Brain training has no effect on decision-making

August 21, 2017 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

 

Increased preference for immediate over delayed and for risky over certain rewards has been associated with unhealthy behavioural choices.

Motivated by evidence that enhanced cognitive control can shift choice behaviour away from immediate and risky rewards, we tested whether training executive cognitive function could influence choice behaviour and brain responses. In this randomized controlled trial, 128 young adults (71 male, 57 female) participated in 10 weeks of training with either a commercial web-based cognitive training program or web-based video games that do not specifically target executive function or adapt the level of difficulty throughout training.

Pre and post training, participants completed cognitive assessments and functional magnetic resonance imaging (fMRI) during performance of validated decision-making tasks: delay discounting (choices between smaller rewards now vs. larger rewards in the future) and risk sensitivity (choices between larger riskier rewards vs. smaller certain rewards). Contrary to our hypothesis, we found no evidence that cognitive training influences neural activity during decision-making, nor did we find effects of cognitive training on measures of delay discounting or risk sensitivity.

Participants in the commercial training condition improved with practice on the specific tasks they performed during training, but participants in both conditions showed similar improvement on standardized cognitive measures over time. Moreover, the degree of improvement was comparable to that observed in individuals who were reassessed without any training whatsoever. Commercial adaptive cognitive training appears to have no benefits in healthy young adults above those of standard video games for measures of brain activity, choice behaviour, or cognitive performance.

Significance statement

Engagement of neural regions and circuits important in executive cognitive function can bias behavioral choices away from immediate rewards. Activity in these regions may be enhanced through adaptive cognitive training. Commercial brain training programs claim to improve a broad range of mental processes; however, evidence for transfer beyond trained tasks is mixed. We undertook the first randomised controlled trial of the effects of commercial adaptive cognitive training  on neural activity and decision-making in young adults, compared to an active control (playing online video games). We found no evidence for relative benefits of cognitive training with respect to changes in decision-making behaviour or brain response, or for cognitive task performance beyond those specifically trained.

Reference:

Kable, J. et al., No Effect of Commercial Cognitive Training on Neural Activity During Decision-MakingJournal of Neuroscience, 2017. p. 2832-16.

Statins stimulate atherosclerosis and heart failure

November 30, 2016 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

statin

“In contrast to the current belief that cholesterol reduction with statins decreases atherosclerosis, we present a perspective that statins may be causative in coronary artery calcification and can function as mitochondrial toxins that impair muscle function in the heart and blood vessels through the depletion of coenzyme Q10 and ‘heme A’, and thereby ATP generation.

Statins inhibit the synthesis of vitamin K2, the cofactor for matrix Gla-protein activation, which in turn protects arteries from calcification. Statins inhibit the biosynthesis of selenium containing proteins, one of which is glutathione peroxidase serving to suppress peroxidative stress.

An impairment of selenoprotein biosynthesis may be a factor in congestive heart failure, reminiscent of the dilated cardiomyopathies seen with selenium deficiency. Thus, the epidemic of heart failure and atherosclerosis that plagues the modern world may paradoxically be aggravated by the pervasive use of statin drugs.

We propose that current statin treatment guidelines be critically reevaluated.”

Reference:

Okuyama, H., et al., Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Rev Clin Pharmacol, 2015. 8 (2): p. 189-99

Teenage pain often dismissed as growing pains

August 8, 2016 by · Leave a Comment
Filed under: Research, Spinewave Bulletin 

teenage child back hip neck chronic pain

A common belief is that pain in children will just go away or be forgotten when life takes over.

In the absence of an identifiable injury such as a sprain or fracture, childhood and adolescent pain is often disregarded – by doctors and parents alike.

The most common type of pain is spinal (back or neck), and many more adolescents complain of pain than is commonly recognised. Between one-third and half of all adolescents aged 13 and over report back pain about every month or even more often1. In fact, the prevalence of these conditions rises so sharply in early adolescence the rates approach adult levels by 18 years.

It’s becoming increasingly clear so-called non-specific “musculoskeletal conditions”, the leading causes of disability worldwide, are significant health issues in children.

Non-specific conditions mean that pain cannot be attributed to a defined and diagnosable anatomical cause. In adults, these conditions are recognised as complex disease states that have biological, psychological and socioenvironmental underpinning.

For a significant proportion of adolescents, non-specific pain has extensive impacts on health and quality of life. For example, in a study in Western Australia, about 20% of 17-year-olds reported either missing school, seeking health care, taking medication, interference with normal activities, or interference with physical/sporting activities due to back pain2. There is also evidence that persistent pain symptoms in adolescence predict chronic pain problems in adulthood3.

The blame for pain in kids is often directed at school bags, computer and small-screen device usage, posture, and/or other biomechanical targets. It is also sometimes believed (permanent) damage is being done to the spine, with lifelong consequences.

However, there is little evidence this is true.

Studies show socioeconomic, lifestyle, cognitive and psychological factors are just as strongly, or even more strongly, related to pain (particularly chronic pain) as physical factors4. These societal beliefs about “physical” causes of pain may be not only incorrect, but detrimental if they cause worry about the spine being fragile and discourage children from physical activity.

To date the complex interaction between painful events, the growing body, health influences, social or environmental influences from family, health care providers and schooling is not fully understood. In particular, very little is known about what brings on initial episodes of painful conditions and whether this underpins the link with future chronic pain.

Given wide recognition that early life events are critical in shaping health as people grow older, understanding the context of common painful conditions in early life is critical to inform future health.

It is important to provide effective treatment to those at risk of developing persistent pain. It is also important not to create medical problems out of transient aches and pains, i.e. not every child needs to be sent off for diagnostic imaging and intensive treatments. But a shift away from the narrow and outdated focus on school bags, posture and damaged spines as the only source of problems is a must.

Efforts to update the narrative around pain are as important for children as for adults.

References:

  1. Kamper, S.J., et al., Musculoskeletal pain in children and adolescents. Braz J Phys Ther. http://dx.doi.org/10.1590/bjpt-rbf.2014.0149
  2. Beales, D.J., et al., Low back pain in 17 year olds has substantial impact and represents an important public health disorder: a cross-sectional study. BMC Public Health, 2012. 5 (12): p. 100.
  3. Hestbaek, L., et al., The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine, 2006. 31(4): p. 468-72.
  4. Chambers, C.T., et al., The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain, 2011. 152(12): p. 2729-38.

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