April 17, 2014

Computer "Brain Training" .... Should You?

When I decided to research the question – Does computer brain (or cognitive) training work? – I had no idea that the answers would so various, or so complicated.

If one headline I found summed up the issue, it’s this one from an article in the cerebral magazine Scientific American: “Study Shows Brain Power Can Be Bolstered—Maybe.”

It’s no wonder we get a “maybe.” To begin with, what IS brain power? There are so many different elements: reaction time, visual and auditory recognition, attention, processing speed, executive function, and the biggie: memory. Reviewers even chop memory into subgroups, like episodic and working memory.

Even if you zero in on a specific cognitive activity of interest, you have to ask: “Who was tested?” Healthy children? Kids with ADHD? Healthy teens? Healthy adults? Adults with cognitive impairment? Study subjects who were motivated? Subjects who really wanted to improve?

It’s just like high school: The smart kids who studied, paid attention in class, and did their homework got excellent grades on their tests. The slackers barely got by. So, if you tried to evaluate the success of a teacher’s training abilities, you’d hear as many answers as there are students in class, and you've have the data to prove it.

Why should computer brain training be any different?

Can Positive Results "Generalize"? Will They Last?

For the moment, let’s assume all the test subjects were truly motivated. If the results showed that training improved performance in one particular area – like processing speed – will that improvement transfer to other areas, too, like verbal memory or visual recognition? Will success with certain computer tests and exercises really help us to do anything other than take those tests and do those exercises?

And there’s another big question: If training does show positive results, will they last?

Naturally, companies that offer computer brain training tout their successes, and cite studies that seem to validate their promises. Erica Perng, head of communications for Lumosity – which claims to have 50 million members in 182 countries -- put it this way: "Lumosity is based on the science of neuroplasticity, the idea that the brain can change and reorganise itself given the right kinds of challenges.”

Then, if you’re wondering whether her company’s services are meant for you, Perng makes this pitch: “People have a variety of reasons for wanting to boost their brain power, whether it's to focus at work, do better at school and standardised tests, or just to stay sharp.”

Who doesn’t fall into one of those categories?

But when we bring science into the discussion – as much as that is possible in this complex arena – the picture becomes much grayer, more nuanced, as we might expect.

Amidst the Noise, Some Common Refrains
Still, in spite of all the different opinions and study findings, some themes emerge. The respected journal Nature published an article -- "Putting brain power to the test" -- that evaluated a six-week online program. Over 11,000 subjects -- invited by the BBC to participate -- received training several times each week on cognitive tasks designed to improve reasoning, memory, planning, visuospatial skills and attention. The conclusions here are similar to others I found:
‘Brain training’, or the goal of improved cognitive function through the regular use of computerized tests, is a multimillion-pound industry, yet in our view scientific evidence to support its efficacy is lacking. Modest effects have been reported in some studies of older individuals and preschool children, and video-game players outperform non-players on some tests of visual attention. However, the widely held belief that commercially available computerized brain-training programs improve general cognitive function in the wider population in our opinion lacks empirical support.

The central question is not whether performance on cognitive tests can be improved by training, but rather, whether those benefits transfer to other untrained tasks or lead to any general improvement in the level of cognitive functioning…. Although improvements were observed in every one of the cognitive tasks that were trained, no evidence was found for transfer effects to untrained tasks, even when those tasks were cognitively closely related.
That issue – generalizability – was raised over and over in reviews. Will learning to perform better in one cognitive area actually help in other areas, or even generally? The typical answer is: There’s no real evidence.

23 Studies of Healthy Kids and Adults
In 2013, researchers reviewed 23 different studies of working memory training programs on healthy children and adults. The report -- which NIH's PubMed site titled "Is working memory training effective? A meta-analytic review" -- concluded that the training programs
... produced reliable short-term improvements in working memory skills…. More importantly, there was no convincing evidence of the generalization of working memory training to other skills…. The authors conclude that memory training programs appear to produce short-term, specific training effects that do not generalize…. (The) current findings cast doubt on both the clinical relevance of working memory training programs and their utility as methods of enhancing cognitive functioning in typically developing children and healthy adults.
The Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study trained 2,832 healthy seniors in one of three cognitive functions: memory, reasoning, and processing speed. The subjects were then periodically tested in their original training functions, up to ten years after the training ended. Study leader Dr. George Rebok of Johns Hopkins University wrote a summary not unlike the one for the meta-analysis above:
Each training intervention produced large and significant improvements [but only] in the trained cognitive ability. These improvements dissipated slowly but persisted to at least 5 years for memory training and to 10 years for reasoning and speed-of-processing training.
Yet Another Meta-Analysis
In 2012, Alexandra Kueider of Johns Hopkins University, with her colleagues, completed a comprehensive meta-analysis -- "Computerized Cognitive Training with Older Adults: A Systematic Review" -- that was reported in the journal PLOS ONE. The researchers reviewed 151 studies (of which 38 met their criteria) published between 1984 and 2011 on the efficacy of computer-based cognitive training for healthy adults 55 and older.

The abstract alone goes on for 30 pages, and the details are mind-numbing. But the conclusions could be summarized in a now-familiar way:
  • Training showed some positive effects, but typically in the trained area only.
  • Claims for generalizability were very uncommon.
The Verdict
So, should we or shouldn’t we? My research unearthed these suggestions:
  • Brain training won’t make you smarter, but it works – to some degree. Remember the “maybe” in that headline at the top of this post. Expect the greatest benefit – if you experience it -- in the cognitive area you’re pursuing, like processing speed. 
  • If you’re not familiar with working at a computer, you could find the programs frustrating. Still, this online training is certainly convenient for housebound seniors, and it’s been shown to be as effective as paper-and-pencil training.
  • Unless you’re already spending too much time staring at a computer screen, there’s no harm in giving online brain training a try. It’s surely better for you than sitting on the couch watching television.
  • Find programs that are fun. Pursue training that targets different cognitive functions, since the “transfering” effect from one function to another is regularly dismissed.
  • Keep in mind the “training effect” – you get better at tasks you perform repeatedly. If you do crossword or Sudoku puzzles, or if you play bridge, you get better at those games with practice. They’re good exercise for the brain, but they do not make you smarter.
  • Don’t expect cognitive miracles, and don’t expect any apparent “progress” to help you function better generally, or to last. Keep expectations in check.
  • Don’t believe the marketing hype, and don’t shell out lots of money based on promises that – so far -- aren’t supported by the evidence.
  • “Brain training” isn't fancy neuroscience. It's more like basic, old-fashioned “learning.” 
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There’s a mountain of information out there on “brain training” and “cognitive training.” If you’d like more information, just plug those words into your Google search box. Be prepared for pages of data and complex – often contradictory -- conclusions.


1 comment:

Dreamtouc Hrenovations said...

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