His “Crazy” Vision Invented Digital Therapeutics to Help Brains in Ways Drugs and Surgeons Can’t
By Jeff Zimman
Today, it was announced that Dr. Michael Merzenich is a recipient of the Merkin Prize, awarded to innovators of breakthroughs that have demonstrably improved human health. I’ve worked with Mike since 1996, and I can affirm the prize was long deserved for the group of scientists who invented the cochlear implant, which, 40 years later, has restored hearing to more than a million people). As well-deserved as the honor is for each of the recipients, in Mike’s case, the prize is for so much less than what his work on the project ultimately achieved: revolutionizing neuroscience and creating both the field of plasticity-based brain exercises, and a hot new field, called “Digital Therapeutics.”
Starting in the 1970s, Mike stirred a decades-long controversy in neuroscience by publishing studies showing that an adult brain is “plastic” (capable of chemical, physical, and functional change) at any age. At that time, brain scientists believed the brain was only plastic in childhood, when new neural pathways were continuously created, based on childhood learning. Most believed that by early adulthood the brain was no longer capable of that kind of physical change. While you could learn new information, the prevailing theory was that the brain’s “operating system” had become “hardwired” by early adulthood and was destined to wear out with advancing age (leading to cognitive aging and dementia).
Mike argued most of that prevailing theory was wrong — that plasticity existed throughout life and that the brain was constantly changing based on life experience, in both positive and negative ways. This is now the dominant view, and the cochlear implant was both important for addressing deafness and, ultimately, for contributing an inarguable “proof point” that plasticity is lifelong and can be harnessed for human benefit.
As inarguable as that proof point may seem in retrospect, for the generations of “brain experts” schooled when it was agreed plasticity ended with adulthood, the argument raged on with a fierceness that only the privileges of entrenched academia can sustain.
Mike has continued to lead the global effort to recognize lifelong plasticity and its potential for human benefit, but he also had a clear vision that could credibly be called “fantastical” until recently: that digital coding could be a new kind of medicine to address intractable brain ailments (neurodegenerative diseases, brain injuries, mental illnesses) and that could fix things that neither drugs nor surgeons could repair.
In the 1990s, his lab made a major shift from the cochlear implant research. Mike said he no longer needed to drill holes in heads to harness plasticity and preferred to “use the holes God gave us” – meaning our eyes and ears. He began developing auditory and visual brain exercises, building software designed to individualize quickly to each user, to progressively challenge brains to be faster and more accurate, and to engage plasticity to lay new neural pathways to improve cognitive function. He directed his team to build the exercises to stimulate and revitalize the brain’s neurochemical systems, by making them attentionally-demanding (to pump acetylcholine, the “pay attention” chemical), filled with novelty (to pump noradrenaline, the “novelty chemical”) and laden with rewards (to pump dopamine, the “reward” chemical).
When Mike described all this to me in 1995, I was a Silicon Valley lawyer helping entrepreneurs create companies. The day we met, I was more than a little skeptical – I thought it was a “wacky” idea that software coding could become medicine. But I was used to meeting with innovators, who were a lot smarter than me, so I asked where we were in this journey. In response, Mike mentioned that a study had just been accepted for publication showing the approach helped children diagnosed with language learning impairments. That allowed me to wonder how I could help this remarkable man with this preposterously ambitious vision.
By continuously pushing the brain to reach beyond its grasp, and by upregulating brain chemical production, Mike and a global team of more than a thousand scientists have harnessed plasticity to improve cognitive performance and address a host of human ailments, including cognitive aging, brain injuries, neurodegenerative diseases, and mental health challenges.
When I met Mike, he was a research scientist and professor at University of California San Francisco, where he influenced thousands of neuroscientists and medical students across five decades. In 2012, he invited me to his UCSF retirement dinner, where hundreds of his students honored him with two words: “More. Faster.”
Those words were his mantra throughout his research and teaching career. They also led to two sabbaticals, in which he set up corporations, believing they could advance the science faster than in an academic setting. In 1996, he co-founded Scientific Learning Corporation, which developed Fast ForWord, an auditory training program to help with language learning impairments and with general reading. In 2003, he started Posit Science Corporation, where he persuaded me to be his co-founder, and he still leads the science team in expanding into other applications for human benefit. Posit Science’s initial focus was on cognitive aging, and it developed the BrainHQ app of brain exercises and assessments.
As BrainHQ’s research and development progressed, it expanded into addressing brain injuries, mental health, and neurodegenerative diseases. Dr. Merzenich credits football legend Tom Brady with teaching him that the same exercises designed to help those with cognitive deficits, could also help someone with a great brain perform even better. What began as secret work to help Brady win his final four Super Bowl rings has expanded to training for elite athletes, the military, special forces, SWAT teams, NASA, and others focused on peak brain performance.
BrainHQ has shown benefits in more than 300 studies, including gains in cognition (attention, speed, memory, decision-making), in quality of life (depressive symptoms, confidence and control, health-related quality of life) and in real-world activities (health outcomes, balance, driving, workplace activities). BrainHQ is used by leading health plans, medical centers, clinics, and communities, and by elite athletes, the military, and other organizations focused on peak performance. You can try a BrainHQ exercise for free daily at https://www.brainhq.com, and if you buy a subscription, you can rest assured that a portion of the receipts will go to further research, because Mike, now in his 80s, still is pushing to create breakthroughs: “more, faster.
