A new clinical trial shows that the right kind of brain training may actually rejuvenate the brain’s communication system. by Super Age

You lost 5 lost years of brain cognition due to your stroke and your incompetent? doctor HAS NOTHING TO FIX THAT, RIGHT? You can't do this on your own, that would be practicing medicine without a license. Don't listen to me, I'm not medically trained.

A new clinical trial shows that the right kind of brain training may actually rejuvenate the brain’s communication system.

10 Weeks Of Brain Training Reversed 10 Years Of Decline

What if you could reverse brain aging with behavior alone? A double-blind trial funded by the National Institute on Aging found that "speed training" (exercises that challenge you to identify and respond to visual information faster and faster) reversed neurotransmitter decline in older adults. The changes matched what's typically seen only with medication. It took just 10 weeks.

More at link.

Does 'Brain Training' Really Improve Cognition and Forestall Cognitive Decline?

 Ask your competent? doctor to give you EXACT BRAIN TRAINING PROTOCOLS. The keyword there is EXACT!

Does 'Brain Training' Really Improve Cognition and Forestall Cognitive Decline?

The concept that cognitive health can be preserved or improved is often expressed as "use it or lose it." Numerous modifiable risk factors are associated with "losing" cognitive abilities with age and a cognitively active lifestyle may have a protective effect.

Yuko Hara, PhD

But what is a "cognitively active lifestyle" — do crosswords and Sudoku count?

One popular approach is "brain trfaining." While not a scientific term with an established definition, it "typically refers to tasks or drills that are designed to strengthen specific aspects of one's cognitive function," Yuko Hara, PhD, director of Aging and Alzheimer's Prevention at the Alzheimer's Drug Discovery Foundation, told Medscape Medical News.

Manuel Montero-Odasso, MD, PhD, director of the Gait and Brain Lab, Parkwood Institute, London, Ontario, Canada, elaborated. "Cognitive training involves performing a definitive task or set of tasks where you increase attentional demands to improve focus and concentration and memory," he told Medscape Medical News. "You try to execute the new things that you've learned and to remember them."

Manuel Montero-Odasso, MD, PhD

In a commentary on Medscape Medical News, neuroscientist Michael Merzenich, PhD, professor emeritus at University of California San Francisco, said that growing a person's cognitive reserve and actively managing brain health can play an important role in preventing or delaying Alzheimer's disease. Important components of this include brain training and physical exercise.

Brain Training: Mechanism of Action

Montero-Odasso, who is also team leader at the Canadian Consortium on Neurodegeneration in Aging and team co-leader at the Ontario Neurodegenerative Research Initiative, explained that cognitive training creates new synapses in the brain, thus stimulating neuroplasticity.

"When we try to activate networks mainly in the frontal lobe, the prefrontal cortex, a key mechanism underlying this process is enhancement of the synaptic plasticity at excitatory synapses, which connect neurons into networks; in other words, we generate new synapses, and that's how we enhance brain health and cognitive abilities."

The more neural connections, the greater the processing speed of the brain, he continued. "Cognitive training creates an anatomical change in the brain."

Executive functions, which include attention, inhibition, planning, and multitasking, are regulated predominantly by the prefrontal cortex. Damage in this region of the brain is also implicated in dementia. Alterations in the connectivity of this area are associated with cognitive impairment, independent of other structural pathological aberrations (eg, gray matter atrophy). These patterns may precede structural pathological changes associated with cognitive impairment and dementia.

Neuroplasticity changes have been corroborated through neuroimaging, which has demonstrated that after cognitive training, there is more activation in the prefrontal cortex that correlates with new synapses, Montero-Odasso said.

Henry Mahncke, PhD, CEO of the brain training company Posit Science/BrainHQ, explained that early research was conducted on rodents and monkeys, with Merzenich as one of the leading pioneers in developing the concept of brain plasticity. Merzenich co-founded Posit Science and is currently its chief scientific officer.

Henry Mahncke, PhD

Mahncke recounted that as a graduate student, he had worked with Merzenich researching brain plasticity. When Merzenich founded Posit Science, he asked Mahncke to join the company to help develop approaches to enhance brain plasticity — building the brain-training exercises and running the clinical trials.

"It's now well understood that the brain can rewire itself at any age and in almost any condition," Mahncke said. "In kids and in younger and older adults, whether with healthy or unhealthy brains, the fundamental way the brain works is by continually rewiring and rebuilding itself, based on what we ask it to do."

If we understand the principles of brain plasticity, "we can build an adaptive brain and give it exercises to rewire in a healthy direction, improving cognitive abilities like memory, speed, and attention," Mahncke said.

Unsubstantiated Claims and Controversy

Brain training is not without controversy, Hara pointed out. "Some manufacturers of brain games have been criticized and even fined for making unsubstantiated claims," she said.

A 2016 review found that brain-training interventions do improve performance on specific trained tasks, but there is less evidence that they improve performance on closely related tasks and little evidence that training improves everyday cognitive performance. A 2018 review  reached similar conclusions, calling evidence regarding prevention or delay of cognitive decline or dementia through brain games "insufficient," although cognitive training could "improve cognition in the domain trained."

"The general consensus is that for most brain-training programs, people may get better at specific tasks through practice, but these improvements don't necessarily translate into improvement in other tasks that require other cognitive domains or prevention of dementia or age-related cognitive decline," Hara said.

Hara noted that most brain-training programs "have not been rigorously tested in clinical trials" — although some, such as those featured in the ACTIVE trial, did show evidence of effectiveness.

Mahncke agreed. "Asking whether brain training works is like asking whether small molecules improve health," he said noting that some brain-training programs are nonsense and not evidence-based. He believes that his company's product, BrainHQ, and some others are "backed by robust evidence in their ability to stave off, slow, or even reverse cognitive changes."

BrainHQ is a web-based brain game suite that can be used independently as an app or in group settings (classes and Webinars) and is covered by some Medicare Advantage insurance plans. It encompasses "dozens of individual brain-training exercises, linked by a common thread. Each one is intensively designed to make the brain faster and more accurate," said Mahncke.

He explained that human brains "get noisy as people get older, like a radio which is wearing out, so there's static in the background. This makes the music hard to hear, and in the case of the human brain, it makes it difficult to pay attention." The exercises are "designed to tamp down the 'noise,' speed up the brain, and make information processing more accurate."

Screenshot from a BrainHQ game used in the ACTIVE study. One of two possible targets flashes in the center of gaze (car), while a third target appears on the periphery (Rte66). With correct answers, the exercise speeds up, distractors appear on the periphery, periphery widens, and contrast lowers between targets and background.

Mahncke called this a "bottom-up" approach, in contrast to many previous cognitive-training approaches that come from the brain injury rehabilitation field. They teach "top-down" skills and strategies designed to compensate for deficits in specific domains, such as reading, concentration, or fine motor skills.

By contrast, the approach of BrainHQ is "to improve the overall processing system of the brain with speed, attention, working memory, and executive function, which will in turn impact all skills and activities."

Supporting Evidence

Mahncke cited several supporting studies. For example, the IMPACT study randomized 487 adults (aged ≥ 65 years) to receive either a brain plasticity–based computerized cognitive training program (BrainHQ) or a novelty- and intensity-matched general cognitive stimulation treatment program (intervention and control group, respectively) for an 8-week period.

Those who underwent brain training showed significantly greater improvement in the repeatable Battery for the Assessment of Neuropsychological Status (RBANS Auditory Memory/Attention) than those in the control group (3.9 vs 1.8, respectively; P =.02). The intervention group also showed significant improvements on multiple secondary measures of attention and memory. The magnitude of the effect sizes suggests that the results are clinically significant, according to the authors.

The ACTIVE study tested the effects of different cognitive training programs on cognitive function and time to dementia. The researchers randomized 2802 healthy older adults (mean age, 74 years) to a control group with no cognitive training or one of three brain-training groups comprising:

1. In-person training on verbal memory skills
2. In-person training on reasoning and problem-solving
3. Computer-based speed-of-processing training on visual attention

Participants in the training groups completed 10 sessions, each lasting 60-75 minutes, over a 5- to 6-week period. A random subsample of each training group was selected to receive "booster" sessions, with four-session booster training delivered at 11 and 35 months. All study participants completed follow-up tests of cognition and function after 1, 2, 3, 5, and 10 years.

At the end of 10 years, those assigned to the speed-of-processing training, now part of BrainHQ, had a 29% lower risk for dementia than those in the control group who received no training. No reduction was found in the memory or reasoning training groups. Participants who completed the "booster" sessions had an even greater reduction: Each additional booster session was associated with a 10% lower risk for dementia.

Montero-Odasso was involved in the SYNERGIC study that randomized 175 participants with mild cognitive impairment (MCI; average age, 73 years) to one of five study arms:

1. Multidomain intervention with exercise, cognitive training, and vitamin D
2. Exercise, cognitive training, and placebo
3. Exercise, sham cognitive training, and vitamin D
4. Exercise, sham cognitive training, and placebo
5. Control group with balance-toning exercise, sham cognitive training, and placebo

"Sham" cognitive training consisted of alternating between two tasks (touristic search and video watching) performed on a tablet, with the same time exposure as the intervention training.

The researchers found that after 6 months of interventions, all active arms with aerobic-resistance exercise showed improvement in the ADAS-Cog-13, an established outcome to evaluate dementia treatments, when compared with the control group — regardless of the addition of cognitive training or vitamin D.

Compared with exercise alone (arms 3 and 4), those who did exercise plus cognitive training (arms 1 and 2) showed greater improvements in their ADAS-Cog-13l score, with a mean difference of −1.45 points (P = .02). The greatest improvement was seen in those who underwent the multidomain intervention in arm 1.

The authors noted that the mean 2.64-point improvement seen in the ADAS-Cog-13 for the multidomain intervention is actually larger than changes seen in previous pharmaceutical trials among individuals with MCI or mild dementia and "approaches" the three points considered clinically meaningful.

"We found that older adults with MCI who received aerobic-resistance exercise with sequential computerized cognitive training significantly improved cognition," Montero-Odasso said. "The cognitive training we used was called Neuropeak, a multidomain lifestyle training delivered through a web-based platform developed by our co-leader Louis Bherer at Université de Montréal."

He explained that the purpose "is to challenge your brain to the point where you need to make an effort to remember things, pay attention, and later to execute tasks. The evidence from clinical trials, including ours, shows this type of brain challenge is effective in slowing and even reversing cognitive decline."

A follow-up study SYNERGIC 2.0 is ongoing.

Puzzles, Board Games, and New Challenges

Formal brain-training programs aren't the only way to improve brain plasticity, Hara said. Observational studies suggested an association between improved cognitive performance and/or lower dementia risk and engaging in number and word puzzles, such as crosswords, cards, or board games.

Some studies suggested that older adults who use technology might also protect their cognitive reserve. Hara cited a US longitudinal study of more than 1800 older adults suggesting that regular internet users had roughly half the risk for dementia compared to nonregular internet users. Estimates of daily internet use suggested a U-shaped relationship with dementia with 0.1-2.0 hours daily (excluding time spent watching television or movies online) associated with the lowest risk. Similar associations between internet use and a lower risk for cognitive decline have been reported in the United Kingdom and Europe.

"Engaging in mentally stimulating activities can increase 'cognitive reserve' — meaning, capacity of the brain to resist the effects of age-related changes or disease-related pathology, such that one can maintain cognitive function for longer," Hara said. "Cognitively stimulating activities, regardless of the type, may help delay the onset of cognitive decline."

She listed several examples of activities that are stimulating to the brain, including learning a new game or puzzle, a new language, a new dance, and learning how to play a musical instrument.

Montero-Odasso emphasized that the "newness" is key to increasing and preserving cognitive reserve. "Just surfing the internet, playing word or board games or doing crossword puzzles won't be enough if you've been doing these things all your life," he said. "It won't hurt, of course, but it won't necessarily increase your cognitive abilities."

"For example, a person who regularly engages in public speaking may not improve cognition by taking a public-speaking course, but someone who has never spoken before an audience might show cognitive improvements as a result of learning a new skill," he said. "Or someone who knows several languages already might gain from learning a brand-new language."

He cited research supporting the benefits of dancing, which he called "an ideal activity because it's physical, so it provides the exercise that's been associated with improved cognition. But it also requires learning new steps and moves, which builds the synapses in the brain. And the socialization of dance classes adds another component that can improve cognition."

Mahncke hopes that beyond engaging in day-to-day new activities, seniors will participate in computerized brain training. "There's no reason that evidence-based training can't be offered in senior and community centers, as yoga and swimming are," he said. "It doesn't have to be simply something people do on their own virtually."

Zoom classes and Medicare reimbursements are "good steps in the right direction, but it's time to expand this potentially life-transformative intervention so that it reaches the ever-expanding population of seniors in the United States and beyond."

Hara reported having no disclosures. Montero-Odasso reported having no commercial or financial interest related to this topic. He serves as the president of the Canadian Geriatrics Société and is team leader in the Canadian Consortium of Neurodegeneration in Aging. Mahncke is CEO of the brain training company Posit Science/BrainHQ.

Batya Swift Yasgur, MA, LSW, is a freelance writer with a counseling practice in Teaneck, New Jersey. She is a regular contributor to numerous medical publications, including Medscape Medical News and WebMD, and is the author of several consumer-oriented health books as well as Behind the Burqa: Our Lives in Afghanistan and How We Escaped to Freedom (the memoir of two brave Afghan sisters who told her their story).

Study: First Effective Scalable Intervention for Common Post-Stroke Deficits

But useless since no protocol was written and distributed worldwide.

Study: First Effective Scalable Intervention for Common Post-Stroke Deficits

SAN FRANCISCO, May 08, 2019 (GLOBE NEWSWIRE) -- In a first of its kind study, computerized brain training was found to improve hemi-spatial neglect, which is a common and often intractable problem after stroke or other acquired brain injury. The brain training studied was from Posit Science, maker of BrainHQ online brain exercises and assessments, and was presented today at the annual meeting of the American Academy of Neurology.
About a third of patients with a brain injury exhibit a complex and debilitating array of neurological deficits known as the “neglect syndrome” (sometimes called, “hemi-spatial neglect” or “neglect”). The most apparent symptom of neglect is the inability of patients to efficiently process information on the side of space opposite the injury. For example, a patient may be unable to navigate, detect food on half their plate, or even safely cross the street. Patients often suffer higher rates of disability and respond poorly to conventional forms of rehabilitation, compared to patients without neglect.
To date, there’s been no widely-applicable intervention for addressing neglect.
In a new study, conducted at Washington University, Spalding Rehabilitation Hospital, and the Boston Veterans Administration Medical Center, researchers (from Harvard, Washington University, and Posit Science) found a relatively small number of hours of computerized brain training (self-administered by the patients in their homes) can drive significant neurological and functional improvements.
While rehabilitation efforts have previously tended to focus on simple interventions (e.g. repeatedly reminding patients to look toward the neglected side), this brain training takes a unique approach by focusing on underlying post-injury deficits in both general alertness and momentary heightened attention. The training makes increasing demands on both general and momentary alertness by having the patient respond to non-matching stimuli and withhold response to an infrequently-presented target stimulus. This is referred to in the literature as Tonic and Phasic Alertness Training (TAPAT), and, notably, does not target spatial attention.
This was a multi-site, double-blind, randomized controlled trial, in which 49 patients were randomized into either (1) an intervention group asked to complete 12 hours of TAPAT training, or (2) an active control group asked to complete an equal number of hours training on computerized causal games.
The researchers found a significant improvement in the primary outcome, a validated measure of spatial bias (Posner cueing task), and in the secondary composite measure of functional ability, as compared to the active control.
“Patients with neglect exhibited a significant reduction in spatial bias, as well as improvements in functional outcomes following a simple, at-home exercise,” summarized Dr. Tom Van Vleet, who presented the data.
“This is a breakthrough result in an area where there aren’t many treatment options,” observed Dr. Henry Mahncke, CEO of Posit Science. “This demonstration that plasticity-based training can personalize to the patient and can be administered at home is important for access and affordability. We expect to work with clinicians, payors, and regulators to make this widely available, as quickly as possible.”
For more information, contact media@brainhq.com

5 Ways To Train Your Brain For Success

Ok, pop psychology but better than anything you are getting from your doctor.
http://www.careergirldaily.com/5-ways-train-brain-success/

1.Learn something new every day

2.Don’t get comfortable

3. Meditate more

4. Exercise both sides of your brain

5. Improve your lifestyle

Mental Training Enhances Cognitive Function and BDNF More Than Either Physical or Combined Training in Elderly Women With MCI: A Small-Scale Study

You'll have to ask your doctor what in this newest research worked when earlier research showed no benefits. Do not take, 'I don't know' for an answer. Screaming may be required or call the president and ask why your doctor won't perform doctor responsibilities. Namely keeping current in their field.

Exercise, pills, brain training show little hard evidence of slowing dementia

 The latest here:

Mental Training Enhances Cognitive Function and BDNF More Than Either Physical or Combined Training in Elderly Women With MCI: A Small-Scale Study

Arsalan Damirchi, PhD, Fatemeh Hosseini, MSc, Parvin Babaei, PhD

First Published September 25, 2017 Research Article

Download PDF	Article information

Abstract

Introduction:

The effects of mental, physical, and combination of these two trainings were investigated on cognitive performance, serum level of brain derived neurotrophic factor (BDNF), and irisin in women diagnosed with mild cognitive impairment (MCI).

Material and Methods:

Forty-four participants were randomized into 4 groups: physical training (PH; 8 weeks’ aerobic training, n = 11), mental training (ME; special computer gaming, n = 11), combined (PH + ME; n = 13), and control group (CO; n = 9).

Results:

Analysis of variance with Tukey post hoc test revealed a significant increase in working memory (P = .012) and BDNF (P = 0.024) in the ME compared with the CO group. Also the ME group in comparison with the PH group demonstrated better working memory (P = .014) and processing speed (P = .024).

Conclusion:

Positive effect of mental training on the cognitive parameters, parallel with BDNF elevation, suggests that mental training is a more useful, safe, and persistent strategy to attenuate the progression of MCI probably via BDNF elevation, but the effect size is relatively small elevation

Exercise, pills, brain training show little hard evidence of slowing dementia

Maybe my ideas here?
Dementia prevention 19 ways
Don't follow me, I'm not medically trained.   

Exercise, pills, brain training show little hard evidence of slowing dementia

Reuters Health News

An extensive review of research on exercise, nutritional supplements, drugs, and brain-training techniques concludes there is no definitive evidence that any of them protect against Alzheimer's disease or other types of dementia.
"To put it simply, all evidence indicates that there is no magic bullet," said Dr. Eric B. Larson, executive director of the Kaiser Permanente Washington Health Research Institute in Seattle, in an editorial online December 18 in the Annals of Internal Medicine, where the analyses appear.
The results are important because as the population gets older, the number of people with dementia increases. However, in some regions, such as the United States, Canada and the United Kingdom, the odds of developing dementia seem to be declining. The reasons are not clear.
The analysis of studies looking at the effects of nutritional supplements found that those like ginkgo biloba, folic acid, multivitamins, vitamin D, vitamin E, and beta carotene "did not reduce the risk for cognitive decline."
A second analysis reviewing tests of diabetes medications, hormones, lipid-lowering medicines, dementia medicines, and anti-inflammatory drugs found that they "neither improved nor slowed decline in cognitive test performance" while sometimes posing a risk of side effects.
A third analysis concluded that tests of brain-training programs, sometimes marketed to normal people or people with mild cognitive impairment, revealed the training might help improve specific skills, but produced no real broad improvement in brain functioning.
"If you exercise one of those functions, that function will improve but other areas may not change all," said Dr. Paul Schulz, a dementia neurologist at the University of Texas Health Science Center in Houston. "So if you exercise attention, that may not improve your ability to find the grocery store."
The same lack of evidence was seen when assessing the ability of physical activity to slow the development of dementia in adults who have not been diagnosed with cognitive impairment. The studies included evaluations of things, such as aerobic training, resistance training, and tai chi.
When it comes to the idea that exercise might delay brain deterioration, "we're not very good at actually studying physical activity," Dr. Rhonda Au, a professor of anatomy and neurobiology, neurology and epidemiology at the Boston University School of Medicine told Reuters Health by phone.
"I think it's a little bit unrealistic to think that in a short period of time for something as complex as Alzheimer's disease or dementia that we're going to see real effects," said Au, who was not involved in the reviews. "The overall take-home message is we're not doing a very good job of studying it in a very systematic way."
With nutritional supplements, evidence is limited because "very few have been thoroughly studied," said Schulz, who also was not involved in the reviews. There's also concern that "we don't know if they interfere with the medications that we do give people that we know helps them."
In a phone interview, he cited the case of a patient who was taking 20 supplements for memory "and he was really confused. We just stopped all 20 and he got a lot better. If you put 20 things in a blender, you don't know what's going to come out the other side."
Schulz and others said there is a strong sense among researchers that they are closing in on treatments that will be effective at stalling dementia.
Dean Hartley, director of science initiatives for the Alzheimer's Association, noted that other groups that have looked at the evidence have offered more upbeat conclusions than the current studies.
For example, a review published in July in The Lancet estimated that among all the causes of dementia, about one-third of them might be modified by a person's lifestyle. That group calculated that getting a good education cuts the risk by 8%. In midlife, preventing or correcting hearing loss reduces the risk by 9%, treating high blood pressure cuts it by 2%, and not being obese lowers it by 1%. Late in life, the risk goes up 5% among smokers, 4% for people with depression, 3% for folks who are physically inactive, 2% for those experiencing social isolation, and 1% if they have diabetes.
"I'm optimistic about this," Hartley told Reuters Health in a telephone interview. The authors of the new analyses "didn't come to the point to say this specifically would change the course of cognitive decline or dementia. But solid evidence is starting to mount to suggest that lifestyle can have an impact."
"When people ask me how to prevent dementia, they often want a simple answer, such as vitamins, dietary supplements, or the latest hyped idea," Larson writes in the editorial.
They can take many commonsense actions that promote health throughout life and may help to avoid or delay (Alzheimer's and other dementias), namely regular physical activity; control of vascular risk factors, including preventing or effectively managing diabetes; not smoking; and maintaining a healthy diet and weight, he writes.
"Engaging in cognitively stimulating activities and avoiding social isolation also are probably beneficial," Larson continues. So is correcting vision and hearing loss in the elderly, along with avoiding long-term use of certain drugs.
"There are things people can do now that will do no harm," Hartley said. "Most of these things will benefit your general health."
—Gene Emery

Report challenges claims of cognitive benefits of online brain-training games

 So what is your doctor suggesting for cognitive challenges to keep your brain sharp? ANYTHING AT ALL?
Maybe this?

The Next 9 Foods You Should Eat To Enhance Cognition

or this?

Scientists show cognitive enhancing drugs can improve chess play

or these 14 posts on brain training?

 

 
http://www.cbsnews.com/news/report-brain-training-games-cognitive-benefits-claims/
NEW YORK -- Can you keep your mind sharp -- as you age -- by playing so-called brain games?
A report Tuesday by AARP focused on what has become a $1.3 billion business.
Ads for online brain-training games tout their cognitive benefits saying they improve memory, brain speed and attention. But the report called the evidence behind these claims of cognitive benefits "weak to nonexistent."

• Can you improve brain health? Scientists weigh in

Sarah Lock, executive director of the AARP's Global Council on Brain Health, shed light on the report.

Sarah Lock, executive director of the AARP's Global Council on Brain Health

CBS News

"They might get better at the game but what we don't know is how that's going to affect your everyday functioning," Lock told CBS News. "So you might get better at the game but it's not going to help you manage your finances any better."
Training to improve one type of cognitive ability -- like memory -- doesn't end up improving other skills such as how fast you process information.
And the report says there's often exaggerating when these products are marketed.
Last year, the FTC fined the makers of Luminosity $2 million for claiming its games could help users reduce or delay age-related cognitive impairment.
The good news is that cognitively stimulating activities are easy to find, such as learning a new skill. At the Greenwich House Senior Center, Betty Tiago is taking up art.
"I think anything creative helps to stimulate your brain," Tiago said.

Betty Tiago

CBS News

Other ideas to help improve cognitive benefits are activities that are novel and require focus and have a level of depth and engagement.
Some recommendations from the AARP include:

• Educational opportunities (formal or informal including volunteering)
• Learn new skill (music or language)
• Leisure activities (playing cards, playing with children)
• Mentally and physically stimulating activities (tennis and dancing)

Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

You'll want your doctor to get the protocols for this.Well maybe not, maybe this is all placebo.

Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training

van de Ven RM¹, Buitenweg JI¹, Schmand B^1,2, Veltman DJ³, Aaronson JA⁴, Nijboer TC^5,6, Kruiper-Doesborgh SJ⁷, van Bennekom CA⁴, Rasquin SM⁸, Ridderinkhof KR^1,9, Murre JM¹.

Author information

Abstract

BACKGROUND:

Brain training is currently widely used in an attempt to improve cognitive functioning. Computer-based training can be performed at home and could therefore be an effective add-on to available rehabilitation programs aimed at improving cognitive functioning. Several studies have reported cognitive improvements after computer training, but most lacked proper active and passive control conditions.

OBJECTIVE:

Our aim was to investigate whether computer-based cognitive flexibility training improves executive functioning after stroke. We also conducted within-group analyses similar to those used in previous studies, to assess inferences about transfer effects when comparisons to proper control groups are missing.

METHODS:

We conducted a randomized controlled, double blind trial. Adults (30-80 years old) who had suffered a stroke within the last 5 years were assigned to either an intervention group (n = 38), active control group (i.e., mock training; n = 35), or waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within a 12-week period. Cognitive functioning was assessed using several paper-and-pencil and computerized neuropsychological tasks before the training, immediately after training, and 4 weeks after training completion.

RESULTS AND CONCLUSIONS:

Both training groups improved on training tasks, and all groups improved on several transfer tasks (three executive functioning tasks, attention, reasoning, and psychomotor speed). Improvements remained 4 weeks after training completion. However, the amount of improvement in executive and general cognitive functioning in the intervention group was similar to that of both control groups (active control and waiting list). Therefore, this improvement was likely due to training-unspecific effects. Our results stress the importance to include both active and passive control conditions in the study design and analyses. Results from studies without proper control conditions should be interpreted with care.

PMID:

28257436

DOI:

10.1371/journal.pone.0172993

[PubMed - in process]

Free full text

A Consensus on the Brain Training Industry from the Scientific Community

But I wonder if they are looking at this wrong. Novel and new tasks build brain reserve so insults like stroke and dementia are not as severe.  2 years old so I wonder if consensus has changed.

A Consensus on the Brain Training Industry from the Scientific Community

October 20, 2014
As the baby boomers enter their golden years with mounting concerns about the potential loss of cognitive abilities, markets are responding with products promising to allay anxieties about potential decline. Computer-based cognitive-training software –popularly known as brain games– claim a growing share of the marketplace. The promotion of these products reassures and entices a worried public.
Consumers are told that playing brain games will make them smarter, more alert, and able to learn faster and better. In other words, the promise is that if you adhere to a prescribed regimen of cognitive exercise, you will reduce cognitive slowing and forgetfulness, and will fundamentally improve your mind and brain.
It is customary for advertising to highlight the benefits and overstate potential advantages of their products. In the brain-game market, advertisements also reassure consumers that claims and promises are based on solid scientific evidence, as the games are “designed by neuroscientists” at top universities and research centers. Some companies present lists of credentialed scientific consultants and keep registries of scientific studies pertinent to cognitive training. Often, however, the cited research is only tangentially related to the scientific claims of the company, and to the games they sell. In addition, even published peer-reviewed studies merit critical evaluation. A prudent approach calls for integrating findings over a body of research rather than relying on single studies that often include only a small number of participants.
The Stanford Center on Longevity and the Berlin Max Planck Institute for Human Development gathered many of the world’s leading cognitive psychologists and neuroscientists –people who have dedicated their careers to studying the aging mind and brain– to share their views about brain games and offer a consensus report to the public. What do expert scientists think about these claims and promises? Do they have specific recommendations for effective ways to boost cognition in healthy, older adults? Are there merits to the claimed benefits of the brain games and if so, do older adults benefit from brain-game learning in the same ways younger people do? How large are the gains associated with computer-based cognitive exercises? Are the gains restricted to specific skills or does general cognitive aptitude improve? How does playing games compare with other proposed means of mitigating age-related declines, such as physical activity and exercise, meditation, or social engagement?
The search for effective means of mitigating or postponing age-related cognitive declines has taught most of us to recognize the enormous complexity of the subject matter. Like many challenging scientific topics, this is a devil of many details. The consensus of the group is that claims promoting brain games are frequently exaggerated and at times misleading. Cognitive training produces statistically significant improvement in practiced skills that sometimes extends to improvement on other cognitive tasks administered in the lab. In some studies, such gains endure, while other reports document dissipation over time. In commercial promotion, these small, narrow, and fleeting advances are often billed as general and lasting improvements of mind and brain. The aggressive advertising entices consumers to spend money on products and to take up new behaviors, such as gaming, based on these exaggerated claims. As frequently happens, initial findings, based on small samples, generate understandable excitement by suggesting that some brain games may enhance specific aspects of behavior and even alter related brain structures and functions. However, as the findings accumulate, compelling evidence of general and enduring positive effects on the way people’s minds and brains age has remained elusive.
These conclusions do not mean that the brain does not remain malleable, even in old age. Any mentally effortful new experience, such as learning a language, acquiring a motor skill, navigating in a new environment, and, yes, playing commercially available computer games, will produce changes in those neural systems that support acquisition of the new skill. For example, there may be an increase in the number of synapses, the number of neurons and supporting cells, or a strengthening of the connections among them. This type of brain plasticity is possible throughout the life span, though younger brains seem to have an advantage over the older ones. It would be appropriate to conclude from such work that the potential to learn new skills remains intact throughout the life span. However at this point it is not appropriate to conclude that training-induced changes go significantly beyond the learned skills, that they affect broad abilities with real-world relevance, or that they generally promote “brain health”.
As we take a closer look at the evidence on brain games, one issue needs to be kept in mind: It is not sufficient to test the hypothesis of training-induced benefits against the assumption that training brings no performance increases at all. Rather, we need to establish that observed benefits are not easily and more parsimoniously explained by factors that are long known to benefit performance, such as the acquisition of new strategies or changes in motivation. It is well established, for example, that improvements on a particular memory task often result from subtle changes in strategy thatreflect improvement in managing the demands of that particular task. Such improvement is rewarding for players (the fun factor) but does not imply a general improvement in memory. In fact, the notion that performance on a single task cannot stand in for an entire ability is a cornerstone of scientific psychology. Claims about brain games often ignore this tenet. In psychology, it is good scientific practice to combine information provided by many tasks to generate an overall index representing a given ability. According to the American Psychological Association, newly developed psychological tests must meet specific psychometric standards, including reliability and validity. The same standards should be extended into the brain game industry, but this is not the state of affairs today.
To date, there is little evidence that playing brain games improves underlying broad cognitive abilities, or that it enables one to better navigate a complex realm of everyday life. Some intriguing isolated reports do inspire additional research, however. For instance, some studies suggest that both non-computerized reasoning and computerized speed-of-processing training are associated with improved driving in older adults and a reduction in the number of accidents. Another study revealed, for a sample of younger adults, that 100 days of practicing 12 different computerized cognitive tasks resulted in small general improvements in the cognitive abilities of reasoning and episodic memory, some of which were maintained over a period of two years. In other studies, older adults have reported that they felt better about everyday functioning after cognitive training, but no objective measures supported that impression. Additional systematic research is needed to replicate, clarify, consolidate, and expand such results. To be fully credible, an empirical test of the usefulness of brain games needs to address the following questions. Does the improvement encompass a broad array of tasks that constitute a particular ability, or does it just reflect the acquisition of specific skills? Do the gains persist for a reasonable amount of time? Are the positive changes noticed in real life indices of cognitive health? What role do motivation and expectations play in bringing about improvements in cognition when they are observed?
In a balanced evaluation of brain games, we also need to keep in mind opportunity costs. Time spent playing the games is time not spent reading, socializing, gardening, exercising, or engaging in many other activities that may benefit cognitive and physical health of older adults. Given that the effects of playing the games tend to be task-specific, it may be advisable to train an activity that by itself comes with benefits for everyday life. Another drawback of publicizing computer games as a fix to deteriorating cognitive performance is that it diverts attention and resources from prevention efforts. The promise of a magic bullet detracts from the message that cognitive vigor in old age, to the extent that it can be influenced by the lives we live, reflects the long-term effects of a healthy and active lifestyle.
We also must keep in mind that studies reporting positive effects of brain games on cognition are more likely to be published than studies with null results –the so-called “file drawer effect”– such that even the available evidence is likely to draw an overly positive picture of the true state of affairs. Statistical methods such meta-analysis, which integrates the results of many studies in a given field of inquiry, allow estimation of effect magnitude as well as the likelihood of the file-drawer effect. While some meta-analyses report small positive effects of training on cognition, others note substantial disparities in methodological rigor among the studies that cast doubt on any firm conclusion. Further, the problems that haunt individual studies do not simply disappear when results from such studies are summarized in a meta-analysis. In particular, the practice of assessing specific tests rather than broader assays of ability is just as problematic on the level of meta-analytic integration as it is on the level of individual studies.
In summary, research on aging has shown that the human mind is malleable throughout life span. In developed countries around the world, later-born cohorts live longer and reach old age with higher levels of cognitive functioning than those who were born in earlier times. When researchers follow people across their adult lives, they find that those who live cognitively active, socially connected lives and maintain healthy lifestyles are less likely to suffer debilitating illness and early cognitive decline in their golden years than their sedentary, cognitively and socially disengaged counterparts. The goal of research on the effectiveness of computer-based cognitive exercise is to provide experimental evidence to support or qualify these observations. Some of the initial results are promising and make further research highly desirable. However, at present, these findings do not provide a sound basis for the claims made by commercial companies selling brain games. Many scientists cringe at exuberant advertisements claiming improvements in the speed and efficiency of cognitive processing and dramatic gains in “intelligence”, in particular when these appear in otherwise trusted news sources. In the judgment of the signatories below, exaggerated and misleading claims exploit the anxiety of adults facing old age for commercial purposes. Perhaps the most pernicious claim, devoid of any scientifically credible evidence, is that brain games prevent or reverse Alzheimer’s disease.
In closing, we offer five recommendations. Some of these recommendations reflect experimental findings in human populations, whereas others are based on a synthesis of correlational evidence in humans and mechanistic knowledge about risks and protective factors.

• Much more research needs to be done before we understand whether and what types of challenges and engagements benefit cognitive functioning in everyday life. In the absence of clear evidence, the recommendation of the group, based largely on correlational findings, is that individuals lead physically active, intellectually challenging, and socially engaged lives, in ways that work for them. Before investing time and money on brain games, consider what economists call opportunity costs: If an hour spent doing solo software drills is an hour not spent hiking, learning Italian, making a new recipe, or playing with your grandchildren, it may not be worth it. But if it replaces time spent in a sedentary state, like watching television, the choice may make more sense for you.

• Physical exercise is a moderately effective way to improve general health, including brain fitness. Scientists have found that regular aerobic exercise increases blood flow to the brain, and helps to support formation of new neural and vascular connections. Physical exercise has been shown to improve attention, reasoning, and components of memory. All said, one can expect small but noticeable gains in cognitive performance, or attenuation of loss, from taking up aerobic exercise training.

• A single study, conducted by researchers with financial interests in the product, or one quote from a scientist advocating the product, is not enough to assume that a game has been rigorously examined. Findings need to be replicated at multiple sites, based on studies conducted by independent researchers who are funded by independent sources. Moreover, participants of training programs should show evidence of significant advantage over a comparison group that does not receive the treatment but is otherwise treated exactly the same as the trained group.

• No studies have demonstrated that playing brain games cures or prevents Alzheimer’s disease or other forms of dementia.

• Do not expect that cognitively challenging activities will work like one-shot treatments or vaccines; there is little evidence that you can do something once (or even for a concentrated period) and be inoculated against the effects of aging in an enduring way. In all likelihood, gains won’t last long after you stop the challenge.

In summary: We object to the claim that brain games offer consumers a scientifically grounded avenue to reduce or reverse cognitive decline when there is no compelling scientific evidence to date that they do. The promise of a magic bullet detracts from the best evidence to date, which is that cognitive health in old age reflects the long-term effects of healthy, engaged lifestyles. In the judgment of the signatories, exaggerated and misleading claims exploit the anxiety of older adults about impending cognitive decline. We encourage continued careful research and validation in this field.

The Allure (and Folly) of Brain Training

What protocol is your doctor having you do to prevent your cognitive decline post-stroke? ANYTHING AT ALL?
http://undark.org/2016/06/15/brain-games-time-and-money-wasted/ 

Neuroscience says these five rituals will help your brain stay in peak condition

I bet your doctor does not know about these and won't tell you about them. That would have required reading and applying research.  But you can't do these on your own, that's dangerous.
http://qz.com/626482/neuroscience-says-these-five-rituals-will-help-your-brain-stay-young/

Congratulate yourself for small wins

Keep your body active

Stretch your brain muscles

Sit upright

Sleep with your phone away from your head

New $3m European-Israeli collaboration to build brain training system and enhance football (soccer) players' game intelligence

I guess sports brain training is more important than recovering from brain injuries. Stroke associations and stroke medical professionals should create a brain training system for stroke recovery.
http://sharpbrains.com/blog/2015/09/10/new-3m-european-israeli-collaboration-to-build-brain-training-system-and-enhance-football-soccer-players-game-intelligence/

Solving the Brain Fitness Puzzle Is the Key to Self-Empowered Aging

Of course some research says that brain train­ing does not work to be followed by the ones that disagree. Which way does your doctor fall? Sounds like you are going to have to do this on your own. Be careful out there, this could be dangerous.
http://sharpbrains.com/solving-the-brain-fitness-puzzle-is-the-key-to-self-empowered-aging/
As the con­cept of brain fit­ness (or, the brain’s abil­ity to func­tion effi­ciently and effec­tively in per­sonal and pro­fes­sional life) goes main­stream, the pro­lif­er­a­tion of sci­en­tific find­ings, media reports, and com­mer­cial claims is gen­er­at­ing much noise and con­fu­sion. Know­ing what to believe and what to do presents a real-life puz­zle, lead­ing many peo­ple to either inac­tion or toward a focus on the wrong priorities.

Click to view and down­load arti­cle as a PDF document.

This past Octo­ber, sixty-nine sci­en­tists, con­vened by the Stan­ford Cen­ter on Longevity, released an announce­ment stat­ing that there is a sci­en­tific con­sen­sus that brain train­ing does not work (Allaire et al., 2014). By Decem­ber, 127 sci­en­tists world­wide had signed another state­ment, chal­leng­ing the pre­vi­ous “con­sen­sus” and sup­port­ing the value of brain train­ing (Alescio-Lautier et al., 2014).
The prob­lem here is not see­ing the for­est for the trees. Eighty-three per­cent of more than 3,000 early adopters sur­veyed by the inde­pen­dent mar­ket research firm Sharp­Brains (which I co-founded) agreed that “adults of all ages should take charge of their own brain fit­ness, with­out wait­ing for their doc­tors to tell them to” (Fer­nan­dez et al., 2013). When we con­ducted in-depth focus groups and inter­views with respon­dents, the main ques­tion many had was not what has per­fect sci­ence behind, but what has bet­ter sci­ence than the other things peo­ple are doing—solving cross­word puz­zle num­ber one mil­lion and one, tak­ing ‘brain sup­ple­ments,’ or doing noth­ing at all until depres­sion or demen­tia hits home.
And the unequiv­o­cal answer to that ques­tion, based upon the most author­i­ta­tive sys­tem­atic reviews of the evi­dence con­ducted to date (The Gov­ern­ment Office for Sci­ence, 2008; AHRQ, 2010), is a resound­ing yes—one thing does work bet­ter than most com­mon alter­na­tives. The chal­lenge is that “thing” is dif­fer­ent for everyone.

More at link.

A Consensus on the Brain Training Industry from the Scientific Community

Well, well, I can't see any real downside of trying to challenge your brain to prevent cognitive decline even if the brain training industry overhypes the results. Because there seems to be no scientific consensus on how to prevent cognitive decline, that just means once again YOU will need to research and come up with your own solutions. Just like you had to do for stroke rehab. It's a wonder that neurologists can even look any patient in the eye and tell them, 'We have nothing proven to help you'.
YOU ARE ON YOUR OWN; DEAL WITH IT.
http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community-2/

A Consensus on the Brain Training Industry from the Scientific Community

So if brain training games do not work, what exactly is your doctor prescribing to prevent your cognitive decline post-stroke?
http://longevity3.stanford.edu/blog/2014/10/15/the-consensus-on-the-brain-training-industry-from-the-scientific-community-2/
One line from there:
However at this point it is not appropriate to conclude that training-induced changes go significantly beyond the learned skills, that they affect broad abilities with real-world relevance, or that they generally promote “brain health”.

10 best apps to train your brain

And post-stroke your cognitive abilities have probably taken a massive hit. You should expect your doctor to have protocols to address any cognitive decline. But they won't, so you will need to self-prescribe your own cognitive training even though such self-prescribing is extremely dangerous and likely to result in your death.  You are going to die anyway so what the hell.
http://www.cnn.com/2014/09/09/health/brain-training-apps/index.html

Brain training helped older adults stay sharp for years: study

This seems to go against all the previous studies that brain training only helped you in the tasks that were trained upon. But what the hell do I know. Ask your doctor what you need to do to prevent your 33% chance of getting dementia/Alzheimers post stroke.
http://news.yahoo.com/brain-training-helped-older-adults-stay-sharp-years-051755376--finance.html

Older adults who underwent a brief course of brain exercises saw improvements in reasoning skills and processing speed that could be detected as long as 10 years after the course ended, according to results from the largest study ever on cognitive training.

The findings, published on Monday in the Journal of the American Geriatrics Society, offer welcome news in the search for ways to keep the mind sharp as 76 million baby boomers in the United States advance into old age.

The federally sponsored trial of almost 3,000 older adults, called the Advanced Cognitive Training for Independent and Vital Elderly study, or ACTIVE, looked at how three brain training programs - focusing on processing speed, memory and reasoning ability - affected cognitively normal adults as they aged.

Brain Jump with Ned the Neuron Review

You'll have to ask your doctor if these brain training games are useful or not.
http://www.theiphonemom.com/Detailed_App_Review-detail/brain-jump-with-ned-the-neuron-review/

‘Brain training’ may boost working memory, but not intelligence

But the real question is, 'Does it delay or prevent the onset of dementia/Alzheimers?
http://www.psypost.org/2013/10/brain-training-may-boost-working-memory-but-not-intelligence-20669

No Evidence of Intelligence Improvement After Working Memory Training: A Randomized, Placebo-Controlled Study

Another nail in the coffin of brain training.
http://www.ncbi.nlm.nih.gov/pubmed/22708717

Abstract

Numerous recent studies seem to provide evidence for the general intellectual benefits of working memory training. In reviews of the training literature, Shipstead, Redick, and Engle (2010, 2012) argued that the field should treat recent results with a critical eye. Many published working memory training studies suffer from design limitations (no-contact control groups, single measures of cognitive constructs), mixed results (transfer of training gains to some tasks but not others, inconsistent transfer to the same tasks across studies), and lack of theoretical grounding (identifying the mechanisms responsible for observed transfer). The current study compared young adults who received 20 sessions of practice on an adaptive dual n-back program (working memory training group) or an adaptive visual search program (active placebo-control group) with a no-contact control group that received no practice. In addition, all subjects completed pretest, midtest, and posttest sessions comprising multiple measures of fluid intelligence, multitasking, working memory capacity, crystallized intelligence, and perceptual speed. Despite improvements on both the dual n-back and visual search tasks with practice, and despite a high level of statistical power, there was no positive transfer to any of the cognitive ability tests. We discuss these results in the context of previous working memory training research and address issues for future working memory training studies