within a particular network,
as well as the connections between networks.
“I’m thinking” “What’s going on?” “What’s important?” “How should I respond?”

Network Connectivity is Altered in Arrowsmith Students
Compared to Typically Developing Controls
Red lines indicate connections that are stronger, and blue lines weaker, in Arrowsmith students

Hyperconnectivity Between Networks
Seen in Arrowsmith Students
* p < 0.05
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
DMN DAN SN FPCN mean
ConnectivityValue
Within Network Connectivity
Control
Arrowsmith
0
0.02
0.04
0.06
0.08
0.1
0.12
0.14
0.16
DMN DAN SN FPCN mean
ConnectivityValue
Between Network Connectivity
Control
Arrowsmith
*
*
*
*

What are the Effects of Arrowsmith Training?
Summer Cognitive Intensive Program offers a good way to begin to explore
this question.
• All students are trained on the Symbol
Relations Task
• Training is intensive, up to five
hours/day, in 30-40 minute blocks, for six
weeks
• Task becomes progressively more
difficult
• Progress contingent upon 90%
performance accuracy at a given level

Variable Improvement in Symbol
Relations Performance
S
ta
rt
F
in
is
h
0
2
4
6
8
1 0
1 2
G ro u p M e a n s
SymbolRelationsScore
*** *
S
ta
rt
F
in
is
h
0
2
4
6
8
1 0
1 2
In d iv id u a l P e rfo rm a n c e
SymbolRelationsScore
****p <
0.0001

Symbol Relations Training
Strengthens Network Connectivity
Warmer colors indicate relatively stronger increases in connectivity between network
components. Changes are proportional to Symbol Relations improvement. Most of
the of involved sites are within and between the Default Mode and Salience
networks.

450
460
470
480
490
500
510
520
530
WScore
Star
t
* ***
Symbol Relations Training
Improves Woodcock-Johnson IV COG Performance
Overall p < 0.005; *p < 0.05 for individual tests
WJ IV ACHWJ IV COG

Connectivity Changes After One Academic Year of
Arrowsmith Training
Overall, the effect of Arrowsmith
exercises is to reduce the
hyperconnectivity between brain
regions seen before training.

450
460
470
480
490
500
510
520
530
WScore
Start
End
*
**
*
*
*
*
*
*
*
*
*
*
Improvements in WJIV Cognitive and Achievement Tests
Seen After One Academic Year of Arrowsmith Training
Overall p < 0.0001; * = p < 0.05 for individual tests
WJ IV COG WJ IV ACH

Summary
• Arrowsmith students are a heterogeneous group with academic performance deficits.
• Brain network connectivity in Arrowsmith students is altered
• In general, between-network connections are stronger (hyperconnectivity)
• Connections within the salience network tend to be weaker
• Intensive training in the Arrowsmith CIP Symbol Relations task strengthens network
connectivity
• The change is proportional to improvement over the training interval
• The salience network is particularly affected
• Academic year participation in the Arrowsmith program reduces the hyperconnectivity
observed prior to training
• Arrowsmith training improves performance in Woodcock-Johnson tests of cognition
and achievement

Future Directions
Key Questions
• Does Arrowsmith training cause lasting changes in brain function?
• What are the effects of Arrowsmith training on “real world” measures of academic
performance?
• Could Arrowsmith training be beneficial for other individuals with cognitive
impairments (e.g., traumatic brain injury, age-related impairments)?
• Could Arrowsmith training improve the academic performance of typically
developing controls?

ChooseMuse.comChooseMuse.com
How to promote brain health at
scale: EEG and Meditation
Ariel Garten
Founder, Muse
ariel@choosemuse.com
Twitter @choosemuse
Insta ariels_musings

Brain Health
@ choosemuse ChooseMuse.com

What is meditation / mindfulness
med·i·ta·tion
A practice or training that cultivates healthy and positive mind states

What is meditation / mindfulness
med·i·ta·tion
A practice or training that cultivates healthy and positive mind states
mind·ful·ness
Intentionally maintaining a non-judgemental, moment-by-moment
awareness of our thoughts, feelings, bodily sensations, and surrounding
environment.

MAYO CLINIC
Productivity: Teams that
established a mindfulness-based
meditation practice within an
organisation showed 10%
increase in work performance
from employees (6).
Stress: Hundreds of articles
demonstrate the effects of
meditation of stress.
8 weeks meditation showed a
significant decrease stress (3),
and increased ability to manage
negative thoughts (4).
Attention: 10-day mindfulness
training increased working
memory capacity during tasks,
and longer sustained attention
during tasks (5).
(1)JAMA Internal Medicine
(2)New York Academy of Sciences
(3)Contemporary Nursing
(4)JAMA Internal Medicine
(5)Cognitive Therapy and Research
(6) Neuroimage
(7) Mindfule Work
A technique validated in 1000 + journal articles

Health: Individuals that
practiced relaxation-
response techniques, such
as meditation and yoga,
showed a 43% decrease in
healthcare utilization (1).
And decreased
absenteeism at work (7)
Sleep: Older adults in 6-
week mindfulness-based
sleep program had
significant improvement
on insomnia symptoms
and fatigue severity (1).
Pain: Individuals with
chronic pain showed a 57%
decrease in pain after 8-
week mindfulness-based
pain reduction program (2).
Experienced meditators
showed a 90% decrease in
pain symptoms (2)
Aging: The brains of
regular meditators in their
50s were estimated to be
7.5 years younger than
non-meditators of the
same age, shown by a
larger volume of grey
matter in the Prefrontal
Cortex (6).
A technique validated in 1000 + journal articles
MAYO CLINIC

Barriers to Meditation Adoption

Muse for Meditation

When you're calm
you’ll hear peaceful weather sounds
When your mind wanders
the weather will intensify and gently guide
you back to a calm state.
While you are meditating, you actually
hear the sound of your own mind
Muse Meditation

See your data, track, build and improve.
Calibrate1 Relax2 Data3

Tens of thousands of lives, all over the globe.

Body: Building the
foundation of stillness

Breath: Riding breath to a
deeper practice

Heart: Learn your rhythm,
find your calm

Neuroscience of mindfulness

Meditation:
Down regulates
Amygdala

Meditation:
Thickens the Pre
Frontal Cortex
Dr Sarah Lazar

Meditation:
Increases
volume of Left
Hippocampus

Meditation:
Increases
Density of Grey
Matter

Meditation:
Impacts
Temporal
Parietal Junction

MIT Machine learning
w/EEG to classify brain states

• Can we improve quality of life
for cancer patients with Muse?
• Muse delivered 3-5 weeks pre-
surgery & used daily at home,
then approx. 2 weeks post-
surgery
• Follow up measures include
QOL psychometrics + standard-
of-care metrics
Muse Study in Process at Mayo Clinic

Baycrest Results
• Average subject
• 10 minutes of Musing per day
• 6 weeks duration

Baycrest Results
• Decrease in somatic symptoms (BSI)
• Increase in sensation of calm
• Improvement in cognitive performance
in stressful situations

Mindfulness in Sports

Meditation in the workplace
people meditating in business settings - maybe
a large image that takes up whole slide?
Meditation in the Workplace

Ariel Garten
ariel@choosemuse.com
Twitter: @ariel_garten
@choosemuse
Instagram: ariels_musings
Brain & Meditation Podcast: Untangle

Access recorded talks, Q&A, and more at:
SharpBrains.com

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