Brilliant Blog

Education, Aging...two seemingly unrelated topics, but with more biology in common than may meet the eye...

You may enjoy the most recent editions of two great blog carnivals: 

- Carnival of Education, hosted by Joanne Jacobs.

- Hourglass: a carnival of biogerontology, hosted by Chris at Ouroboros. Chris recently launched this blog carnival to provide a home for "bloggers who are writing about biogerontology, lifespan extension technologies, and aging in general."

Anne writes my favorite post at Existence is Wonderful, linking education/ learning/ nurture with aging.

She first explains that

"Many people use the word "aging" as a shorthand not just for the mere process of getting older (which is not only inevitable for everything in existence, but something to celebrate --- "getting older", after all, means "experiencing more life"!), but for the physical degeneration that occurs as metabolic, immune, and mechanical side effects take hold as a person ages. Personally I find this dual use of the word "aging" terribly confusing".

And then adds

"We don’t necessarily know what hard limits are on longevity until we optimize care. I saw a dramatic turnaround in my fish when I learned how to properly configure the tank setup, and I hope to see the day when human medicine makes a similar leap in effectiveness"

A dreaded diagnosis, that dimmed and dooming dilemma. Feared, sometimes fought, too often forgotten. It is the grayest, ghastliest elephant in the room: dementia.

What is dementia? I, like many others who dedicate their professional efforts to its study and treatment, have no good answer. I believe we are lost in our lexicon, trying to define a brain state so vexing and elusive it drives us out of our minds.

I hope we can do better, and I am not alone. In a sensitive and forward-looking editorial entitled Dementia: A Word to be Forgotten, Drs. Trachtenberg and Trojanowski of the University of Pennsylvania argue that alternate terms are more appropriate for research, clinical, and everyday settings. From scientific and biological perspectives, dementia is unspecific and subjective. Within the walls of the physician’s office, delivering the diagnosis of dementia can erect unintended walls around patients and families; vulnerable individuals, assuming that the "cruel connotations in the lay language" actually apply to them, are unnecessarily isolated. The authors recount a patient and caregiver experience upon first hearing the term applied:

An immediate epiphany occurred, and suddenly the potential danger and threatening sentence of the word became manifest. It was frightening that somebody might say it to her while she was still able to fully grasp and sense its toxic effect and that it would hasten and seal her fate in the manner of a self-fulfilling prophesy. (Archives of Neurology 2008;65(5):594)

Words to Live by

Idiot, midget, lunatic, and many other pejorative terms have thankfully been excised from clinical and polite discussion. The resulting advantage goes beyond conformity to standards of socially-acceptable discourse. It enables the productive consideration of limitations which should not be dismissed or ignored. In the case of cognitive and behavioral disorders of aging, many resist confronting their concerns, preferring self-conscious group chuckles surrounding "senior moments." What's more, practicing physicians have few incentives or resources to probe for late-life neuropsychiatric conditions. While nihilism prevailed for some time, attitudinal change has taken hold. Proactive people are arriving at specialty evaluation centers with mild cognitive symptoms, well before one would ever consider dropping the D-bomb. Consequently, we need to employ alternative concepts to signify the presence of potentially serious brain dysfunction.

Witness Brain Fitness

SharpBrains readers young and old already know that Brain Fitness is an achievable goal. Increasing public awareness and diverse tools and venues for pursuing successful brain aging now exist. Useful starting points for discussion are emerging, many reflecting the concept of positive cognition. But what do you call that ghastly gray elephant?

Brain Failure describes the loss of Brain Fitness, and fittingly refers to the state of mental degeneration and dependence experienced by millions. Of the many more aging individuals who are threatened to endure such a fate, the reasonable approach is to confront the possibility of Brain Failure by pursuing Brain Fitness. Nihilists and slackers are of course welcome to slip down the blissful slope toward Brain Disaster. Those who perceive signs of Brain Failure should seek help in identifying the biological and environmental determinants of their symptoms. Cognitive and behavioral disorders are common in aging, and are now routinely detected and treated at earlier stages than ever before. When medical and neurodegenerative diagnoses are communicated, there is no benefit in evoking stigma or sounding the death knoll. Regardless, if I had to choose an obsolete and hurtful label, I'd rather be senile than demented. Everyone familiar with Brain Failure understands it can be unremitting and cruel; we must also recognize that is remediable. Brain Fitness is still the goal, even in the throes of Brain Failure.

-- Dr. Joshua Steinerman wrote this article for SharpBrains. Dr. Steinerman is Assistant Professor of Neurology at New York’s Albert Einstein College of Medicine, where he directs the Neurodegenerative Disease Clinical Trials Program.  He is the founding scientist of ProGevity Neuroscience.

Good article in the Washington Post today: 

Is It Really Smart to Teach Old Brains New Tricks?

The reporter presents a good overview of what is happening, but framed around a highly artificial choice for consumers: either you a) do physical exercise, or b) take part in social interactions, or c) engage in mental exercise.

What about switching off those TVs and having time for all a, b, c, and more? Research does not support a "general solution" to cognitive health but a multi-pronged one, featuring a good nutrition, stress management, and both physical and mental exercise. Each individual presents different contexts and priorities: for example, while research has shown how doing zero weekly aerobic exercise can translate into lower cognitive functioning, it does not support that, should you already engage in 2 or 3 weekly 30-minute sessions of cardio exercise, including walks, sports, gym...doing more physical exercise would be the absolute, only, priority for cognitive health.

In 2007, Americans paid over $14 billion in health club membership fees alone (IHRSA, 2007). The $225 million we estimate for brain fitness software represents the birth of a small but promising field. The benefits of well-directed mental exercise (in the form of software, or meditation, of cognitive therapy) are becoming increasingly well-documented, but they have to be better understood: nothing can be said to help prevent Alzheimer's Disease, but a growing number of tools will be able to help maintain important cognitive functions, from speed of processing to working memory and beyond. 

Consumers will need help to navigate this growing field and make informed decisions. They will need to understand how our brains work, what cognitive skills are and why they matter, how different lifestyle factors play a role in our lifelong cognitive performance, and how to analyze the value and the limitations of a growing array of options.

I had the fortune to interview neuroscientist Yaakov Stern -one of the leading Cognitive Reserve researchers- last year to try to translate recent research findings into practical implications. One of my questions was, "OK, so our goal is to build that Reserve of neurons, synapses, and skills. How can we do that? What defines "mentally stimulating activities" or good "brain exercise"?"

Dr. Yaakov Stern: "In summary, we could say that "stimulation" consists of engaging in activities. In our research almost all activities are seen to contribute to reserve. Some have challenging levels of cognitive complexity, and some have interpersonal or physical demands. In animal studies, exposure to an enriched environment or increased physical activity result in increased neurogenesis (the creation of new neurons). You can get that stimulation through education and/ or your occupation. There is clear research showing how those two elements reduce the risk. Now, what is very exciting is that, no matter one's age, education and occupation, our level of participation in leisure activities has a significant and cumulative effect. A key message here is that different activities have independent, synergistic, contributions, which means the more things you do and the earlier you start, the better. But you are never stuck: better late than never."

The more, the better. Switch off that TV, make time for friends, and physical and mental exercise.

Many baby boomers, intuitively perhaps, seem to be doing precisely that.

Related in-depth interviews with researchers:

- Build Your Cognitive Reserve-Yaakov Stern

- Art Kramer on Why We Need Walking Book Clubs

- Can Intelligence Be Trained? Martin Buschkuehl shows how

- Improving Driving Skills and Brain Functioning- Interview with ACTIVE's Jerri Edwards

Dr. Pascale Michelon recently shared with our readers which brain areas and cognitive functions are engaged as we solve the type of brain teaser known as Spot the Difference, where we have to find the differences between two versions of one image:

"1) You have to identify the objects that you see: this involves your occipital lobes (in red).

2) You have to analyzed the spatial relationships between the objects that you see: this involves your occipital and parietal lobes (in green).

3) You have to remember what you see in one picture and compare it to what you see in the other picture, that is you have to use your short-term memory: this involves your frontal (in blue) and parietal lobes.

4) You have to mark down the locations where you see a difference: this involves mostly your frontal lobes (for the movement)".

Ready! Set! Go!: how many differences can you spot, and which ones?

Source of image: Wikipedia

In the post Top 10 Brain Training Future Trends I asked for suggestions to refine our predictions for the 2007-2015 period. A good number of people contributed, and the winner is...

Scott Spears, retired public schools superintendent.

His prediction: 

"Prediction 11: The notion of schooling will be structurally dramatically altered through the use of diagnostics related to the acquisition and improvement of basic cognitive skills (such as brain processing speed, attention, memory, and sequencing), along with prescriptions employing emerging brain fitness software exercises, beginning in the earliest grades and progressing through high school.

Schools will be structured around the acquisition of foundational cognitive skills, related physical fitness to support brain fitness, student awareness and knowledge of brain function and responsibility for one's own fitness. Schools will be much more organically structured along the learning needs of individuals, will be a community repository and asset for access to continuing brain and physical fitness programming, and will continue to provide important content knowledge acquisition experiences delivered through integrated experiential learning, custom-designed for the individual learner, and varying by time and place as needed.

Group learning gaps will close as the playing field levels in the acquisition of the basic cognitive skills required for high levels of success and learning. "Special education" as such will first disappear in the middle and later grades as students receive early intervention for cognitive skill development and as the plethora of currently diagnosed mental disorders are better understood as brain function issues that can either be prevented or remediated through neuroscience-based interventions, and will finally entirely disappear as a function of the design of individual learning plans for every student.

The nature of schooling is thus liberated from the current model of emphasis on content acquisition to become more focused on the teacher-student interface of interest-directed learning undergirded by the skills necessary for high-order thinking and learning."

When I contacted Scott to inquire about the main obstacles for this prediction to come true, he responded:

"The obstacles are many because this is such a disruptive, new technology that is difficult to explain to so many in education who have no "frame" beyond what they believe about teaching and learning from their undergraduate preparation."

Scott: many thanks for your thoughtful comment. We will mail you a hardcopy of our Market Report titled The State of the Brain Fitness Software Market 2008. Looking forward to more of your contributions! 

Posts related to this prediction:

- Learning & The Brain: Interview with Robert Sylwester

- Brain Connection: Eric Jensen on Learning and the Brain

- Are Schools (Cognitively) Nutritive for Children's Complex Thinking?

Welcome to the 30th edition of Medicine 2.0, the blog carnival devoted to articles that analyze the current and potential impact of web 2.0 technologies on medicine and healthcare.

"Medicine 2.0" 101

The first question is, of course, "What exactly is Medicine 2.0?". The second, "Who cares?". The third, "Why?" 

Anthropologists are here to help. Who better to help understand emerging artifacts of the health and medical tribe, as evidenced by the fantastic lecture An Anthropological Introduction To Youtube given to the Library of Congress by Professor Michael Wesch. As Open Thinking suggests, the video which is 55 minutes long provides an "excellent backgrounder on social media, user-generated content, and online communities through the lens of anthropology."

If you are more the PowerPoint type, you can access the great slide presentation and list of websites provided by eHealth: see Web 2.0 in Clinical Research.

The Future of Medicine and Health 2.0

Admittedly, the Medicine 2.0 field is still small and emerging. But, how will it grow? What new healthcare outcomes will it enable and support? What may be the trade-offs to consider, if any?

The Healthcare Blog offers a Description To Action: The Future of Health 2.0 Tools. "What makes these efforts particularly interesting is that, through a collaborative Web-based process, they attempt to distill and document the current best knowledge about any topic. In health care, the goal is easily accessible state-of-the-science information, the equivalent of ongoing medical/scientific review articles that detail what we know and don’t know about life and care processes."

For example, have you ever thought why, if scientific knowledge is constantly evolving, museums of science and medicine do not update their content more often? Biomedicine on Display outlines visions for The participatory museum — what’s a medical museum 2.0 like?, including a superb questions, "How can our exhibitions be ‘perpetual beta’ rather than finished?"

Now, participating in defining and updating exhibitions, vs. simply acting as passive spectators, will translate into a neuronal impact on museum visitors' brains, strengthening some cognitive skills and weakening others. We can expect The Atlantic Monthly to publish an article in, say, 5 years, asking Is Medicine 2.0 Making Us Stupid? In support of this prediction, you may enjoy our SharpBrains post on Can Google Kill Neurons and Rewire Your Whole Brain? 

Tools and more Tools

Medicine 2.0 is predicated on the emergence of tools that enable interaction and communication in ways that simply were not possible a few years ago. 

Digital Pathology Blog asks Will the iPhone Change Medicine Forever? presenting this scenario: "For example, the iPhone shows a graphic of a slice of the human brain. It allows the med student to see 10 push pins on different parts of the brain, click on each one, and attempt to correctly name each feature. If the answer is wrong, the correct answer is displayed so the med student can learn from that mistake. A medical school student using this software on his iPhone approached one of the doctors involved in its development and said “I learned 10 new anatomical terms today while waiting for the bus.”  

Managing and processing information will become as critical as breathing air. Efficient MD suggests ways to store, categorize and retrieve information from a variety of online and printed sources with How Doctors Can Use Evernote, while Tomography Blog lists specific search engines for Diagnostic Imaging.

There's more. Allan's Library points out tools for Making Academic Web Sites Better, and David Rothman introduces us to SemanticMEDLINE, a new tool from Cognition Technologies.

How do all these tools change the day-to-day practices of clinicians and researchers? Dr. Mouse, a Peruvian surgeon, explains (in Spanish) Como Uso Web 2.0 en Mi Practica Medica - how web 2.0 is already enhancing his research and clinical practice. 

Challenges, A Few

"Don’t forget, patients and your future employers will find what you publish about yourself and your life on the web. So use it wisely…" Wise words of advice in Web vs real life: Advice for medical students from Bertalan at ScienceRoll.

Clinical Cases and Images provides the context, covering a recent negative study, published in the Journal of General Internal Medicine, that questioned potential patient privacy issues and conflicts of interest. See Content of Weblogs Written by Health Professionals: More Bad than Good? 

Science in the Open reports from BioBarCamp - Meeting friends old and new and virtual, how, while "many people expressed an interest in ‘Open Science’, ‘Open Data’, or some other open stuff," it was clear that "many people meant many different things by this". Establishing commonly-accepted definitions, standards and policies will be a must.

Also a must will be upgrading to existing technologies. This is a not-so-easy task. Crossover Health explaisn in Dude! The $100M VistA Open Source Opportunity: "What the heck - $11B project without any of this stuff in place, no clear plan, no direction, no people to do the work, and constant changes."

Finally, in case you wonder whether Twitter is mature enough for wide professional adoption, Laika's MedLibLog thinks perhaps not yet: Twitter Traumas: Twitter’s Janus Face.

Final Details

And that's all for this edition. Michelle vs the Med Student will host next one on August 24th. You can submit your articles through the official form.

In the meantime, you can participate in the Medicine 2.0 Microcarnival Launch!, the latest experiment launched by Bertalan on Friendfeed.

Enjoy the week!
 

Back in July, I wrote a post entitled 10 Brain Tips To Teach and Learn. Those tips apply to students of any age, including adults, for ideally adults are still learners. Why is adult learning relevant in a brain-focused blog, you may wonder:

The short of it…

As we age, our brain:

• still forms new brain cells
• can change its structure & function
• finds positive stress can be beneficial; negative stress can be detrimental
• can thrive on novel challenges
• needs to be exercised, just like our bodies

The long of it…

Adults may have a tendency to get set in their ways – I’ve been doing it this way for a long time and it works, so why change? Turns out, though, that change can be a way to keep aging brains healthy. At the April Learning & the Brain conference, the theme of which was neuroplasticity, I attended several sessions on adult learning. Here’s what the experts are saying.

CHANGE and EXERCISE

According to Kathleen Taylor & Annalee Lamoreaux, understanding that we have the ability to change our mental models, also known as epistemological change (a change in the way of knowing), will let us open the door to transformative learning (being willing to change and having an understanding of how to change). You can download the slides from their presentation here.

Learning something new outside our areas of expertise:

• keeps us fresh, which can add a spark to our teaching
• reminds us what it is like to be a student, which can help us empathize with our students
• exercises our mental muscles 

Couple mental exercise with physical exercise, and you can improve general cognition and boost your creativity. Learn more about this from John Ratey’s book Spark: The Revolutionary New Science of Exercise and the Brain, which makes a compelling case that exercise is beneficial for cognitive health. 

NEUROGENESIS

Our brains may be aging, but they are also continuing to develop. Neurogenesis is the process of forming new brain cells, and unlike what was previously thought, this process continues throughout life, as noted in this Society for Neuroscience brain Adult Neurogenesis.

PLASTICITY

Neuroplasticity refers to the brain’s ability to rewire itself. It empowers us to:

• fix damaged areas of our brains (as evidenced by the work of Edward Taub, Michael Merzenich, and Paul Bach-y-Rita, all mentioned in Doidge’s book, referenced below)
• continue to learn well into old age
• alter our behavior and performance over time

Norman Doidge writes extensively about plasticity in The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science, and notes that “brain plasticity occurs in response to the environment, the task at hand, and our thoughts and imaginings.” Indeed, “in some cases, the faster you can imagine something, the faster you can do it.”

STRESS and EXERCISE

In his session on stress and neuroplasticity in learning, Bruce McEwen concurred with Doidge, noting that “structural plasticity in the adult brain is modulated by experience”. He went on to discuss the impact of stressful experiences on neuronal activity, delineating three types of stress:

1. positive, which consists of positive challenges

2. tolerable, which consists of adverse life events coupled with good social and emotional support

3. toxic, which consists of a sustained stress agent and a lack of social and emotional support Exercise, in addition to aiding cognition, can be beneficial in helping the brain and the body manage stress.

CHALLENGE and NOVELTY

Elkhonon Goldberg, neuroscientist and co-founder of SharpBrains, discussing Brain Plasticity and Cognitive Fitness, pointed out that “as we age, our expert knowledge remains strong, and our capacity for solving problems within our areas of expertise can often exceed that of those who are younger.” He further employed us to “turn neuroplasticity to your advantage” by:

• welcoming novel challenges

• beware of being on mental autopilot

• remain cognitively active

Goldberg elaborates on these points in his latest book, The Wisdom Paradox: How Your Mind Can Grow Stronger As Your Brain Grows Older.

Taken in sum, all of these ideas have me imagining professional development programs where teachers are encouraged to explore avenues outside of their expert areas. (More on that in a future post!) The combination of being a mentally and physically active lifelong learner isn’t just good modeling for younger brains; it’s also beneficial for us!

(Next post will consist of additional resources on these topics.)

Laurie Bartels writes the Neurons Firing blog to create for herself the "the graduate course I’d love to take if it existed as a program". She is the K-8 Computer Coordinator and Technology Training Coordinator at Rye Country Day School in Rye, New York. She is also the organizer of Digital Wave annual summer professional development, and a frequent attendee of Learning & The Brain conferences

The August issue of Venture Capital Journal brings a very good piece on the emerging brain fitness software  (also called "neurosoftware") category: 

-- Mind Games (subscription required)

-- Dakim, Lumos Labs, Posit Science and other “brain fitness” startups are starting to gain mind share — and capital — from venture firms.

The reporter and I spoke as Lumos Labs received its $3m round, and we discussed other fundable start-ups, featuring CogniFit. Which, as mentioned over the weekend, just raised $5m.

If case you are a new SharpBrains reader, perhaps visiting us after reading this VCJ article, let me provide a quick overview of the category and our Market Report (which is annual, not quarterly as the article states):

A) Report Highlights

We estimate the size of the US brain fitness software market at $225M in 2007, up from $100m in 2005 (50% CAGR), analyzing the size and trends of four customer segments: consumers, healthcare & insurance providers, K12 school systems, and fortune 1000 companies, military, and sports teams. Two segments fueled the market growth from 2005 to 2007: consumers (grew from $5m to $80m, 300% CAGR) and healthcare & insurance providers (grew from $36m to $65m, 35% CAGR).

Ten Specific Highlights from The State of the Brain Fitness Software Market 2008 report include:

1) 2007 was a seminal year for the US Brain Fitness software market, which reached $225 million in revenues – up from an estimated $100 million in 2005.

2) Over 20 companies are offering tools to assess and train cognitive skills to four customer segments: consumers; healthcare and insurance providers; K12 school systems; and Fortune 1000 companies, the military, and sports teams.

3) The Nintendo Brain Age phenomenon has driven much of the growth. The consumer segment grew from a few million in 2005 to an estimated $80 million in 2007.

4) There is major confusion in the market, so education will be key. Users and buyers need help to navigate the maze of products and claims.

5) Over 400 residential facilities for older adults have launched computerized “brain fitness centers.” Sales to the healthcare and insurance provider segment grew from $35 million in 2005 to an estimated $65 million in 2007.

6) More than five programs have shown results in randomized controlled trials. Cognitive functions that can be trained include: visual and auditory processing, working memory, attention, and decision-making.

7) A product has obtained 510(k) FDA clearance for rehabilitation of stroke and Traumatic Brain Injury patients. Another product is being used by a growing network of ADHD specialists.

8) Large-scale, fully-automated cognitive assessments are being used in a growing number of clinical trials. This opens the way for the development of inexpensive consumer-facing, baseline cognitive assessments.

9) The potential for K12 Education remains largely untapped due to limited research linking cognitive training to academic performance.

10) Companies, sports teams and the military are finding opportunities to improve productivity. The aging workforce will make this a must.

B) Table of Contents

Editorial

Executive Summary

Chapter 1: Why now? Market Overview

• Brain fitness software market: the focus of this report
• Four customer segments of the brain fitness industry
• Part of the larger neurotechnology market
• Brain fitness became a media darling in 2007
• Confluence of market forces drives growth
• Demand: range of consumers and institutional buyers of brain fitness products
• Science: new findings spark focus on brain fitness market
• Supply: separating hype from reality in the claims of brain fitness software products
• Policy: brain fitness starting to shape public policy agenda
• Navigating the brain fitness software program landscape
• Interview with Dr. Yaakov Stern - The connection between building a cognitive reserve and delaying alzheimer’s symptoms

Chapter 2: The Science of Brain Fitness

• New brain paradigm: lifelong capacity to change and create new neurons
• Neuroimaging: enabling scientific exploration of the brain
• Cognition: core brain function
• Some cognitive functions improve as we age – others typically decline
• The four “pillars” of brain health
• Software-based brain fitness programs: effective to train specific skills
• Cognitive assessments: critical to identify bottlenecks and measure progress
• Cross-training the brain builds up the cognitive reserve
• An emerging field: much more research needs to be done
• Interview with Dr. Jerri Edwards - Improving Brain Functioning for better Driving and Aging

Chapter 3: Consumers – Taking Charge of Their Brain Health

• Nintendo creates global awareness for “brain training”
• Growing appetite for “casual games” among players over forty
• Baby boomers move the market by sheer size
• Consumer interest in health and wellness
• Growing concerns about herbal supplements
• Commercial software products flood market with inconsistent claims
• A number of critical questions remain unanswered
• Company profiles: select consumer brain fitness products

Chapter 4: Healthcare and Insurance Providers – Focus on Preventive Health & Clinical Conditions

• ”Brain fitness centers” becoming mainstream in residential facilities
• A major incentive for insurers: delaying the onset of Alzheimer’s symptoms
• Emerging clinical applications
• Stroke/ Traumatic Brain Injury Rehabilitation
• Attention Deficit Disorders
• Potential future clinical applications
• Use of computer-based cognitive assessments in large-scale clinical trials
• Open questions
• Company profiles: select brain fitness products sold through healthcare or insurance providers
• Interview with Torkel Klingberg – Expanding Working Memory for kids with ADD/ ADHD
• Interview with Elizabeth Zelinksi – Healthy Aging Enhanced with Computer-based Programs

Chapter 5: K12 School Systems – Responding to Learning Disabilities in New Ways

• Early K12 brain fitness applications
• Mismatch between academic needs and the claims of existing offerings
• A great resource: the US Department of Education’s “What Works Clearinghouse”
• Scientific Learning’s history and plans
• What Works Clearinghouse’s take on Fast Forword
• Houghton Mifflin’s Earobics
• Other program developers
• Open questions
• Interview with Dr. Bradley Gibson – Linking Computer-based Cognitive Training to Academic Performance

Chapter 6: Fortune 1000 Companies, Military & Sports Teams – Improving Productivity

• Fortune 1000 companies increase health & wellness budgets
• In light of the aging workforce, a focus on brain fitness is a logical extension
• In companies starting to embrace serious games, brain fitness may be a new application
• Military and sports teams leverage new brain fitness technologies
• Programs to improve driving skills proliferate
• Few pure-breed players, but some market leaders are starting to take notice
• Interview with Dr. Daniel Gopher – Applications for Computer-based Cognitive Simulations

Chapter 7: Future directions: market trends 2007-2015

End Notes

 

C) Companies Included in the report:

Advanced Brain Technologies

Applied Cognitive Engineering

Brain Resource Company

BrainTrain

CNS Vital Signs

Cogmed

CogniFit

Cognitive Drug Research

Cogstate

Dakim

Gemstone

Houghton Mifflin

Lexia Learning

Lumos Labs

MyBrainTrainer

Nintendo

NovaVision

Posit Science

Scientific Brain Training

Scientific Learning

TeachTown

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