• Dr Jack’s review of Brain Training on the Nintendo DS

    INTRODUCTION

    This review comprises my opinions, both as a consumer and a neuroscientist, of Dr Kawashima’s Brain Training on the Nintendo DS. I have previously (http://www.drjack.co.uk/brain-teasers-brain-training/) outlined my view that brain training is simply a matter of teasing your mental faculties with a variety of word, number and problem solving challenges on a regular basis. In this regard, the greatest advantage of the Nintendo DS brain training over the old-fashioned (but quite possibly equally effective) books of crosswords and number puzzles, is its fantastic convenience and flexibility. You can carry around with you literally thousands of mentally-taxing brain teasers for use during your daily commute, or to the far corners of the globe, and it will take up no more room in your baggage than a small book.

    I have also previously described (http://www.drjack.co.uk/does-brain-training-really-work-by-dr-jack-lewis/) why I think that, despite the BBC’s headline-grabbing publication of research suggesting that “BRAIN TRAINING DOESN’T WORK”, I sincerely believe that the jury is still out on that issue. So below you will simply find my considered opinion on how this game rates – as a way to while away some spare time in a manner that probably won’t change your life, but certainly won’t do you any harm and might just sharpen up some very basic, but fundamental, cognitive abilities.

    THE REVIEW

    I promised to review Dr Kawashima’s “Brain Training – How Old Is Your Brain” a long time ago. Why did it take me so long to deliver on this promise? To be honest, it took me months to clock up enough days of brain training to finally unlock all the games. At the very beginning you have access to only 3 (quite dull) brain training games and then, as you complete more and more days of training, you are rewarded by being given access to more and more of the games (most of them much better than the first 3). Slightly annoying, perhaps, but ultimately an unquestionably good strategy for incentivising more regular training.

    Despite being very curious to investigate this brain training phenomenon I only managed 1 session in Mar, 1 in Apr, 3 in May, 0 in June, 4 in July and 11 in Aug. It is interesting to note that the inspiration for training more regularly at the end of July was that this was the very first time I had encouraged someone else to give it a go. When I saw what my girfriend had scored I found that I was suddenly powerfully motivated to keep up my training, whilst over March-June my efforts were distinctly half-hearted. Having more than one person using the same console is clearly the key to nurturing motivation. Humans are naturally competitive and so if it worked for me it should work for you too. So my first piece of advice is, once you’ve got the hang of it, be sure to get friends and family having a go too.

    I know exactly how often I trained over the past few months thanks to the scrollable calendar feature, which automatically stamps each day that you switched on and played. Not only does this allow you to see, at a glance, how dedicated (or in my case slack) you have been with your training, but the 3D floating head of Dr Kawashima, after greeting you at the beginning of each training session, takes it upon himself to praise or berate you according to how long it’s been since your last visit.

    FIRST IMPRESSIONS

    My first impressions of the game were that it was better than I had expected. I was surprised and happy to see that the floating 3D head’s opening presentation explaining the concepts of  brain training included real fMRI brain data to help illustrate some of the key points. I was impressed that Nintendo were brave enough to include some real science, trusting that their customers would not be scared off by it. Quite courageous of them.

    The very first session involves a preliminary brain training game to establish your inital “Brain Age”. Determined to nail it I was nonetheless shocked that I managed to get the best possible “Brain Age” of 20. All those decades of education were not wasted then! Before you start hating me for being a smart alec, let me reassure you that my “Brain Age” soon shot up to my real age and well beyond over the months that followed. The point is that this “Brain Age” score is pretty arbitrary to say the least – it shoots up and down like a roller coaster because it is based entirely on your current performance and doesn’t seem to take any of your previous performances into account. It is merely there to provide you with the impetus to keep on training. Trust me it works – it took me months and months to nail a “Brain Age” of 20 again. And then I never wanted to do it again because I knew I was almost guaranteed to do worse. Whatever your best ever “Brain Age” is – seeing a considerably worse one by your name each and every time you switch on to play makes anyone with a grain of competitiveness want to step up and take it on.

    Over the weeks and months I developed a distinctly love/hate relationship with Dr Kawashima’s floating head. Some of the silly things he says, like: “What wonderful results! I might start crying here…” genuinely made me chuckle, on more than one occasion (invariably drawing quizzical looks from whoever happened to be sitting opposite me on the train). On the other hand, some of his advice on how to keep your brain in tip top condition is very weak and the extremely repetitive observation that doing calculations/reading out loud/drawing from memory/moving the stylus from target to target/counting syllables etc. etc. will “activate your prefrontal cortex and improve your general brainpower” becomes extremely tedious. But on balance, this is one of just a handful of pretty minor gripes. Overall Dr Kawashima’s Brain Training on the Nintendo DS is an extremely smart, convenient and quite technologically-advanced little game that positively encourages people to take an active interest in the health of their brain.

    DAILY TRAINING

    The Daily Training games consists of a variety of ways to tax different clusters of brain areas involved in different cognitive functions. “Calculations” involves performing simple addition, subtraction or multiplication problems that are displayed on one screen and whilst you use the pointer to scribble your answer on the other screen. The aim is to complete a predetermined number of sums as quickly as possible and the punishment for a wrong answer is a (quite severe) time penalty. The format of this challenge is unimaginative to say the least and in the first instance makes you feel like you’re back in primary school. But by the time my training was completed I had performed so many rapid calculations that, as with all things, I improved in leaps and bounds. Being able to perform simple calculations extremely quickly is a useful skill to have and comes in useful in everyday life. Trying to work out if you have enough money to pay for the items you are about to take to the till is one example. So I didn’t resent being made to feel like I was back in primary school too much. I’ve since caught my local shop keepers short changing me once or twice now as a result. I’m sure it was unintentional on their part, but I simply wouldn’t have bothered adding it up in my head if I hadn’t been put in the habit by “Calculations”. Later on you get to unlock one of the mystery games that takes the maths challenges to the next level by making you remember pairs of answers for long enough to perform calculations upon the correct answers to previous calculations. Pretty challenging and completely impossible if you are on the way home after a long session at the pub!

    My two least favourite were probably “reading out loud” and “syllable count”. If I want to read out loud I have a plethora of my own books to choose from. And how anyone but rap artists might benefit from honing the ability to count the syllables in a proverb beats me. It may exercise the brain areas involved in reading and producing words, or in the parcellation of words into smaller chunks, and could therefore potentially yield some improvement in these functions under normal conditions, but they are a pretty dull way to pass the time.

    “Head count” – on the other hand, is a different matter. You have to keep track of a hoard of stick men scuttling into and out of a house, which gives the old working memory a genuinely good work out. This is because it requires you to constantly update the number of stick men currently within the house despite the frantic comings and goings. On hard mode this game is particularly challenging, as the stick men leave and arrive not just through the side doors, but through the chimney as well, which means you have to count the vertical comings and goings as well as the horizontal.

    Another favourite is “Low to High” – where a series of carefully spaced numbers are flashed up on the screen for a very brief period of time and, thanks to the wonders of iconic memory (the impression left on the brain by a flashed image), you find yourself able to touch the squares within which the numbers were displayed just moments before, in the correct order from lowest to highest. If you get it right an additional number is added in the next round to make it progressively more challenging. Once you get up to the heady heights of tackling 7 or 8 numbers it is really hard! A very enjoyable game and one which helps to develop a potentially useful cognitive skill of extracting information from briefly viewed images – excellent for anyone who wants to become a spy, or work in film or TV for that matter.

    VOICE-RECOGNITION

    I was very surprised to find that the Nintendo DS was equipped with voice-recognition software that actually works fairly well. This is essential for a classic psychological mind bender called the Stroop test, which exercises brain areas involved in inhibiting impulsive responses. It involves a colour word being presented on the screen e.g. “red” or “green” or “yellow” or “black”, but the meaning of the word must be ignored and instead the colour that the word is written in must be stated out loud. In other words if the word “blue” is presented in red-coloured font, your brain has to work extra hard to suppress the temptation to say the word “blue” in order to allow the correct response to be uttered i.e. “red”.

    I must admit that the first time I tackled that particular game I found myself thinking: “will this gadget really understand me?” Despite my doubts I was impressed to find that it could recognise most of my speech. Yet if there is any background noise it is completely hopeless, particularly on the train. I would definitely recommend experimenting with different ways of saying the words to help you figure out how best to deliver the word to ensure it is properly recognised. This game is one of the handful of tests used to define your brain age – an extremely arbitrary scale by all accounts – but when your brain age is given as 62 because you wasted 3 solid minutes repeating the word yellow over and over again in voice steadily becoming increasingly loud and irritable you may find that putting some time into finding a voice that it can register accurately pays dividends in the long run. The same goes for experimenting with writing numbers in such a way that no matter how fast you try to write, it is always correctly registered by the software. I cannot tell you how frustrating it is (and how often you find yourself getting frustrated in this way, particularly when on the move) when you see the sum 2+2 and your scribbled “4” is misread as an “8”. A 5 second penalty seems pretty harsh when you knew the right answer but couldn’t get the damned thing to recognise it properly.

    MEMORY TEST

    Another game in the battery of tests that defines your “Brain Age” includes a memory test. You are given 3 minutes to memorise a long list of words and 2 minutes to recall them. I think Nintendo missed a great opportunity here as there are some great mnemonic strategies that they could have offered here to help you improve memory performance more quickly and to a greater degree. Now that really would have been bona fide brain training! As I already know these memory tricks, I found that this test was an absolutely brilliant forum in which to practice creating memorable links between a random list of words. This is the real challenge in using memory tricks – being able to dream up a potent image of an imaginative scenario whereby two successive words are intertwined and then get on quickly to the next pair of items. If I hadn’t been playing this game I would not have had so many opportunities to practice this extremely useful skill and would not have improved to the point of being able to recall as many as 36 of the 40 words. Importantly this transferred directly into a benefit in my day-to-day life as I was able to quickly dream up some mnemonic links between 10 facts that I wanted to mention in a meeting just 15 minutes before the meeting was due to commence. All that brain training had clearly boosted my memory-making faculties as I recalled every fact effortlessly, which made a good impression on the audience and saved time shuffling through notes and papers to find the relevant information.

    I’ll share some of these mnemonic tricks with you in my next post so you can try it our yourself. So watch this space!


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  • Does brain training really work? by Dr Jack Lewis

    BBC study slams brain training – but don’t throw your Nintendo DS away just yet…

    Since Dr Kawashima’s Brain Training (UK) / Brain Age (US) game was launched on the Nintendo DS in 2005 a great buzz has been generated by the enticing prospect of sharpening up our mental faculties. Indeed, claims that it can improve memory, make us smarter, sharpen reaction times and improve general brain power have convinced over 3 million of us in the UK alone to buy this game (including me! – I’m in the process of writing a review on it, so watch this space). Then, in 2007, Lumos Labs launched “Lumosity” – a web-based, subscriber-accessed, brain training program with an ever-expanding range of colourful and engaging brain training games. Just one year later Lumos labs managed to attract $3,000,000 in private investment to further develop their cognitive training offerings. Brain training has become a billion dollar global industry.

    In a previous blog I suggested that there is nothing special about each individual brain training game – I argued that the same benefits would be achieved by picking up a puzzle book containing number games, word puzzles and problem solving tasks on a daily basis:

    http://www.drjack.co.uk/brain-teasers-brain-training/

    However what these commercial offerings do provide is a structured training program, consisting of a wide variety of different games and puzzles, the opportunity to measure and keep track of your progress and the convenience that might encourage you to train for long enough and regularly enough to notice some benefits. The only problem is that in the 5 years since these games were launched there has not been a single shred of independent evidence (to my knowledge) that these games actually benefit brain functions useful in everyday life, rather than just the inevitable performance improvements in the games themselves. We already know that practice makes perfect. There have been reports that brain training works – but these studies were invariably linked to the very companies that had a vested interest in such findings.

    Doubts started to be voiced in early 2009, for instance, Which? magazine assembled a panel of experts who concluded that Brain Training on the DS had no “functional impact on life whatsoever”. By the autumn of 2009 the BBC had clocked that is was high time that the concept of Brain Training was put to the test and set the “biggest brain training experiment ever” in motion – an independent clinical trial the results of which would be published in a suitable peer-reviewed journal. They asked distinguished scientists from the University of Cambridge (Dr Adrian Owen, MRC Cambridge Brain Unit) and King’s College London (Professor Clive Ballard, director of research for the Alzheimer’s Society) to design a suitable experiment involving 11,000 participants, which ultimately led to the conclusion that “Brain Training Games Don’t Make Us Smarter”:

    http://www.bbc.co.uk/labuk/results/braintestbritain/1_results_summary.html

    However, lack of proof of a brain training effect is not the same as proving beyond all reasonable doubt that brain training doesn’t work. At the bottom of this piece is a list of 5 reasons why the results of Bang Goes the Theory’s Lab UK study does not necessarily mean that brain training on consoles like the Nintendo DS is ineffective. These are centred around the following facts: they created their own games rather than using commercially-available ones (maybe their games were not as effective?), they required people to train only 3 times per week (maybe it would have worked with a more intense training regime?) and the games involved people sitting at a PC using mouse and keypad to register responses (i.e. they missed out on the technological advances of touch screen and voice recognition in the Nintendo DS). They have certainly demonstrated that the games they created, when played infrequently, across a relatively short period of time, using an outdated user control interface (that slows down the speed at which responses can be made in time-critical games), did not lead to improvements in a separate set of ‘benchmarking’ games that may or may not have been sensitive enough to detect improvements in attention, memory and problem solving skills. However, their failure to detect any improvements whatsoever (in the under 60’s at least) could boil down to any of these factors or more likely a combination of them. I’m not suggesting for a minute that these results are invalid. All I’m saying is that the proverbial jury is out regarding the putative efficacy of brain training – we must wait until more evidence has been gathered before potentially throwing the brain-train-baby out with the bathwater.

    The compromises that they had to make in order to pull off such a large clinical trial are inevitable, but may have hampered their ability to capture any discernible effect. In order to get such large numbers of people to participate they clearly needed to avoid requiring people to give up their time too often and for an unnecessarily protracted period of time; otherwise people would have dropped out of the trial like flies. What led them to create their own games, rather than testing existing ones, may have involved the desire to avoid the potential wrath of powerful multinational companies. Even if they had been brave enough to wish to test the actual games to which the claims were attached the BBC would never have got away with wasting license fee payers money by coughing up the cash to issue each of these volunteers with a Nintendo DS – even if it would mean benefiting from the advances of speed-enhancing touch screen and voice-recognition technologies. Yet until further clinical trials, including some that investigate the potential of brain training in a way that gives it the best possible chance to shine, have confirmed or contradicted the current findings – I myself will not be throwing my DS away just yet.

    If I was Nintendo I would wish to tackle this issue head on. I would ask an independent scientific body to find a suitable group of research scientists who could conduct a fully independent study totally uncorrupted by any conflicts of interest. This group should together combine a thorough understanding of the human brain with specific experience in measuring the cognitive abilities of healthy individuals – perhaps an education specialist, an occupational psychologist and a neuroscientist. They would oversee a further large-scale, independent, clinical trial that implements a more intense training program based on the best brain training game in the Nintendo DS armoury. I would develop a battery of tests that are able to capture improvements in brain function that actually come in useful during everyday life, as opposed to performance improvements in a rather arbitrary batch of computer games.  For instance, if a person’s ability to tot up the cost of a batch of 10 items in a shopping basket improves as a result of intense brain training, they will be better able to spot when a cashier over or under charges them at the till and it would become possible to confidently state that they have benefited from the brain training in a meaningful way. If they are better able to remember a route on a map after training, then they will be less likely to suffer the stress and inconvenience of getting lost. If they are better able to pay attention to and ultimately recall verbal instructions, in an environment containing a cacophony of visual and acoustic distractions, then the benefits from brain training may actually help them in real life. To ensure participants stay with the program to the very end I would incentivise the much more intense training regime with cash rewards e.g. if they successfully completed 1 month of 2×30 minute training sessions per day they would receive a cash bonus, 2 months and they get a double cash bonus plus a further prize and if they complete the full 3 months they would get a quadrupled cash bonus. I would dish out 10,000 Nintendo DS consoles to individuals who would benefit most from the alleged cognitive improvements that are expected to occur – the chronically unemployed perhaps. That way, whether or not any improvements in cognitive function was detected, any improvement in the employment status of these 10,000 compared to a control group of another randomly selected 10,000 (who have also been receiving job seekers allowance for a prolonged period), would give Nintendo a possible second bite of the cherry by demonstrating a generic improvement in motivation levels and the power to benefit society as a whole. In addition to the milestone incentives, if they did look to keep unemployed hands and minds busy, it might also help to improve brain training dedication by dangling a carrot over the “high score leader board” – whereby those that achieve the best scores overall could be given paid work experience in a role that utilises the skills tapped by each specific game. Just think of the headlines: “Intense Brain Training DOES Improve Mental Abilities AND Gets The Chronically Unemployed Back Into Work”

    Get Dr Jack Lewis’s daily #braintweet by following him on Twitter: www.twitter.com/DrJackLewis

    5 Potential Flaws with the Lab UK Brain Training Study:

    1. At least 3 times per week for 6 weeks
      1. POTENTIAL FLAW: the training regime is very sparse. In other words not surprising that there was no significant improvement because it didn’t tax the participants brains hard enough to benefit memory, planning, problem solving etc.
      2. REASONING: I would expect multiple training sessions EACH AND EVERY DAY to be necessary for significant improvements because the brain is only likely to invest resources in building better lines of communication between brain areas supporting a certain function if it is really needed (i.e. often used)
      3. SOLUTION: a commuter training regime – twice per day (on bus or train) on the way to and from work or school. Perhaps longer sessions at the weekend.
      4. BONUS: using dead time when people would otherwise be staring into space – even if it doesn’t translate into long term improvements such a brain training regime definitely helps to wake up a sleepy brain (it works for me!!)
    1. Brain training transfer to other brain skills like memory, planning or problem solving
      1. POTENTIAL FLAW: improvements in memory, planning or problem solving may have occurred but were not successfully detected
      2. REASONING: the selected tests may not have been sensitive enough to detect subtle improvements that occur with such a sparse training regime.
      3. SOLUTION: use more sensitive tests or increase frequency of training.
    1. Choice of brain training games
      1. POTENTIAL FLAW: brain training games may not have been sufficiently taxing to elicit significant improvements
      2. REASONING: the games were not those used by Dr Kawashima’s Brain Training and so the results of this experiment might not be applicable
      3. SOLUTION: perform a study using the actual Nintendo DS game and console.
    1. No improvement in PC-based brain training games compared to just using the internet
      1. POTENTIAL FLAW: this does not capture the ability of the Nintendo DS to do brain training on-the-go, nor voice activated responses, nor faster responses enabled by touch screen technology – scribbling a letter/number or tapping at a certain location.
      2. REASONING: portability of Nintendo naturally lends itself to more intense training regime, writing on touch screen lends itself to faster responses than a keypad or mouse, voice activation allows verbal responses i.e. exercises different brain areas.
      3. SOLUTION: compare brain training games on Nintendo DS to normal games on Nintendo DS in order to take these important issues into account.
    1. Further investigation into effects of brain training in 60+ year olds
      1. POTENTIAL FLAW: Brain training must have shown some promise in the elderly yet it’s reported negatively to fit into “BRAIN TRAINING DOESN’T WORK” headline
      2. REASONING: Usually studies inflate even weak results to justify the study. Here they seem to want the negative findings and hence the improvements in the elderly are downplayed until further investigation.
      3. BONUS: Clearly you CAN teach an old dog new tricks!
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  • Brain Teasers = Brain Training by Dr Jack Lewis

    Dr Jack Lewis is keen to get people motivated to get the best out of their brains, so has compiled a quick overview of brain training options:

    Brain teasers are good for you. Brain teasers include word games, number puzzles, spot the difference, Where’s Wally-type games, attention directing or splitting challenges, general knowledges quizes and so on. Brain training simply involves perfoming various different brain teasers on a regular basis. Your brain constantly adapts to serve you better. The more often you perform a certain mental function the more the brain will do to make changes so that the next time you do it, you can perform it slightly faster, with a greater degree of success and more efficiently.

    How do we know that practice increases the connections between different brain areas? Two brain imaging studies have demonstrated that when people practice a skill very hard for prolongued periods of time despite the fact that the changes happen at the ultramicroscopic level of the synapses where two brain cells meet the net effect of billions of these changes occuring over many months is that the grey matter gets larger in the part of the brain responsible for that function. The part of the brain that controls hand movements is significantly larger in professional string and keyboard musicians than non-musicians because of all the training they have done over the years to manipulate their instruments with split second precision. Another brain region, the hippocampus, creates and recalls memories particularly for geographical locations and is significantly larger in the brains of London Cabbies – who navigate around their city based on a sound KNOWLEDGE of every landmark, road and bridge – than in the brains of bus drivers – who simply drive the same route over and over again.

    The synapses connecting various different groups of brain cells together that are responsible for perfoming a certain task, say a crossword for instance, are strengthened each time to try to solve the puzzle in order that they can function slightly more efficiently next time round. If you do the crossword every day, then the net effect of many slight overnight adjustments to the brain areas involved in searching your memory for suitable words that have a certain meaning, a certain number of letters and specific letters in at certain positions within the word, become noticably better after just a few days. The same goes for number puzzles. Or games that involve prolonged concentration. Or the ability to recall trivia when it becomes relevant to conversation.

    We all know that practice makes perfect and the strengthening of connections between the relevant brain areas to enable more efficient communication between them is the reason why. Of course getting good at doing crosswords is not particularly useful in its own right, but the point is that once you become good at recalling suitable words for the sake of the crossword, you will also find it easier and quicker to bring the appropriate word to mind during conversation or when creating written documents – and that can be extremely useful.

    There are numerous websites that have compiled a large variety of different puzzles (http://www.brainbashers.com/puzzles.asp) and various others where you can try out electronic versions of classic physical puzzles like the Tower of Hanoi (http://www.mazeworks.com/hanoi/index.htm). However these all pale into comparison next to custom-designed brain training games such as those available at Lumosity (www.lumosity.com), which have not only the advantage of a much more aesthetically-pleasing look and feel of games that are genuinely fun and engaging to play, but also as you have to log in to play (they offer a free 30 day trial) you can keep track of how your performances improve over time.

    Nintendo DS were the first console manufacturer to produce and market games with the aim of improving brain function which all started with the release of Dr Kawashima’s Brain Training in 2005. This predominantly involes some quite predictable tasks like the Sudoku number puzzles, simple rapid-fire arithmetic, but also some unexpected treats like the Stroop Test (naming the colour of the font ignoring the meaning of the word which can be tricky when the word RED is written in blue font!) which take advantage of some pretty nifty voice processing software. I must admit I found myself thinking “can I really speak to this machine?”

    The effect of the advertising campaign that accompanied the release of this game was quite profound as it not only encouraged everyday consumers to purchase Nintendo’s products, but more importantly sent out the message that the brain is something that you can do something pro-active to improve; a concept that has been long-accepted to be the case in children but the mantra “you can’t teach an old dog new tricks” meant that this was rarely considered to be applicable in adults. Such a message is particularly enticing for people entering into old age, for whom the prospect of holding onto their marbles for as long as possible is extremely desirable and thus motivating. In this regard the key thing to remember is that, as far as the brain is concerned, it’s a simple matter of use it or lose it. Exercising brain areas involved in problem-solving by tackling word games, logical reasoning problems, memory challenges and number puzzles keeps such mental faculties in tip-top condition. If you don’t continue to use these mental abilities then they will fall into disrepair because the brain receives no indication that connections between appropriate areas should be maintained and reinforced. The upshot: it is never too late to improve your mental fitness. By emulating the lifestyles of individuals enjoying a healthy brain in their 80s and 90s, who have regular social interaction, cards games, read extensively, stay physically active and challenge themselves daily with various puzzles and quizes, the odds of being afflicted by Alzheimer’s disease are reduced by 25%.

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