Technology for Improving Cognitive Performance

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NIH Scientific Program Areas in RD of Technology
for Improving Cognitive Functions

• Technology for Improving Cognitive Performance
• (ICDR) June 29, 2006, Washington, DC.
• Daofen Chen, Ph.D.
• Program Director, Systems and Cognitive
  Neuroscience (NINDS/NIH)
• Jeffrey W. Elias, Ph.D.
• Chief Cognitive Aging Program (NIA/NIH)

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Outline

• NINDS/NIA scientific program areas of common
  interests
• NIH funding initiatives in RD of neurotechnology
  and assessment tools in cognitive and behavioral
  studies
• Competence Technological Press (Dr. Elias)
• Neuroethical issues related to development and
  use of neurotechnologies

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NINDS/NIA scientific program areas of common
interests

• Neurological disorders
• Neurodegenerative diseases (Parkinsons or
  Alzheimers)
• Stroke
• TBI
• Sensorimotor integration and control
• Cognitive function and dysfunction
• Neuroprotection
• Rehabilitation (repair, and plasticity)
• ..

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The Public Health Crisis of Alzheimers

• Will claim one in 10 baby boomers
• Medicare currently pays 1/3 of all its
  health-care funds for 4.5 million Alzheimers
  patients (91 B in FY05, will double in 4 years)
• In next 5 years, 1/2 M new diagnosis annually,
  as 78 M baby boomers reach 65 (14 M cases
  projected in boomers lifetimes)
• We either will become one, or will care for one
  (or know one in extended family)
• Requires 19K/year in out-of-pocket costs for
  each caregiver family

Robert Essner, Wyeth Corp, Washington Post,
June 26, 06
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The Public Health Crisis of Alzheimers

• Currently 28 Alzheimers compounds in development
  (pharm industry)
• But, its still slow due to the complexity
• Inadequate resource in RD
• Efforts at Wyeth Corp
• A potent serotonin receptor antagonist to enhance
  cognition and QOL
• An antibody directed against beta-amyloid
• Call for designating the epidemic as a No.1
  research priority

Robert Essner, Wyeth Corp, Washington Post,
June 26, 06
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NIH PA Neurotechnology Research, Development,
And Enhancement (R01/R21)

• Informatics tools for analyzing, organizing,
  querying, integrating, sharing, or visualizing
  data about the brain or behavior
• Microfluidic systems for in vivo spatial and
  temporal controlled delivery of neurotransmitters
  and other biomolecules
• Proteome analysis arrays, proteome data storage
  and analysis of proteome data from the nervous
  system
• Genetic approaches to study structure or function
  of neural circuits in animal models
• Biosensors that would be selectively activated by
  neurochemicals, such as particular
  neurotransmitters or pharmacological compounds
• Delivery systems for exogenous agents such as
  drugs, gene transfer vectors, and cells
• Non-invasive methods for in vivo tracking of
  implanted cells
• Tools for real-time analysis of
  neurophysiological events
• Tools for data mining for genetic discovery and
  functional insights into genomics and proteomics
  of the nervous system
• Nanocrystals or quantum dots covalently bonded to
  neural receptor ligands
• Probes of brain gene expression that can be
  imaged non-invasively (e.g., with magnetic
  resonance or near infrared optical imaging)
• Genetic approaches to manipulate or monitor
  synaptic activity
• Microelectromechanical system (MEMS) devices used
  for monitoring neuron function in slice and
  culture preparations
• Amplifiers that are small and light enough to be
  worn by mice for recording neural activity from
  many neurons
• Tools, technologies and algorithms for
  neuroprosthesis development
• Tools to enhance visualization of specific brain
  markers
• New methods or agents to study neural
  connectivity in living or post mortem brain,
  especially human brain
• Improved electrodes, microcomputer interfaces,
  and microcircuitry for chronic implantation,
  monitoring of neural activity, and promoting
  efferent function
• Dynamic monitors of intracranial pressure and
  cerebral spinal fluid composition (particularly
  important in following disease progression or
  recovery from brain injury)

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NIH Neurotech PA program areas related to
technologies in cognitive and behavioral
neuroscience research (1)

• Informatics tools for analyzing, organizing,
  querying, integrating, sharing, or visualizing
  data about the brain or behavior
• Genetic approaches to study structure or function
  of neural circuits in animal models
• Tools for real-time analysis of
  neurophysiological events
• Amplifiers that are small and light enough to be
  worn by mice for recording neural activity from
  many neurons
• Tools, technologies and algorithms for
  neuroprosthesis development
• Tools to enhance visualization of specific brain
  markers
• New methods or agents to study neural
  connectivity in living or post mortem brain,
  especially human brain
• Improved electrodes, microcomputer interfaces,
  and microcircuitry for chronic implantation,
  monitoring of neural activity, and promoting
  efferent function
• Tools for relatively non-invasive ways to assess
  damage and monitor function in regions of injured
  or diseased brain tissue

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NIH Neurotech PA program areas related to
technologies in cognitive and behavioral
neuroscience research (2)

• Non-invasive optical imaging approaches
• Technologies for detection, intervention, and
  prevention of acute, adverse neurological events
• Biomarkers to indicate existence of, or change
  in, brain disorders
• Technologies to facilitate high-throughput
  analysis of behavior
• Tools for therapeutic electrical stimulation for
  rehabilitation following stroke, trauma or other
  events or disorders that disrupt normal function
  of the nervous system
• Telemetry devices small and light enough to be
  worn by mice for transmitting data (e.g.,
  electrophysiological data) during behavior
• Software to translate neuroimaging data from one
  data format into another
• Algorithms that use shape analysis approaches to
  understand human neuroimaging data
• Computational approaches to analyzing video data
  (like those used in behavioral research)

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Other related NIH program announcements and
activities related to RD in technologies for
cognitive and behavioral neuroscience research

• Development of PET and SPECT Ligands for Brain
  Imaging (SBIR/STTR)
• Novel Technologies for In Vivo Imaging
  (SBIR/STTR)
• Probes for Microimaging The Nervous System
  (SBIR/STTR)
• Basic and Translational Research in Emotion (R01)
   
• Methodology and Measurement in the Behavioral and
  Social Sciences (R01/R03/R21)  
• Research Partnerships for Improving Functional
  Outcomes  (R01/R21)
• ..

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Other related NIH program announcements and
activities related to RD in technologies for
cognitive and behavioral neuroscience research

• Neurorehabilitation
• Cognitive rehab after TBI and Stroke
• NIH Neural Prosthesis Working Group
• Cochlear implants
• BCI

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New funding initiative from NIH Neuroscience
Blueprint

• NIH Toolbox for Assessment of Neurological and
  Behavioral Function
• Request for Proposal (RFP) AG-260-06-01, issued
  by NIA
• NIH Blueprint, an intra-agency partnership to
  accelerate neuroscience research by increasing
  collaboration and information-sharing among 16
  ICs
• Contract mechanism to develop toolbox for
  providing tools of assessing cognitive,
  emotional, sensory and motor function
• Emphasis is on seeking innovative approach to
  outcome measures
• RFP 260-06-01 was made available electronically
  in March, 2006 and was due on May 15, 2006

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Issues Relative to Aging, Cognition, and
Technology

• Autonomy
• Trust
• Complexity
• Information Management
• Technological Press Cognition
• Executive Function

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Aging and Technology Use

• The motivation for much of the emphasis on the
  use of technology for older individuals is
  autonomy.

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Autonomy and Technology

• Lives are not lived in total autonomy even when
  we are at our most capable.
• We accept social influence and a pooling of
  knowledge and resources to obtain goals.
• Nevertheless, the technology and autonomy
  relation is being tested as never before.

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Autonomy and Technology

• Technology is most easily accepted when it
  promotes or maintains agency.
• Agency Actions to promote self-interest.
• Agency Promotes the obtaining of goals.
• Agency Flexibility of time as opposed to
  hostage to time and place.
• Agency Better time use not worse time use
• Agency more control rather than less control
• Agency better self regulation, not worse

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Too Much Information!
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(No Transcript)
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When does information become usable knowledge?
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Competence Technological Press
Dr. M. Powell Lawton - the most significant
thinker, researcher, and practitioner in
environment-behavior studies within the field of
gerontology. Physical Environments and Aging
Critical Contributions of M. Powell Lawton to
Theory and Practice Examines many aspects of
environmental gerontology



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Competence Technological Press
High
Positive affect and adaptive behavior
Marginal
Negative affect and maladaptive behavior
Marginal
Competence
ZONE OF MAXIMUM PERFORMANCE POTENTIAL
ZONE OF MAXIMUM COMFORT
Negative affect and maladaptive behavior
Low
Weak
Strong
Technological Press
(Adapted from Lawton Nahemow, 1973)
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• Environmental Docility Hypothesis
• The environment becomes a more potent
  determinant of behavioral outcome as
  personal competence decreases.
• Lawton and Simon, 1968
• Environmental Proactivity Hypothesis
• As personal competence increases, the variety
  of environmental resources that can be used in
  satisfaction of a persons needs increases.
• Lawton, 1989

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Factors Contributing to Cognitive Age Changes
1.) Sensory Decline
2.) Memory Decline
3.) Speed of Processing Decline
4.) Motor function Decline
5.) Mobility Decline
6.) Affective information processing focus
7.) Executive function decline
8.) Previous knowledge
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EXECUTIVE FUNCTIONS HAVEACTIVE PASSIVE
BEHAVIOR PATTERNS

• ACTIVE
• Environmental Dependency (e.g., frontal pull
  utilization behavior habit driven).
• Imitation Behavior (echolalia, echopraxia).
• Disinhibition (behavior habit driven
  impulsivity social awkwardness).
• Vulnerability to intrusions (distractibility
  tangentiality, childishness).

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EXECUTIVE FUNCTIONS HAVEACTIVE PASSIVE
BEHAVIOR PATTERNS

• PASSIVE
• Apathy (loss of initiative loss of spontaneity,
  lack of persistence, need for prompting).
• Behavioral stereotypy (motor/cognitive
  perseverations)

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SUMMARY OF ISSUES FOR EFFECTIVE IMPLEMENTATION OF
TECHNOLOGY

• COGNITIVE ABILITIES
• FAMILIARITY OF THE ENVIRONMENT IN WHICH THE
  TECHNOLOGY IS INTRODUCED
• ENVIRONMENT COGNITIVE INTERACTIONS
• ACCEPTANCE/USABILITY
• COST/BENEFITS USER (PRIVACY-EFFORT-TIME)

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ISSUES FOR EFFECTIVE IMPLEMENTATION OF TECHNOLOGY

• COST-BENEFITS - MARKET
• TYPE OF TECHNOLOGY
• FAMILIARITY WITH TECHNOLOGY
• ACTIVE OR PASSIVE INTERACTION WITH TECHNOLOGY

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Think Low Tech Prior to Implementation of High
Tech

• ACCESSIBILITY Is device reasonably accessible
  and manipulated is dexterity, strength, or pain
  an issue?
• VISION Can controls be seen and are visual
  errors of operation anticipated in design?
• AUDITION Is audition a considered component of
  usability and has reduced usability with
  background noise and poor hearing been
  anticipated?

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Think! Low Tech Prior to Implementation of High
Tech
Common visual and auditory communication and
technology use concerns with aging include

• Poor usability with background noise
• Poor usability when there are competing
  information sources
• Too many auditory signals of the same nature for
  different devices
• Poor usability in low contrast visual
  environments
• Poor usability when there is visual glare

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TECHOLOGICAL PRESS VS TECHNOLOGICAL ADAPTATION
GOAL  FIND THE RIGHT BALANCE     CAUTION  ONE
SIZE WONT FIT ALL
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Think! Fit to the Individual and the Environment
Acceptability The degree that the perceived
benefit exceeds the perceived cost of use

• Takes too much time relative to perceived benefit
• Cost in seen as too high relative to benefit
• Cost in aggravation and irritation exceeds
  perceived benefit
• Intermittent effectiveness cost seen as too high
  relative to effort and frustration
• Cost to self-concept doesnt exceed perceived
  benefit

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Research on brain cognitive function and the RD
of new integrative technologies and education

• The Coevolution of Human Potential and
  Converging Technologies
• Summary of a NSF-DOC workshop held in 2003
• Annals of the New York Academy of Sciences
• May 2004 - Vol. 1013 Page vii-258

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Neuroethical issues pertaining to developments in
cognitive neuroscience and applications of the
new forms of knowledge and technologies

• What new forms of law will be necessary to cope
  with rapid advances in cognitive intervention and
  monitoring?
• What common concepts will require re-evaluation
  based on new models in our understanding of the
  brain and its functional properties?
• How will these emerging technologies, with an
  enhanced capacity to monitor and control
  cognitive function, be restricted or applied?
• How will the law cope with discoveries and
  revelations from brain science that call for a
  revision of some of its most basic core
  assumptions of human autonomy and freedom?

Sententia, 2004