The Science Behind 'Brain Training'

I clicked one called Hidden, which showed a standard numeric keypad, the kind used on cell phones and calculators. The keypad was hidden while a man’s voice recited a short list of numbers. When his list was complete, the keypad reappeared, and I was supposed to click on the list—in reverse order. Another game showed a circle with nine smaller circles strung along it like carriages on a Ferris wheel. As the big circle slowly rotated in a clockwise direction, the little circles lit up in a random sequence. Once the sequence was completed, I had to click on the little circles in the same order.

All of the games were easy on the first pass, but immediately grew hard enough—meaning that the sequence to be remembered grew longer and was presented faster—that I began making mistakes.

Having offered Cogmed to a few dozen of her patients, as young as six and as old as 63 (including a successful attorney whose ADHD was diagnosed in her forties), Garcia said she’s convinced of its benefits, sometimes in combination with medication and sometimes on its own. And at a total cost to families of about $2,000 for the 25 sessions, she said, it compares favorably with many other kinds of ADHD treatments.

Where Cogmed beats all other forms of cognitive training is in the number of published, randomized clinical trials demonstrating its benefits and the number of trials still under way, led by independent researchers at leading institutions without any commercial connection to the company.

Julie Schweitzer, director of the ADHD Program at the University of California in Davis’s MIND Institute, conducted a randomized study of children diagnosed with ADHD.  When published in July 2012 in the journal Neurotherapeutics, Schweitzer’s study found that children in the placebo group spent just as much time off-task at the end of the study as they had at the beginning, but those who trained on Cogmed sharply increased the amount of time they spent doing school work.

Children who have survived cancer are another group often in need of cognitive rehabilitation. “Somewhere around 20 to 40 percent of children treated for leukemia will end up with cognitive changes over time,” said Kristina K. Hardy, a neuropsychologist at Children’s National Medical Center in Washington, D.C. “For those treated for brain tumors, the figure is conservatively around 60 to 80 percent.”

What distinguishes these young survivors from most others seeking cognitive rehabilitation is that the effects of radiation or chemotherapy on the brain become apparent only with the passage of time. Immediately following treatment, a recent study found, survivors of acute lymphoblastic leukemia showed no significant change in their verbal IQ scores, but by early adulthood, their scores had dropped by an average of 10.3 points. 

In 2012, Hardy reported the results of a pilot study comparing Cogmed to a placebo form of computerized. Among 20 children who had survived either brain cancer or leukemia, those who trained with Cogmed saw substantial improvements compared to the placebo group on their visual working memory and in parent-rated learning problems.

Most recently, children with Down syndrome have been shown to benefit from Cogmed. “Following training,” concluded a study published last June, “performance on trained and untrained visuospatial short-term memory tasks was significantly enhanced for children in the intervention group. This improvement was sustained four months later. These results suggest that computerized visuospatial memory training in a school setting is both feasible and effective for children with Down syndrome.”

Brian Skotko, co-director of the Down Syndrome Program at Massachusetts General Hospital, told me, “If Cogmed was a drug, everyone would call this study groundbreaking.”

Not all studies of Cogmed have been positive. A large one published in October found little benefit. But as Klingberg has written in defense of Cogmed in particular and working-memory training in general: “Working memory training is still a young field of research. As with all science, no single experiment explains everything, and results are never perfectly consistent … Many questions remain. But there is no going back to the notion that working memory capacity is fixed.”

This post is adapted from Dan Hurley's Smarter: The New Science of Building Brain Power.

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