MIL-OSI UK: expert reaction to new brain training app to improve concentration

Source: United Kingdom – Executive Government & Departments

Research published in Frontiers in Behavioural Neuroscience demonstrates that cognitive training with a dedicated app is effective in enhancing attention in young adults.

Dame Til Wykes, Vice Dean Psychology and Systems Sciences and Professor of Clinical Psychology and Rehabilitation, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:

“Although it is generally accepted that apps are beneficial, high quality scientific evidence of benefit is scarce. This research is therefore welcome but it does only show benefits on another computer test not on real life. Does it really improve handling your emails and for how long?

“The benefits seem to be limited to a computer test and only with supervised app use. It may be more beneficial to spend the 8 hours a month on other activities like going for a walk or the gym where there is plenty of evidence of cognitive and other health benefits.”

Dr Ashok Jansari, Senior Lecturer in Cognitive Neuropsychology, Goldsmiths, University of London, said:

“The study by the team at the Cambridge Department of Psychiatry addresses a very important issue in modern society brought on by the ever-increasing number of tasks that we need to juggle in daily life which is thought to result in decreased ability to concentrate and difficulties in ‘staying on task’ in everyday life. The study reported by this world-leading research group has been run robustly and evaluated the positive benefits of using a game-like app called Decoder on a well-established laboratory task known to be related to sustaining attention. Relative to another less engaging computer activity or no ‘intervention’, playing Decoder resulted in improvements on the laboratory task. Further, this improvement in sustained attention did not have a detrimental effect on a task measuring the ability to switch attention.

“The study is well conducted and the results are promising. However, there are a number of limitations that need to be borne in mind. One of the most important of these is that there is a lack of ‘ecological validity’ in any of the measures. In the fields of neuroscience and neuropsychology, a major issue has become how well results from carefully constructed laboratory-based tasks relate to everyday behaviour. While the study clearly shows a benefit of playing Decoder on a laboratory-based measure of sustained attention, we have no idea of how this relates to sustaining attention on everyday tasks which the study is ultimately aiming to improve. Further, an important issue that needs to be addressed is how long-lasting these effects are. Does one have to keep playing Decoder to improve sustained attention and if one stops, does that result in returning to previous levels of poorer attention? Given the plethora of brain-training systems on the market despite the lack of evidence for generalisability to everyday behaviour, and indeed even lawsuits for false advertising (as happened in the $2 million successful lawsuit by the US Federal Trade Commission against the brain-training game Luminosity in 2016) it is vitally important that researchers address these issues if their aim is for the general public to invest in apps for real-world benefits. Finally, while the paper itself refers to the attentional difficulties experienced by individuals with ADHD as well as the difficulties of pharmacological interventions, there is quite a gap between the complex cognitive difficulties of such individuals and those experienced by the average busy healthy young person of the type that participated in this study. Therefore, further research is needed to demonstrate whether first, Decoder has any benefits beyond standard laboratory measures of attention and second, whether there is any implication if any for its impact on individuals with very complex clinical attentional disorders such as ADHD.”

Prof Thom Baguley, Professor of Experimental Psychology, Nottingham Trent University, said:

“The press release is broadly accurate in its description of the study, but over simplistic in its analysis of the context. There isn’t really good evidence that young people today have more difficulty focusing attention than those of previous generations.

“This is a generally well-conducted small study of the short-term effects of brain training using a new iPad game. The sample size is moderate (25 per group) and they use an active control condition (a Bingo game) which is good practice. As multiple measures are used this makes it easier to detect some effect of the intervention and the authors correct for comparisons between groups but not for the number of measures. Ideally one would pre-register the choice of primary measure and any corrections for multiple measures.

“The game technology is largely iterative in terms development when compared to other apps  – the main innovation appears to be in terms of creating a game that is entertaining and motivates continued play rather than in terms of the underlying science.

“The findings are broadly in line with existing evidence on how brain training apps may impact performance. Brain training can boost performance in the short to medium term on tasks that are relatively similar to the original training. Here the main test and the Decoder game appear to share underlying similarities. There is also some overlap with the active control task, but their data also show that the active control is less motivating or engaging than the Decoder game.

“It is difficulty to fully control differences in motivation and engagement between conditions rather than specific effects of cognitive training. It is also unknown whether any gains in concentration can be sustained long-term or generalise to other tasks.

“As the study looked only at healthy volunteers and there isn’t sufficient evidence as yet to link these findings to treatment of ADHD.

“To date there is no good evidence that brain training can produce long-term gains that would have a material and positive impact on everyday life, but it is unlikely to be harmful based on what we do know.”

‘Improvements in attention following cognitive training with the novel ‘Decoder’ game on an iPad’ by George Savulich et al. was published in Frontiers in Behavioural Neuroscience at 00:01 UK time on Monday 21st January.

Declared interests

Professor Dame Til Wykes: Development of online therapy for schizophrenia – CIRCuiTS

Dr Ashok Jansari: No conflicts of interest.

Prof Thom Baguley: No conflicts of interest.


MIL-OSI UK: expert reaction to low levels of cannabis use in adolescents and grey matter volume

Source: United Kingdom – Executive Government & Departments

Research published in Journal of Neuroscience presents evidence suggesting structural brain and cognitive effects in adolescents following one or two instances of cannabis use.

Dr Amir Englund, Post-doctoral researcher in Psychopharmacology, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:

“The present study is one of the first studies to explore very low level and early use of cannabis on the brain of teenagers, specifically using cannabis only once or twice. The researchers present results which suggest that the teens who had used cannabis (compared to never-users) once or twice over the 2-year follow-up period showed increases in brain volume in areas which have more of the brains cannabinoid receptors. In this study, greater brain volume was associated with slightly worse IQ performance. Although this is a well-designed study, it is important to note that this is one of the first of its kind, with a relatively small sample size and shows conflicting results compared to previous studies exploring brain changes related to cannabis use. A 2015 study (Weiland et al.) which matched users and non-users according to use of alcohol found no differences in brain structures in both adolescents and adults. Two Dutch studies (Koenders et al. 2016, 2017) which followed young adults over a 3-year period found no evidence that cannabis use impacted brain structure. Lastly, a very recent Australian study of 120 non-users and 141 users were not able to detect differences in cortical thickness, brain surface area or gyrification.

“I welcome this new study as we know early use of cannabis is a risk factor/indicator for future mental health problems and cannabis related problems. However, we need more and larger studies in order to confirm the results of this study.”

Prof Derek Hill, Professor of Medical Imaging, University College London (UCL), said:

“This research uses well established brain image analysis methods to assess whether the size and shape of adolescent brains is changed by using cannabis just once or twice.  Previous work has focused on brain changes in people who are long term heavy users of cannabis, so this research potentially helps understand whether brain changes start after smoking just one or two joints.

“The results suggest that many parts of the brain appear larger in the teenagers who have used cannabis just once or twice.  Slightly bigger brains, however, doesn’t necessarily mean damage to the brain.  There could, for example, be a change in brain volume because of a small change in the amount of fluid between brain cells rather than because any change in the brain cells themselves.

“Furthermore, it is also possible that the larger brains is a random finding. Only 46 teenagers were studied, and the majority of these had just one brain scan, which is compared to a control. The subjects didn’t all have a scan before and after they used the cannabis, which would be a more reliable way of determining whether the cannabis use resulted in a change in their brain. 

“The researchers do, however, suggest that their results support evidence from research on animals that has shown that cannabis use can result in changes in the brain cells themselves.  Such a suggestion is an interesting theory, which merits further investigation. But the results in this paper certainly don’t prove that the brain of the teenagers who’ve used cannabis just once or twice are permanently altered in a harmful way.”

Prof Sir Robin Murray FMedSci, Professor of Psychiatric Research, Institute of Psychiatry Psychology & Neuroscience, King’s College London (IoPPN), said:

“The question of whether cannabis use causes brain changes is an extremely important one given the worldwide increase in use of cannabis.  Previous studies of brain structure have been contradictory with some suggesting that heavy use is associated with decreased brain volumes, some no effect, and some the opposite. 

“This study is novel in that it compared 46 adolescents who had used cannabis only once or twice with others who had never used cannabis.  The results show increased cortical volumes in a number of areas such as the temporal lobes (where there are lots cannabinoid receptors). The authors have done their best to rule out other possible explanations e.g. that the differences were present before the cannabis use or the subjects were also using alcohol). This is a sophisticated and well-presented study by an internationally re-knowned team. However, it remains a small study and it is very surprising that persistent brain changes could result from the use of cannabis (or any other recreational drug) only once or twice.  Therefore, the findings will need to be replicated on a much larger scale before we can accept the conclusions.”

Prof David Nutt, The Edmond J Safra Chair and Head of the Centre for Neuropsychopharmacology, Division of Brain Sciences,  Dept of Medicine, Imperial College London, Imperial College London, said:

“This is an observational study of brain function and grey matter volume in teenagers who have use cannabis.  They unexpectedly found larger brain volume in some brain regions.

“The imaging aspects of the study have been well conducted and are of good size but ultimately despite using a control group they cannot prove that the differences are due to cannabis use. Their rather imprecise use of the term increased/increases in relation to their brain volume measures incorrectly implies causality.

“Of course it is not possible to do a randomised administration of cannabis to young people to properly test this theory. But if it was a direct pharmacological effect of cannabis then it would likely be more apparent in those using more of it. So it is surprising that they don’t supply data on the brain measures in those who have used cannabis on more than two occasions. If there was a dose effect this would help us understand if this a pharmacological effect of cannabis use.

“Also this increase in size doesn’t seem to have a major impact on brain functioning.  So while this study alone is not able to prove small amounts of cannabis negatively affect the brains of adolescents, this area of research is important and certainly worthy of further study – along with alcohol and other psychoactive substances – as to whether they have unwanted brain effects in young people.’

‘Grey Matter Volume Differences Associated with Extremely Low Levels of Cannabis Use in Adolescence’ by Catherine Orr et al. was published in The Journal of Neuroscience at 18:00 UK time on Monday 14th January, which is also when the embargo will lift. 

All our previous output on this subject can be seen at this weblink:

Declared interests

Prof Robin Murray: No conflicts of interest.

Prof Derek Hill: “I have no conflicts of interest related to this work.”

None others received.