1. A Call to Action: Improving brain & mental health
via digital platforms and neuroplasticity research

2. Sponsors
Welcome!

3. 215 Participants in 17 Countries

5. Source: The SharpBrains Guide to Brain Fitness: How to Optimize Brain Health
and Performance at Any Age

6. 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

7. 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

8. October 28, 2014
SharpBrains Summit
Improving Brain Health:
A Call to Action
Thomas R. Insel, MD
Director, NIMH
Public Filer
Nothing to Disclose

9. Brain health and Brain training – In the News
Emily Underwood Oct 22, 2014

10. Frame of Reference

11. 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.

12. 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

13. The Human Connectome Project
Functional
Connectivity
Structural
Connectivity
Molecular Imaging
Multimodal
Integration
New Molecular Imaging
Temporal
Connectivity
Wash U
U Minn
MGH

14. “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

15. 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.

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. 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

18. Defining mental illnesses as circuit disorders
OCD
PTSD
Depression
Insel. Sci Am, 2010

19. 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

20. 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

21. Treating mental illnesses as circuit disorders
Sci Transl Med 2012 Nat Rev Drug Dev, 2013

22. 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

23. 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

24. 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

25. Transforming the Culture
Academia
Standardization
Integration
Data/Reagent/Tissue Sharing
Industry
Foundations
Government

26. 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.

27. “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

28. Thank you !
Paving the Way for Prevention, Recovery, and Cure
www.nimh.nih.gov
Research = Hope

29. 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

30. 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

31. Challenge
Develop effective approaches to enhance
cognition in both healthy and impaired
individuals

32. Current Approach
60 year old with mild cognitive impairment
• Poor characterization
• Poor targeting
• Non-personalized
• Unimodal
• Open Loop
This is just not good enough

33. Create a New Approach
closed-loop
targeted
personalized
multimodal

34. Video Games

35. 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

36. 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”

37. Bridging the Gap Between Technology and Neuroscience
Neuroscapelab.com

39. New Technology
Mobile / Wireless

40. New Technology
Virtual Reality Motion Capture

41. Enhance the Effects
Neuromodulation Neurofeedback
Video Games

42. Glass Brain

43. Thanks for your attention

44. 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

45. 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

46. 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)

47. Enhancing learning and facilitating transfer is possible
In young adults, action-packed fast paced games appear
to have an edge

48. Better vision

49. ACTION
SOCIAL
Medal of Honor
UT
Call of Duty
Tetris
the Sims
Restaurant Empire

50. Before
After

51. Green & Bavelier, 2007, Psych. Science
Li, Polat, Makous & Bavelier, 2009, Nat. Neuro
Li, Polat, Scalzo & Bavelier, 2009, J. of Vision

52. Better Mental Rotation

53. 1 2 3 4
Feng, Pratt, Spence, 2007, Psych Science

54. Action-Games: FPS
Pretesting Post-testing
Training
10 hours
of in labs training
Feng, Pratt, Spence, 2007,
Psych Science

55. 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)

56. Not all games are created equal
Action games in young adults and children have that effect
Social Games, Tetris not so much

57. 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

58. Action video game play results in
enhanced attentional control
Test of Variables of Attention (T.O.V.A.®)

59. http://www.tovatest.com/
- Target Frequent
- Target Infrequent
Dye, Green and Bavelier (2009) Current Directions in Psych. Science

60. 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.

61. 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

62. 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

64. 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

65.  To learn more, visit SharpBrains.com