Brain-boosting supplements, puzzle games, or good ol’ exercise and a nice book— Which of these can help us to optimize how well we focus, solve problems, and remember information? Here, we examine the evidence and discuss the best ways to boost your brain.

Nootropics: Do they work?

A nootropic drug is a substance that’s taken to enhance how the brain functions. Proponents of nootropics claim that they enhance cognitive efficiency, focus, and memory. Unlike a prescription drug that would have the same effect, such as Ritalin or Adderall, fans of nootropics are attracted to claims that nootropics are nonhabit- forming and aren’t stimulants. Nootropics emerged onto the market in the 1970s and are still being researched for their safety and efficacy. Many nootropic products that can be purchased online are not approved by the United States Food and Drug Administration (FDA) because the FDA does not evaluate dietary supplements for approval. The exact ways in which some of these drugs enhance brain function is still unclear, but there is some existing evidence of their benefit.

The first nootropic drug put on the market was piracetam in 1971. Research on piracetam has shown it to have diverse physiological effects, which researchers theorize is due to its ability to restore fluidity to cell membranes. Theoretically, in restoring fluidity to the cell membrane, piracetam optimizes the performance of our cells. Additional studies have shown that piracetam influences membrane fluidity specifically when normal fluidity is compromised. This decrease in cell membrane fluidity is often seen during aging, which suggests that piracetam might provide benefits for us as we advance in age. Studies conducted on aged human brains support the existence of this restorative effect, and a separate study including patients with Alzheimer’s disease showed increased fluidity in the hippocampal cell membranes. It is speculated that this increased membrane fluidity can aid in neurotransmission, neuroplasticity, and neuroprotection.1  

In one study, patients with age- associated memory impairment were given a high dose of piracetam, a moderate dose, or a placebo, and were enrolled in memory training to observe the effects, if any, that piracetam would have on memory. The patients receiving the highest dose of piracetam saw the greatest improvement in their scores, and the patients on the moderate dose saw greater improvements in their scores than the placebo  group.2 Further, studies have shown that piracetam has the potential to prevent  cognitive deterioration. In one such study, patients with early Alzheimer’s  disease were given either piracetam or a placebo and were assessed using 14 different cognitive tests. After one year, no improvement occurred in either group, but patients taking piracetam deteriorated on only one of the 14 tests, while patients taking the placebo deteriorated on nine out of the 14.3

Many other studies exist on an extensive list of nootropics, but many of these studies haven’t been conducted directly on humans or are too small to establish steadfast evidence of efficacy. Many of these studies conclude by calling for more extensive research, not only on their potential benefits but also their adverse effects, as many nootropics come with a variety of reported side effects.4

While the concept of cognition-enhancing drugs for healthy individuals is an exciting development to monitor for the future, it’s clear that much more research needs to be conducted on nootropics before they can be widely and safely recommended. However, there are several science-backed ways that healthy adults can improve their cognitive performance without these supplements.

EFFECTS OF EXERCISE ON NEUROPLASTICITY

A review of studies, written in 2011, discussed the benefits exercise can have on cognition in healthy adults. According to the review, convergent evidence from studies conducted on both humans and animals shows that physical activity facilitates neuroplasticity, or the brain’s ability to form and reorganize synaptic connections. This enhanced neuroplasticity can improve cognitive functions such as focus and memory. The review noted that for these cognitive benefits to be sustained over a long period of time, the increase in cardiovascular fitness achieved from physical exercise must be maintained through consistent, habitual exercise.5

WHICH TYPE OF EXERCISE IS BEST FOR THE BRAIN?

 A post from the New York Times (NYT) online wellness blog discussed which exercise, including steady aerobic, strength training, and high-intensity interval training (HIIT, was most beneficial for the brain.6 The NYT wellness blogger cited a study published in the Journal of Physiology, which was conducted on rats. The study compared the brain cell genesis of three groups of rats: those who completed steady aerobic exercise, rats who completed strength training exercises, and rats who completed HIIT. The results of the study showed that rats participating in long- distance, steady-state aerobic exercise showed the highest rate of hippocampal neurogenesis among all three groups. The longer those rats ran on their wheel, the higher the rate of hippocampal neurogenesis. Coming in second was the HIIT group, and coming in last, with no discernible effect on hippocampal neurogenesis, were the beefy, strength training rats. These results don’t mean you have to stop lifting weights if you aspire to peak brain health, as there are other studies that have published in the British Journal of Sports Medicine determined that a combination of aerobic and resistance exercises was effective in enhancing brain health for adults over the age of 50, regardless of current state of brain health. The authors of the study included several types of exercises in their analysis of current research, including yoga and tai chi. This review determined that aerobic exercise significantly improves thinking and reasoning, while resistance training has a notable effect on the brain’s ability to plan, organize, and remember information. Regarding time, frequency, and intensity of these brain-boosting workouts, the authors’ analysis showed that sessions of moderate to vigorous intensity, lasting 45 to 60 minutes, are great for maintaining brain health.7

TRAIN YOUR BRAIN WITH PUZZLES AND GAMES

Dual n-back brain training.

A recently published study conducted at Johns Hopkins University tested two brain-training methods that scientists routinely utilize in research settings in order to determine which of these tests was more effective. With brain- training programs released in recent years, such as the popular Luminosity programs, researchers and the public have questioned whether these programs are worth the time and money. The Johns Hopkins study determined that the “dual n-back” exercise improved participants’ working memory by 30 percent. The dual n-back group also showed significant changes in brain activity in the prefrontal cortex, the critical region responsible for higher learning. The dual n-back is a memory sequence test in which people must remember a constantly updated sequence of visual and auditory stimuli. The Johns Hopkins study participants saw squares flashing on a grid while hearing letters. They had to remember if the square they just saw and the letter they heard were both the same as the one previously displayed. As the test got harder, they had to recall squares and letters two, three, and four rounds back.8

Here are some websites that have attempted to replicate this test for free (and do a pretty good job):

• brainscale.net
• dual-n-back.com
• soakyourhead.com.

Puzzle games can improve mental flexibility, study shows. Have you ever heard of the popular video game Cut the Rope? If you haven’t, it’s a fun game for all ages that can be downloaded onto your phone through your phone’s application store. Cut the Rope is a complex puzzle game, with the objective being to get a piece of candy into the mouth of a little cartoon monster. The candy is attached to a series of ropes, and players must cut these ropes in a strategic manner in order to swing the piece of candy around obstacles and into the monster’s mouth. During the study, conducted at Nanyang Technological University and published in the journal Computers in Human Behavior in 2014, students played either Cut the Rope or another designated game for one hour a day for four weeks. Upon completion, cognitive tests showed that players of Cut the Rope saw improvement in mental flexibility and ability to adapt and focus. Participants selected to play games other than Cut the Rope did not see these same effects.

BOOKS ON THE BRAIN: READING FOR ENHANCED COGNITIVE PERFORMANCE

A study from 2013 published in the Journal of the American Academy of Neurology suggests that sustaining a habit of reading throughout one’s life can significantly decrease mental decline in old age. For this study, 294 elderly people were given thinking and memory tests every year for six years. In addition, the participants completed surveys that determined how often they participated in mentally stimulating activities, such as reading and writing, throughout their lives and in the present day. After participants died, their brains were examined for evidence of the physical signs of dementia, such as lesions, brain plaques, and tangles. The study found that the rate of decline was reduced by 32 percent in people with frequent mental activity in late life, compared to average mental activity, while the rate of decline of those with infrequent activity was 48-percent faster than those with average activity. This is great news for everyone reading this issue. Keep it up! It’s good for your brain.

REFERENCES

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2. Israel L, Melac M, Milinkevitch D, Dubos G. Drug therapy and memory training programs: A double-blind randomized trial of general practice patients with age-associated memory impairment. Int Psychogeriatr. 1994;6:155–170.
3. Croisile B, Trillet M, Fondarai J, Laurent B, Mauguière F, Billardon M. Long-term and high-dose piracetam treatment of Alzheimer’s disease. Neurology. 1993;43:301–305.
4. MacLellan L. The science behind the 15 most common smart drugs. Sept 20, 2017. Quartz. https://qz.com/1064224/the- science-behind-the-15-most-common-smart-drugs/. Accessed Dec 12, 2017.
5. Hötting K, Röder B. Beneficial effects of physical exercise on neuroplasticity and cognition. Neurosci Biobehav Rev. 2013 Nov;37(9 Pt B):2243–57.
6. Reynolds G. Which Type of Exercise Is Best for the Brain? Feb 2016. The New York Times website. https://well.blogs.nytimes. com/2016/02/17/which-type-of-exercise-is-best-for-the-brain/. Accessed Dec 12, 20-17.
7. Hsu CL, et al. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med. 2017; Epub ahead of print.
8. Blacker KJ, et al. N-back versus complex span working memory training. Journal of Cognitive Enhancement. 2017;1(4):434–454.
9. Wilson RD, et al. Life-span cognitive activity, neuropathologic burden, and cognitive aging. Neurology. 2013;81(4).
10. Oei AC, Patterson MD. Playing a puzzle video game with changing requirements improves executive functions. Computers in Human Behavior. 2014;37:216–228.