Does Brain Training Work? More food for thought.

It was like a scene reminiscent of a Dickensian novel.

Except Oliver Twist wasn’t asking for more. He was saying, “This doesn’t work!”

I had been given a heads up at the beginning of last week that a paper was about to be published on the effectiveness of brain training and that it was likely to engender significant media coverage.

They were not wrong. It certainly grabbed a lot of attention.

One friend came up to me and said “Jenny have you read the report that says brain training doesn’t work!”. “Yes” I said, “.......but have you read the feedback looking at the concerns about the methodology used and the generalisation of the conclusions reached?” “Well, no I haven't,” she said "But it was done using a very large number of people in the study and the researchers are from Cambridge, so it must be very valid.”

Another friend simply expressed her relief at the headline she had heard. “Thank goodness” she said, “Now I don’t have to worry about which game or training program I need to look at, because now it's been shown they don’t make a difference”.

Oh no!

Now, while I am delighted that the topic of brain training is out at the forefront of people’s minds and that it has engendered a good deal of healthy debate, I have been dismayed at how one sweeping statement can colour people’s overall acceptance of what is the “truth”.

My concern is that for the vast majority of people, the only message they have heard is “Brain Training doesn’t work” Period. Without any exploration of what this study did or did not really demonstrate.

My first friend concluded that because the study is published in a respectable journal, because it involved a large number of study subjects (the largest of it’s kind to date) and it’s authors are academics from a well respected academic institution, that the findings therefore must be correct and to be taken note of. My question to her, which she dismissed, was despite all that, is it not still possible to have produced a flawed study with an incorrect or overgeneralised conclusion?

Lets look at what all the fuss has been about.

The study was conducted by Jessica Grahn and Adrian Owen and others from the Cognition and Brain Sciences Unit in Cambridge UK, in conjunction with the BBC’s “Bang Goes The Theory” TV program.

11,430 participants were involved in the 6 week online study. All were healthy adults aged between 18 and 60 years of age.

They were divided into three groups.

The first group undertook basic reasoning, planning and problem solving activities. The second group undertook more complex activities more similar to computer brain training programs for exercise on memory, attention, maths and visual-spatial learning. The third group were asked to use the Internet to research answers to trivia questions.

All the participants had base line cognitive testing done before and after the study, using tests that are commonly used in looking at brain function in older adults who have sustained a brain injury or dementia.

The study’s finding reported that all three groups showed the same amount of minimal improvement which the authors put down to "practice making perfect" and then went on to say that that therefore brain training (while helping you by practice to improve a certain mental skill) does not translate into in to better overall improved cognitive functioning in every day life.

Looking a little closer at this study, the participants spent a grand total of 24 training sessions of 10 minutes each over the six week period. 240 minutes is not very long to look at how effective a training program is. I very much doubt that if I spent 3 to 4 hours over six weeks learning Japanese, I would have not learnt more than a few rudimentary words or sentences. Learning a new skill or undertaking training takes a lot of time, consistency, practice and effort. Is their program actually a good example of brain training?

Other neuroscientists who have their own cognitive training programs have stated that in their programs participants are required to be spending a minimum of 30 minutes per brain training session and for a minimum of 15 hours in total to see any cognitive benefit.

The paper was also criticised in having poor quality control as all the subjects merely logged on to the study training program from their own homes with no regulation about what else was going on around them during the time of their “training”. The gold standard for all studies involves adequate control of all variables.

Plus the cognitive tests they used on their healthy subjects, are usually used on people over the age of 60 with significant cognitive impairment. Would one expect any significant improvement then in healthy individuals with such minimal training?

So what can we take from this paper ?

With the huge amount of money being spent in the development and sales of brain training programs: $265 in sales in one year expecting to increase exponentially, we do need better assessments of the different brain training programs out there. We need a better idea of how effective they are and whether the results marries up with the promise. Are you paying for effective cognitive training or for simply a bit of fun and entertainment.

The Cambridge study used their own brain training program, which had a number of limitations and was clearly shown to be ineffective. But that finding on it’s own does not necessarily mean all the other programs are ineffective as well.

It is misleading for the results to be extrapolated to say that because their program was ineffective therefore all brain training programs are ineffective. There is a vast array of published research in the literature that reveal some very effective positive results from certain training programs. What about all the existing training programs that are used to assist people who are recovering from stroke for example? Is there anyone who would dispute their value in assisting people in recovery from their brain injury?

Just because one brand of whitening toothpaste doesn’t do a very good job doesn’t mean that all the other brands of whitening toothpaste don’t work as well.

My own sceptical mind also wonders about having a TV program involved with this study. Is there perhaps a little vested interest in getting people interested in watching the TV show? A bit like the newspapers who know that bad news sells. Will having a controversial headline produce the same effect?

What the paper maybe does highlight, is that there are no short cuts to maintaining your brain or trying to improve one’s mental cognition. And yes, I would certainly agree with that. I also think we need to incorporate an array of initiatives to maintain or attempt to improve mental fitness. Brain training programs are only one facet.

There is plenty of evidence supporting the notion that managing other lifestyle factors including physical exercise, eating well, managing stress and getting enough sleep, will all help in our quest to stay mentally fit and optimise our brain health.

What I suggest now is for you to grab a cup of coffee and settle down for a bit of a read for yourself. Here is the article from Nature magazine. Let me know what you think. I do enjoy a bit of a debate.

Owen, A. M. et al. Nature advance online publication doi:10.1038/nature09042 (20 April 2010).