Title: Innovative approaches to enhancing prefrontal functions: brain stimulation, neuroplasticity-based cognitive training and music.
Abstract
Cognitive, social and affective impairments associated with abnormal frontal cortical structure, function and connectivity lead to poor outcome across a wide range of neuropsychiatric conditions but pharmacotherapy has not been very effective in alleviating these deficits. In this talk, I evaluate the potential efficacy, utility and feasibility of non-pharmacological cognitive enhancement strategies that we have tested in neuropsychiatric conditions: schizophrenia, Parkinson’s disease, and brain cancer survivors.
First, we examined the effects of applying transcranial direct-current stimulation (tDCS) to the frontal cortex, and found improved error-monitoring and adaptive control behaviors in schizophrenia patients that were accompanied by normalized error-related negativity.
Second, we combined deep brain stimulation (DBS) with functional near-infrared spectroscopy (fNIRS) to observe the potential cortical and behavioral effects of DBS of the subthalamic nucleus (STN) in early stage of Parkinson’s disease. We found that frontal cortical activity increased during a working memory task with STN-DBS. However, there was no addition behavioral benefit above and beyond the dopaminergic medication in this group.
Third, we used a neuroplasticity-based brain fitness training to boost cognitive function in pediatric survivors of brain tumor and documented changes in frontal activity using fNIRS before and after training. Working memory and frontal cortical activity improved after 6-week brain fitness training.
Lastly, we demonstrate that the most effective, high-compliance and safe solution for improving cognitive, social and affective functioning in people with schizophrenia might lie in music. Music-making is a complex and multisensory, cognitive and social activity that promotes pro-social behavior and leads to brain reorganization. Hence, music-training is a readily available cognitive remediation strategy. Furthermore, singing (or speaking) inhibits auditory hallucinations that originate from inner-speech. We found beneficial effects of music training on working memory and social cognition across old and young participants.
In sum, these strategies provide excellent options for adjunct therapies in addition to traditional pharmacotherapy and suggest that there is a need for a more integrative and innovative treatment approaches to remediate and enhance human cognition at all levels of performance.