This April the US Patent Office issued a new patent to Posit Science for inventions utilizing brain training software to address depression, mood and anxiety disorders. Its solution, BrainHQ, offers 29 different mental exercises aimed to target specific areas like memory, people skills and intelligence. The press release stated it “is believed to be the first patent of its kind”.
Therapies like this this are likely to become more significant over the coming years as mental health gradually gains more public attention and new forms of ‘digital therapy’ slowly get more recognition. We speak to Dr Henry Mahncke, CEO of Posit Science, to learn more. The lightly edited Q&A can be found below.
Can you explain how brain training works?
Effective brain training programs harness the brain’s plasticity – the brain’s ability to change chemically, structurally and functionally – to target root causes of neurological problems, such as mood disorders or cognitive impairment. These plasticity-based brain training programs are different from brain games, which just give the brain something to do, but don’t necessarily change the brain in a helpful direction. An effective program aimed at cognitive enhancement might improve the speed and accuracy of information processing in the brain, allowing information to be encoded more accurately and reliably, and as a result, improving memory. An effective program aimed at depression might engage attention and reward neuro-modulatory pathways in the brain on specific schedules to improve their strength. And of course, a key aspect to an effective program is that it is objectively evaluated in a randomized controlled trial.
For example, the NIH-funded, 2800-person, ACTIVE Study evaluated brain training that is now part of BrainHQ from Posit Science, and showed that 10 hours of this specific kind of brain training, on average, reduced the risk of onset of depressive symptoms by 38%, reduced the risk of deepening of depressive symptoms by 30%, and improved feelings of control by 68%. Other studies of BrainHQ exercises have shown additional positive results. We are encouraged by these kinds of results. As the science advances, we plan to engage with appropriate regulatory agencies to explore the shortest path to getting a form of relevant exercises into the hands of patients who may be helped.
Is this similar to the growing use of computer games to treat depression?
There is definitely an increasing interest in using all kinds of digital tools to treat depression, ranging from computerized cognitive behavioral training, to ordinary computer games, to specialized brain training tools. This reflects a growing awareness that the brain is capable of changing itself – talk therapy for depression itself causes brain change! Over time, we expect to see clinical trials that help doctors and patients understand which type of tool is most effective for which kinds of patients, and in which types of situations – not every type of treatment is going to help every person with depression. This deeper understanding of the science will lead to new ways to help people who need it, because their drug therapies aren’t working, or because they want to choose an effective treatment option that isn’t a drug.
There are a number of organizations working in this field – how come yours is the only one to receive a patent?
Our science is very innovative and very good.
‘Software as a therapy’ is gradually getting more recognition in mental health. How close are we to mainstream acceptance?
Forward-thinking practitioners are beginning to use software as therapy under appropriate supervision by a healthcare professional. For example, thanks to the work of Dr. Alice Medalia at Columbia University, the New York Office of Mental Health now offers brain training through community-based mental health centres. But, we still have a way to go – professional societies should review the published data and define guidelines and clinical best practices, and health care payers need to respond to the data and cover the cost of these treatments. Right now, it’s easier for a doctor to get paid to supervise drug therapy than to supervise brain training, and that doesn’t make sense.
Are you using the data collected in BrainHQ to gain greater insights into different complaints?
Absolutely. BrainHQ is currently being used in all kinds of situations. One of the most surprising to me is when Tom Brady of the New England Patriots called us to tell us he was using BrainHQ to sharpen his already very good visual speed and attention! On the other end of the spectrum, BrainHQ is being used in dozens of active clinical trials in a wide array of conditions, including prevention of Alzheimer’s disease, recovery from brain injury, and treatment of cognitive impairment in many conditions (such as, multiple sclerosis and chemobrain). What we’re learning as scientists is that the right kind of brain training can improve brain function in just about anyone – it can help people at the top of their game get even sharper, and it can help people who want to recover some abilities they’ve lost.
There has been a rise in clinically peer-reviewed apps and solutions for mental health. Who else do you think it doing interesting work in this arena?
There’s an incredible project going on at UCSF led by Dr. Eddie Chang and funded by DARPA, where they have the ability to make direct electrical recordings from participant’s brains, because that’s required for epilepsy treatment. We’re working with that team to integrate real-time brain activity with brain training to see if we can make brain training even more responsive and effective. Being able to watch real brain activity, and see a brain training program respond to it in real time is amazing! In the future, this technology could lead to the integration of consumer-friendly brainwave recording devices and brain training.
There are a lot of apps out there, and a lot look interesting. But no app has yet been cleared by the FDA as a medical device indicated for the treatment of a clinical disorder. That will represent a breakthrough in treatment options.
How do you think mental healthcare will be different in 10 years’ time?
Within 10 years, we’re going to see the integration of real-time, real-world assessments of mental health into everyday life, and we’re going to see physicians and health care systems actively monitoring and treating mental health with a device everyone carries in their pocket – their phone. People will casually comment on how they’re doing, and those who are at risk for a mental health issue will have the opportunity to check-in frequently using their mobile devices to help them track their health, identify things in the real world that are affecting their mental health, and use appropriate exercises to strengthen their brain function and make them more resilient. We’ll see mental health move from a model in which treatment occurs after a mental health catastrophe to a preventative model, where we keep brains healthy and avoid catastrophic events. And, most of this will be led by smartphone developers and AI specialists, and not by drug companies.
In the wider ‘medical tech’ sphere what do you think the most interesting trends at the moment are?
I’m looking forward to the end of the talk about a trend toward “digital medicine,” and the realisation that the digital revolution can have a positive impact on nearly every aspect of healthcare, as it has had on other industries, No one talks about digital banking anymore – there’s just banking, and of course you do it on your phone. That needs to happen to medicine as well – and we’re starting to get there.
Is there anything else you’d like to share?
One of the scientists here at Posit Science just ran the Boston Marathon last weekend! That’s an amazing achievement, and it reminds me that wherever we are physically or mentally, we can aspire to – and achieve – even better performance.