Posit Science Invited to Speak at Johns Hopkins University About Cutting
December 17, 2008
At a symposium today hosted by Johns Hopkins University in Baltimore, Maryland, Posit Science researchers presented the latest research in brain plasticity and how the company is translating the science into technology to improve lives. Henry Mahncke, Ph.D., and Laila Spina, Psy.D., presented evidence that cognitive intervention developed by Posit Science can facilitate neuroplasticity, the brain’s ability to reorganize itself throughout life. This strengthening of the brain can have a positive impact on a wide variety of conditions from healthy aging to Mild Cognitive Impairment (MCI) to “Chemobrain.”
Among the research cited by the Posit Science scientists was the IMPACT study, the largest study ever done on a commercially available cognitive training program. Led by scientists from Mayo Clinic and the University of Southern California, IMPACT studied the effects of doing the Brain Fitness Program on adults 65+. The program consists of 6 computer exercises designed to facilitate neuroplasticity and strengthen the brain, thereby improving memory and speed of processing. The study proved that mature adults can make statistically significant gains in these areas by doing this kind of brain training (see also Posit Science Corporation).
The researchers also cited a smaller study led by scientists from the University of California at San Francisco and the University of California at Davis that investigated the effects of the same training on people with Mild Cognitive Impairment (MCI). As many as 85% of patients with MCI go on to develop Alzheimer’s disease. Preliminary data from the study indicate significant improvements in those who did the Brain Fitness program training while those who did not continued to decline.
Drs. Mahncke and Spina also shared research showing that training on the Brain Fitness Program helps cancer patients with the condition known as “Chemobrain.” “Chemobrain” affects people’s ability to concentrate, make decisions and fulfill family, career and community responsibilities. In the pilot study, Posit Science researchers studied the impact of training on the Brain Fitness Program on people with “Chemobrain.” Study results showed that 94% of participants experienced positive changes in their overall wellbeing and reported statistically significant improvements in cognitive function, stress levels and health-related quality of life.
The meeting was attended by rehabilitation therapists, social workers as well as Johns Hopkins staff neurologists, psychiatrists and psychologists.
Dr. Mahncke is Vice President of Research and Outcomes at Posit Science. Dr. Spina is a research neuropsychologist.
New inventions in computerized brain training may help people with a variety of cognitive disabilities lead fuller lives, said Jeff Zimman, Chairman of Posit Science(R) Corporation. Zimman presented today at the annual Technology Innovators Conference in Washington, DC, a meeting organized by The National Center for Technology Innovation to promote innovation to assist people with disabilities.
Zimman said cognitive training programs can assist millions of people in performing at higher levels of cognitive function and have better quality of life. Posit Science technology incorporated in its Brain Fitness Program(TM) and Insight(TM) products has been shown to improve cognitive function in healthy adults in a number of published studies. Now, research has been expanded to a wide range of neurological conditions, including traumatic brain injury, schizophrenia, stroke, geriatric depression, mild cognitive impairment, dementia, and chemobrain.
“There are now more than 30 published papers on the use of our technologies in randomized controlled trials,” Zimman said. “Those peer-reviewed articles show that our technologies enable most people to think faster, focus better and remember more. We believe there is great promise in using this non-invasive technology to address many cognitive impairments.”
Posit Science has sold more than 100,000 units of the Brain Fitness Program, which improves auditory processing and memory, in the past two years and recently introduced a new version of its visual processing and memory program, InSight 1.1. Two current PBS documentaries, “The Brain Fitness Program” and “Brain Fitness 2″ feature these two training programs and the company’s science and scientists.
Researchers at 28th annual National Academy of Neuropsychology (NAN) Conference in New York City this weekend will present data to help physicians understand more about cognitive remediation training in breast cancer survivors affected by “Chemobrain”. Chemobrain is a well documented phenomenon of patients with varying types of cancer. It is associated with reduced cognitive abilities; impairing memory, concentration, decision-making ability, quality-of-life, and the ability to process information rapidly. Declines in processing speed and memory often diminish the confidence of patients with Chemobrain; causing them to withdraw from interactions with their family, peers or co-workers at a time when support from these sources may be most needed.
The data being presented are part of a larger study in breast cancer survivors using the Posit Science Brain Fitness Program(TM) Classic to alleviate Chemobrain symptoms. The program, which is widely regarded as a breakthrough by the medical community, is a series of 6, specially engineered, computer based exercises designed by neuroscientists.
The results presented by lead Investigator, Sarah-Jane Kim, MA, show that cognitive training on the Posit Science Brain Fitness Program Classic significantly improved memory and sped up thinking. The breast cancer patients who did the training actually surpassed healthy, aged-matched peers in the ability to process information quickly.
Additional data presented by researcher Cate Stasio, herself a breast cancer survivor, show that cancer survivors with symptoms of Chemobrain are motivated and able to complete cognitive remediation training regardless of their treatment regimen, disease severity (stage of cancer), activity level, or self-perception of stress.
Nineteen breast cancer survivors, all women, who underwent chemotherapy and reported having Chemobrain participated in the study. Study results showed that 94% of participants experienced positive changes in their overall well-being and reported statistically significant improvements in cognitive function, stress level and health-related quality of life.
Sueann Mark, PhD, was a study participant. “When I began the training, I couldn’t remember appointments, where I put things and I had trouble finding the right word,” she said. Dr. Mark said she started to notice changes after using the program for just a couple of weeks. “My attention span was getting longer. I could read through entire articles that a couple of weeks ago I couldn’t get through. Knowing that I was exercising my mind and reactivating it was really comforting to me.”
“While further studies are needed, the implications for improved brain health in cancer patients look promising,” said lead researcher, Sarah-Jane Kim. “It’s a practical approach to improving the quality of life in cancer patients because it is non-invasive and therefore, does not require additional medication and does not interfere with the cancer treatment.”
According to a study from Nottingham, the United Kingdom, “Chemotherapy-associated memory deficits in adults are prevalent with systemic treatment utilizing 5-fluorouracil (5-Fu). 5-Fu disrupts cell proliferation and readily crosses the blood-brain barrier. Proliferating cells within the adult dentate gyrus of the hippocampus give rise to new neurons involved in memory and learning and require neurotrophic factors such as brain-derived neurotrophic factor (BDNF) to nurture this process of adult neurogenesis.”
“Some of these proliferating cells are anatomically and functionally supported by vascular endothelial cells. We propose that systemically administered 5-Fu chemotherapy will cause deficits in hippocampal memory that are associated with altered BDNF levels and proliferating cells (particularly vascular-associated cells) in the dentate gyrus. This was tested by determining the effect of 5-Fu on spatial working memory as modelled by the object location recognition test. Numbers of vascular-associated (VA) and non-vascular-associated (NVA) proliferating cells in the dentate gyrus were measured using double-labelling immunohistochemistry with markers of proliferation (Ki67) and endothelial cells (RECA-1). 5-Fu-induced changes in hippocampal BDNF and doublecortin (DCX) protein levels were quantified using Western immunoblotting. 5-Fu chemotherapy caused a marginal disruption in spatial working memory and did not alter the total proliferating cell counts or the percentage of VA and NVA proliferating cells in the dentate gyrus. In contrast, 5-Fu significantly reduced BDNF and DCX levels in the hippocampus, indicating alterations in neurotrophin levels and neurogenesis,” wrote S. Mustafa and colleagues, University of Nottingham (see also Chemotherapy).
The researchers concluded: “These findings highlight the usefulness of animal models of ‘chemobrain’ for understanding the mechanisms that underlie chemotherapy-associated declines in cognitive performance and memory.”
Mustafa and colleagues published their study in European Journal of Neuroscience (5-fluorouracil chemotherapy affects spatial working memory and newborn neurons in the adult rat hippocampus. European Journal of Neuroscience, 2008;28(2):323-330).
Cancer patients have complained for years about the mental fog known as chemobrain. Now in animal studies at West Virginia University (WVU), researchers have discovered that injections of N-acetyl cysteine (NAC), an antioxidant, can prevent the memory loss that breast cancer chemotherapy drugs sometimes induce. The WVU researchers’ study has just been published in the September issue of the Springer journal Metabolic Brain Disease (see also Springer).
Rats were given the commonly used chemotherapy drugs adriamycin and cyclophosphamide. When on the drugs, rats who were trained to prefer a light room to a dark room forgot their training.
“When animals are treated with chemotherapy drugs, they lose memory,” said Gregory Konat, Ph.D., professor of neurobiology and anatomy at WVU. “When we add NAC during treatment, they don’t lose memory.”
Chosen for its antioxidant properties, NAC is a modified form of the dietary amino acid cysteine.
Jame Abraham, M.D., director of the Comprehensive Breast Cancer Program at WVU’s Mary Babb Randolph Cancer Center, said as “chemobrain” entered the national lexicon, many patients expressed frustration about doctors not taking the complaints seriously.
“In the past, there was a lot of ignorance among doctors about chemo-induced cognitive problems,” Dr. Abraham said. “In some patients, problems can persist for up to two years.”
The WVU authors say as many as 40 percent of cancer patients undergoing chemotherapy complain of symptoms such as severe memory and attention deficits. Previously, scientists suspected the cancer, rather than chemo drugs, might be the cause.
Earlier this year, Dr. Abraham’s team of researchers used MRI scans to document the extent of changes to the brain in women who received chemotherapy for breast cancer. Now the connection between drugs and memory loss is clear, and a potential remedy is suggested as well.
“At this point, we have no evidence to say that NAC is safe in patients who are getting chemotherapy,” Abraham said. “We need more studies to confirm the role of NAC in patients.”
Clinical Psychiatry News
August 01, 2008
The wakefulness-promoting drug modafinil reduced self-reported severe fatigue, according to a study of more than 600 cancer patients undergoing chemotherapy that was presented at the annual meeting of the American Society of Clinical Oncology.
Gary R. Morrow, Ph.D., of the University of Rochester (N.Y.) and his colleagues randomized 631 patients undergoing four cycles of chemotherapy to receive either 200 mg modafinil (Provigil) daily or placebo.
Among those with severe fatigue at baseline, patients on modafinil had significantly greater reductions in fatigue, compared with those on placebo.
Participants were asked to rate their level of fatigue at baseline (during the second cycle of chemotherapy) and during the final cycle. They rated fatigue on a 10-point scale: mild (1-4), moderate (5-6), and severe (7-10).
A total of 67 patients reported mild fatigue at baseline; 106 and 458 reported moderate and severe fatigue, respectively.
Among patients with mild and moderate fatigue, modafinil also reduced fatigue, compared with placebo, but the differences were not significant. This was not surprising, Dr. Morrow said during a press briefing. “With side effects, quite often the potency of the effect is somewhat dependent on where you began,” he said.
Modafinil–a nonamphetamine stimulant–is currently indicated for the treatment of excessive sleepiness resulting from obstructive sleep apnea, shift-work sleep disorder, and narcolepsy. Last year, researchers also at the University of Rochester reported success with modafinil in treating “chemobrain,” a reduction in cognitive function that has been associated with chemotherapy.
There may be some overlap between chemo brain and fatigue, Dr. Morrow said in an interview. Problems with executive function are commonly described in chemo brain. Cancer-related fatigue appears to particularly affect tasks associated with executive function. Cancer patients complain of not being able to “get around” to doing things they know they should do.
Cephalon Inc. provided modafinil and placebo for the trial. Dr. Morrow reported that he has no relevant financial relationships.