futurist perspective

7/31/2019 Futurist Perspective

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Futurist Perspectiveon the Implications

o ec no ogy orBehavioral Health &Social Services

David Whitehouse MDCMO Strate and Innovation

The 2009 Institute for Behavioral HealthInformatics:

Confidential property of OptumHealth. Do not distribute or reproduce without express permission of OptumHealth.

Optum Behavioral Solutions The Future of Technology in Behavioral

Health


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Medical andPharmaceutical

24% ($116.2M)

Indirect Medical CostsImpaired

Productivity

63% ($311.8m)Long-Term Disability

1% ($6M)

Absenteeism6% ($27M)

Short-Term Disability6% ($27M)


1

Copyright 2004 Harvard Business School Publishing Corporation. All rights reserved.Source: Bank One. Figures based on 2000 annual data. Workers compensation accounted for < 1% of indirect medical costs.


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increase in overall sickness absence, particularly frequentshort periods of absence; poor health (depression, stress, burnout); physical conditions (high blood pressure, heart disease,

-, , , ,and backache, low resistance to infections).

Work performance reduction in productivity and output; increase in error rates; increased amount of accidents; poor decision-making; deterioration in planning and control of work.

Staff attitude and behavior

loss of motivation and commitment burnout staff working increasingly long hours but for diminishingreturns poor timekeeping labor turnover (particularly expensive for companies attop levels of management).

tension and conflicts between colleagues; poor relationships with clients; increase in disciplinary problems.


2


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Work-related suicide

Overwork-related deaths, including suicides - karojisatsu areofficially recognised and compensated in Japan. Figuresreleased in May 2007 showed of the record 205 individuals inJapan qualifying for workers' compensation insurance payouts

in the 2006 fiscal year, 65 involved death by suicide and oneinvolved an attempted suicide, according to the Ministry of

Anthony McDermott, factory worker, 50Suicide verdict on bullied factory worker,Hazards news 11 Februar 2006

Health, Labour and Welfare. This was up from 42 work-relatedsuicides the previous year.

Wayne Williams, engineer, 28Suicide note blamed work pressure, Hazards news, 24 June 2006An en ineer who killed himself wrote in a suicide note sa in 'the ressure of

,

A father of four killed himself after beingbullied by his managers for two years, aninquest has heard. Anthony McDermott, 50,left a letter explaining his factory floorordeal before hanging himself. He workedfor the same firm for 14 years but the


3

work has turned my mind into a ticking time bomb,' Wayne Williams hangedhimself after a party to mark the end of a year-long contract in Singapore.

hearing was told that at the end he found abullying campaign soul destroying anddemeaning.


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Co-Morbidity

% Co-Morbidity Increase in

Co-Morbidity with Medical Member Medical Cost

with Depression Medical Costs

Heart Disease

Cancer

35% 163%

30% 100%$4,000

$6,000

$8,000

,

$4,258

$2,977

$8,103

Cost ~ 5,000 More

Asthma

Diabetes

Hypertension

40% 183%

25% 109%

22% 103% TotalPo ulation

Non- Depressed

$0

$2,000

Stroke

Arthritis

35% 100%

25% 183%Average 28%Co-Morbidity

22% of Americans have some form

of diagnosable mental disorder

9.5% of the population is affected bydepression in any given year

Sources: Census Bureau Current Population Survey, CMS,


4

treated according to minimum standards

Kaiser Family Foundation, EBRICDC; Milliman; U.S. Dept. of Health & Human Services,SAMHSA; ChapterHouse,


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Brain differences associated with depression

Area 25 altered metabolism and 39% (bipolar)

Mental disorders as brain disorders

,

Cg25

Brain Resource l enabl ing opt imal so lu t ions for bra in heal th l www .bra inresource.com

Drevets et al., Nature, 1997Brain Resource l enabl ing opt imal so lu t ions for bra in heal th l www .bra inresource.com

Progressive Brain Structural Changes Mapped as

Psychosis Develops in At Risk Individuals

200520062007 first quarter2007 second quarter2007 third quarter2007 fourth quarterFebruary 2008


5

Brain Resource l enabling opt imal solut ions for brain health l www.brainresource.com

Sun et al, Schiz Res., 2008Brain Resource l enabling opt imal solut ions for brain health l www. b r a in r e s o u r c e . c o m

Manolio, Brooks, Collins, in press.


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Looking Beyond ECT, Meds or Therapy

St. Jude Medical AcquiresNorthstar NeuroscienceAssets for $2 Million

TMS

CSS

On June 8, 2009, St. JudeMedical, Inc., acquiredNorthstar Neuroscience,Inc.s intellectual propertyportfolio, clinical study data,device designs, and

Northstars Renova Cortical Stimulation System*Medical College of Wisconsin, MilwaukeeI

manu ac ur ng equ pmenfor $2 million. Northstarfocused on developingcortical stimulationtherapies for the treatmentof major depressivedisorder stroke and other


6

6

University of Pittsburgh, Pittsburgh

Massachusetts General Hospital, Boston

, ,neurological disorders..


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STAR*D

Largest U.S. study of Major Depression 3,671 patients over one year.

No medication better than another.

= , . ,

More than one med = more likely to relapse

Rush, J. American Journal of Psychiatry. 2006; 163:1905-17.

STAR*D Clinical Study ResultsRelapse Rates (QIDS-SR )16 >_11

Level1 Level2

(1 Failure)

Level3

(2 Failures)

Level4

(3 Failures)

Level1 Level2

(1 Failure)

Level3

(2 Failures)

Level4

(3 Failures)1-9 Weeks 8-10 Weeks 14 Weeks


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Methods and FindingsWe obtained data on all clinical trials submitted to the US Food and Drug Administration (FDA)for the licensing of the four new-generation antidepressants for which full datasets were

-.initial severity on improvement scores for drug and placebo groups and on drugplacebodifference scores. Drugplacebo differences increased as a function of initial severity, risingfrom virtually no difference at moderate levels of initial depression to a relatively smalldifference for patients with very severe depression, reaching conventional criteria for clinicalsignificance only for patients at the upper end of the very severely depressed category. Meta-regression analyses indicated that the relation of baseline severity and improvement wascurvilinear in drug groups and showed a strong, negative linear component in placebo groups.

Conclusions

severity, but are relatively small even for severely depressed patients. The relationshipbetween initial severity and antidepressant efficacy is attributable to decreasedresponsiveness to placebo among very severely depressed patients, rather than toincreased responsiveness to medication.


8


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WIRED MAGAZINE: 17.09Med-Tech : Drugs

RX FOR SUCCESSWhat turns a dummy pill into a catalyst for relieving pain, anxiety,

depression, sexual dysfunction, or the tremors of Parkinson's disease? The

Placebos Ar e Ge t t in g

Mo r e Effect ive .

D r u gm a k e r s Ar e

brain's own healing mechanisms, unleashed by the belief that a phonymedication is the real thing. The most important ingredient in any placebois the doctor's bedside manner, but according to research, the color of atablet can boost the effectiveness even of genuine medsor help convince apatient that a placebo is a potent remedy.Steve Silberm an

Yellow p ills

D e sp e r a t e to Kn o w W h y.By Steve Silberman

Red pi l ls

can give you a more stimulating kick. Wake up, Neo.

make the most effective antidepressants, like littledoses of pharmaceutical sunshine.

e a e sparticularly those labeled "antacid"are superior forsoothing ulcers, even when they contain nothing butlactose.

The co lo r g r een

M o r e i s b e t t e r ,

scientists say. Placebos taken four times a day delivergreater relief than those taken twice daily.

re uces anx e y, a ng more c o e p .

B r a n d i n g m a t t e r s .

Placebos stamped or packaged with widely recognizedtrademarks are more effective than "generic" placebos.

Cl eve r na m es


9

can add a placebo boost to the physiological punch in realdrugs. Viagra implies both vitality and an unstoppableNiagara of sexy.


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CATIE Stud of Anti-Ps choticsLargest and longest study of its kind

Over 1,400 patients with schizophrenia

18 months: Tolerability and Efficacy

Efficacy and Tolerability: poor

CATIE Study Phase 1:74% stopped meds for anyTime to Discontinuation for Any Cause

Olanzapine (N=330) Risperidone (N=333)

Ziprasidone (N=183)

Quetiapine (N=329)Perphenazine (N=257)

0.9

1.0

tients

men

t

reasonSubstantial side effects: 64%

to 70%.

0.7

0.6

0.4

0.3

0.5

ProportionofPa

ContinuingTreaRegular Antipsychotics fared as

well as Atypicals

18Lieberman JA et al. N Engl J Med. 2005;353:1209-1223.

0.1

.

0.00 3 6 9 12 15 18

Time to Discontinuation for Any Cause (months)

Stroup, T and McEvoy, J. AmericanJournal of Psychiatry2006, 163: 600-622


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The Current situation


11


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Many Treatments Ineffective for Many


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Pharmacogenetics

The death of nine-year-old MichaelAdams-Conroy didn't seem at first likea si nal event in medicine. It seemed

or une agaz ne c o er ,

like homicide.

While recuperating from whatseemed to be flu, Michael went into a

.His grieving parents, Jayne and Neil,soon got another shock: an autopsyshowed a massive overdose of Prozac

in Michael's blood and tissues, raisingthe specter of a murder chargeagainst them

- '

CYP2D6 gene deletion occurs in 6% ofCaucasians and CYP2D6 gene duplicationoccurs in 30% of East AfricansCYP2D6 metabolizes a broad array of

painful pilgrimage to a medical frontier

known as pharmacogenetics, thestudy of how genetic idiosyncrasies

drugs, from cough suppressants toantidepressantsIn Michaels case CYP2D6 gene deletioncaused fluoxetine to build up in his body


13

influence responses to drugs to a level exceeding any previouslyreported in cases of Prozac overdose


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Differences in Metabolism

Schizophrenia: Abilify

ADD: Atomoxetine


14


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The truth is.

healthcare professionals to deliver patient carewi h h ffi n i n n f h

the full range of current knowledge couldsupport.


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Personalized Medicine Why do we need it?

Successful When it Leads to Innovation

Old Paradigm: Trial and Error Medicine

an mproves an ar o are.

Fails When We Settle for Trial andError Medicine as theStandard of

Care.

STAR-D

Largest U.S. study of Major Depression 3,671.

No medication better than another.

37% remission after 1 trial, 67% after 4.(Massive dropout rates = 21, 30 and

More than one med = more likely to relapse

Rush, J. American Journal of Psychiatry. 2006; 163:1905-17.


16


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The future is nowC H A P T E R 2Neuroscience Research Agendato Guide Development of aPathophysiologically Based

eurosc encebrings a newri or and

Dennis S. Charney, M.D., David H. Barlow, Ph.D.,Kelly Botteron, M.D., Jonathan D. Cohen, M.D.,David Goldman, M.D., Raquel E. Gur, M.D., Ph.D.,Keh-Min Lin M.D. M.P.H. Juan F. L ez M.D.

insight intoMH

James H. Meador-Woodruff, M.D., Steven O. Moldin,Ph.D., Eric J. Nestler, M.D., Ph.D., Stanley J.Watson, M.D., Ph.D., Steven J. Zalcman, M.D.

.perhaps the greatest promise for the field lies in the combined use of the variousmethods. There are a variety of benefits that can be gained by the integrated useof different modalities, many of which are beginning to be explored.

,identifying intermediate phenotypes related to the patients genotype and behavioralphenotype. The neurobiological phenotype may be discerned by neuroimaging,

cognitive evaluation, and neurophysiological testing. The neurobiological phenotype


17

monitoring the neurobiological response to treatment


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How neuroscience changes assessment

Dont just ask people how they feel, measure the brain inaction

Analogous to a cardiac stress test

You use a standard assessment of general plussocial cognition - to measure brain efficiencies

By simulating real world challenges, you canidentify the strengths and weaknesses that

characterize each individual brain B com arin those results to matched controls

in a database, you can reliably identifysignificant differences

Brain Health Strategies decision support ruleshelp link each clients Markers to their best

personalized solution

But brain tests and genetic tests by themselves are


18

expensive, complex, not easily accessible


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BRID: neuroscience power behind Optum Brain

Integration

Standardization

insights that arepossible onlywhen there is a

Brain ResourceInternational Database

huge databasewith

INTEGRATED

Linking Markers to SolutionsThese are: the most complicated aspects of data

andSTANDARDIZEDdata

Independent Scientific

the source of the clinical power of theassessmentthe critical element in the difficulty for


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IntegrationBrings together measures of genomics, brain, cognition and experience thatare normally assessed in isolation.

Genomics

Brain

Cognition Experience


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NIH and NIMH Databases

WWW Available Human Databases

dbGaP

Genotype and Phenotype http://www.ncbi.nlm.nih.gov

--3/2008

Linked Efforts to Accelerate Parkinson's Solutions (LEAPS)

Linking Genome Wide Association Study of Schizophrenia8/2008

Major Depression: Stage 1 Genome wide Association in

Population-Based Samples7/2008

NEI Age-Related Eye Disease Study

' va a e uman a a ases

http://hendrix.imm.dtu.dk/services/jerne/brede/ Brede database/ Data from fMRI scientific articles containing

Talairach coordinates

http://www.fmridc.org/f/fmridc Peer reviewed repository of fMRI studies and their underlying data

- -

NINDS Repository Neurologically Normal Control Collection Whole Genome Association Study of Bipolar Disorder

7/2008 http://www.pdgene.org/

Parkinson's disease genetic association studies

http://www.ncbi.nlm.nih.gov/SNP/

NCBI Single Nucleotide Polymorphism http://www.nbirn.net/bdr/index.shtm

ey are ne er astandardized or

integrated p: ase.org cg - n we come.cg A community website for Huntington's Disease (HD) research

http://www.hprd.org/ Human Protein Reference Database. Centralized platform to visually

depict and integrate information pertaining to domain architecture,post-translational modifications, interaction networks and diseaseassociation for each protein in the human proteome

http://132.183.217.124/brainbank/Main

National Brain Databank: Brain Tissue Gene Expression Repository.

Biomedical Informatics Research Network (BIRN) Data Repository.Biomedical imaging data from humans and animal models areavailable for download with descriptive metadata, and in some cases,associated clinical, microarray, or other biomedical data.

Gene expression data from microarray experiments on brain tissue

samples, along with diagnostic results from postmortem studies ofneurological and psychiatric disorders http://arrayconsortium.tgen.org/np2/home.do

NIH Neuroscience Microarray Consortium http://mecp2.chw.edu.au/

RettBASE: IRSA MECP2 Variation Database. Mutation andpolymorphism data from the published literature pertaining to Rettsyndrome and related clinical disorders


21


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Brain Resource International Database

1. All these measures are taken ineach individual in the core database.1. All these measures are taken ineach individual in the core database.

Depression; Conduct DisorderSchizophrenia Eating DisordersPTSD Sleep DisordersADHD Panic Disorder

ement as p epsyMultiple Sclerosis HIV/AIDS

Head Injuries

2. In thousands of normals.2. In thousands of normals.

3. And in a spectrum ofclinical groups.3. And in a spectrum ofclinical groups.


22

e ata ase nc u es over 20,000 atasetsIt covers 6-100 years of age.

It includes sites in the USA, Europe, Africa and Australasia.


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Screening and Assessment

BRISC: Brain Resource Inventor of Social Co nition10- 15 minute test identifying social cognition, depression,

anxiety and stress.

BRISC provides a sensitive, yet rapid and cost-effective screening to prioritizehigher risk individuals, saving time and money.

DemographicDetails

DASS Scale:De ression

EmotionalIntelligence

Personality

Anxiety

Stress

BRISC indicates if an individual is at risk per3 critical numbers

A new approach to screening that goesbeyond diagnosis specific instruments tocapture a brain at risk whatever thediagnosis; quantifies the distress and


2424

Negativity BiasSocial Skills

Emotional Resilience

helps by highlighting unique strengthsand vulnerabilities


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Detailed, Personalized Informationon Functional Difficulties, Strengths

A true functional assessment that not onlyrelates to real world issues; but establishespersonalized markers that can guide

an ea nesses

30-45 minute Web-based tool that measures social and generalcognition covering cognitive domains including: memory,

unique specific interventions

a en on, sensory-mo or s s, execu ve unc on, mpu s v y,and emotional recognition.

Motor tapping Digit SpanRecognitionMemory

Choice reactiontime

Verbalinterference

EmotionRecognition

Press Dpress


25

Switching ofattention

Executivemaze

SustainedAttention

Emotion RecognitionRecallGo No Go

Delayed Memoryrecognition


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Social Cognition A powerful addition to

nce arw nEmotional responses = inheritedpatterns of behavior shaped by

adaptation.Facial expressions of emotion have

remnants of previous adaptivebehavior, persisting in mild form.

-support for basic emotions and theirfacial expression

, , , ,

sadness, and surprise


26


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Depression: General Cognitive Markers

Response Speed Depression What Depression

Attention-Concentration

Memory

Impulsivity Depression Profile

Info Processing Efficiency

Executive Function

-2 -1.5 -1 -0.5 0

Emotion Recognition

-4 -3 -2 -1 0-4 -3 -2 -1 0-4 -3.5 -3 -2.5 -2 -1.5 -1 -0.5 0

Depression: Soc ial Cognitive Markers

-4 -3.5 -3 -2.5 -2 -1.5 -1 -0.5 0 0.5 1

Negativity BiasNegativity Bias

Emotional Resilience

Emotional Res i l ience

Sociability

Depression

Social SkillsSocial Skills

Neg ativity Bias

Emot ion: Sadness Speed

Assessing strengths andweaknesses and identifying


27

Brain Resource 2008 27

-8 -6 -4 -2 0Emotion: SadnessAccuracy


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Combo of general/social cognition separates

1. HypoprocessingDepression Subtypes

ty-Inhib

itio

0.0

2.5

1

2

2. HyperprocessingAnxiety

+Impulsivi

-2.5

roupCentroid

FearRT

-7.5

-5.0

-5.0 0.0 2.5-2.5 5.0


28

a an ega v y as


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These marker indicators also predict different categories:

SSRI with Hyperprocessing,

SNRI with Hypoprocessing

Tric with Mixed

Med_type2.5

.

2. SNRI

3. TriCFea

rRT

0.0

1

2

Group Centroid

-5.0

-2.5

3

-2.5 0.0 2.5

91.8%


29

VigilanceAttentionResponse Speed


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When people get depressed their brains react in different ways:Knowing this has implications in how best to help themPredispositions: Genomic; Neuroticism; Negativity Bias; Stress

Hyperprocessing No Adaptive Compromise Hypoprocessing

EEG Beta

Nonconscious ERPautomatic bias to emotion

processing

EEG Coherence measures

Variability of all responses

Emotion Regulation

EEG Theta: Alpha

Conscious ERP emotionprocessing

Motor response speed

Startle EMG

ANS Arousal

Right Hemisphere

fMRI Amygdala ACC

SymmetryfMRI Amygdala ACC

Medial Frontal

ANS Arousal

Memory, attention,planning

Left Hemisphere

Markers

Medial Frontal

Cortex

Limbic Cortical Tone:

SSRI

TriC higher dose SNRI

Stabilize Limbic Cortical Tone: SNRI

Limbic Cortical Tone:

volume Lateral FrontalCortex

Treatment


31

Source: Williams & Gordon, The Neuroscientist, 2007.


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The Texas Algorithm and STAR-D

Builds on the bestalgorithms and enhances


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BRC advantages at step one

Initial drug selection in STAR-D is just citalopram in the Texas Algorithm itcould be SSRIs, Bupropion SR, Venlafaxine XR, Mirtazapine, orNefazadone, but there is no guidance for selection of a particular agent.

Treatment success at the first step is less than 50% with high drop out ratesand non-adherence.

Using web based neuropsychology tests backed by an integrated databasewhich is normed and age and education matched to create better

understanding of the probable endophenotype at a personalized level, while an individual level for a specific agent can significantly increase the likelihoodof a successful step one match increasing the chance of a faster moreacceptable response, greater adherence and decreased costs from possibly

.

In this regard BRC is complimentary to the Texas Algorithm AND makes iteven more useful by creating an easy to use decision support for step one.


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No medicationtriggered


35

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Urgent risk(caseidentification)


36

36


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ons stent

with selfreportedde ression-anxiety-stress


37

37


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But, no

Thinking Emotionmarkers formedication

.

Or, for othercognitive


38

38

problems


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But there is aSelf Regulationmarker forpoor emotionalres ence.


39

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Case 1 Summary

Urgent Risk case identification

No Thinking/Emotion markers indicating a biologicalalteration, or other cognitive problem

= indicates psychotherapy (like CBT)*.

Self Regulation marker present (poor emotional resilience)

= Confirms likely value of psychotherapy (like CBT)

*


40

.

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Example of use of BR methodology

The Database provides a frame of reference for better quantification of the

Drug X may cause a significant change in the DV, however only drug Y shows achange that is clinically meaningful

p =


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Wh are we so reluctant to incor orate the im lications?



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The Implications of a Brain that canchange itself.

Can we train and develop the

cognitive brain?

n an age o now e ge wor erscould this hold the competitive

e ge


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Cajal: At the start of the 20th century Cajalproposed that brain cellsunlike every othercell in our bodydont divide. They dont die,

.

the womb with the only brain we willever have.

Pasko Rakic, the chairman of Yale Universitysneurobiology department was the most convincing moderndefender of this theory. All neurons of the rhesus monkeybrain are enerated durin re-natal and earl ost-natal

life, Rakic wrote in his 1985 paper, Limits ofNeurogenesis in Primates. Not a single newneuron was observed in the brain of any adult


45

animal.


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Fernando Nottebohm

Showed that songbirds, in order to survive andcreate new songs, added at least 1% of new tissueto their song centers each day


46

J h Alt 1962 MIT h d h i h b


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Science30 March 1962:vol. 135. no. 3509 . 1127-8

Joseph Altman: 1962 MIT suggests the accepted truths might be wrong.

Are New Neurons Formed in the Brains of Adult Mammals?In an autoradiographic investigation, the production of brain lesions in rats was combinedwith intracranial injection of thymidine-H3. Inaddition, some neurons and neuroblastsshowed labelin su estin the ossibilit of roliferation of neurons in adult rats

Michael Kaplan: 1977 The University of New Mexico

The electron microsco ic observations re orted in this stud reveal: I that a steadrate of granule cellneurogenesisoccurs during the first year of a rodents life; (2) thatnewly formed granule neurons in the dentate gyrus of the newborn mouse and adult ratare a result of neuroblast division; and (3) two distinct classes of mitotic cells can beidentified during the peak period of postnatal neurogenesis-those with synapses ontheir cell bodies and processes and those with no synapses or processes.

Rakic told him They may look like neurons in New Mexico but they dont inNew Haven


47

Eli b th G ld P i t


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Elizabeth Gould: Princeton

In 1989 Gould while looking at rat brain degeneration in rats

following glucocorticoid administration found that the brain alsohealed itself

, -Early life experience alters response of adult neurogenesis to stressChristian Mirescu, Jennifer D Peters & Elizabeth Gould

.post-doc, Mirescu, they deprived newborn rats of their mother for either 15 minutes orthree hours a day. Earlier studies had shown that even after these rats become adults, theeffects of their developmental deprivation linger: They never learn how to deal with stress.

.

from the stress response. But these deprived rats cant do that. Its as if they are missingthe off switch. The rat might have forgotten its pain, but its brain never did. Pre-nataltrauma also has life-long implications. Being low in a dominance hierarchy also


48

. .thumb, a rough lifeespecially a rough start to lifestrongly correlates with lower levelsof fresh cells.

Ronald Duman: Yale


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Ronald Duman: Yale

demonstrating that antidepressants increased neurogenesis in the

adult rat brain. In fact, the two most effective treatments they lookedatelectroconvulsive therapy and Prozac increased neurogenesis in

, .the exact same molecules, especially trophic factors, that are suppressed by stress.

Luca Santarelli: Columbia

-

Requirement of Hippocampal Neurogenesis for theBehavioral Effects of AntidepressantsLuca Santarelli,1* Michael Saxe,1* Cornelius Gross,1Alexandre Surget,2 Fortunato Battaglia,3 Stephanie Dulawa,1Noelia Weisstaub,1 James Lee,1 Ronald Duman,4 Ottavio

Arancio,3 Catherine Belzung,2 Ren Hen1 .


49

. ere, us ng gene c an ra o og ca me o s, we s ow a srup ng antidepressant-induced neurogenesis blocks behavioral responses to antidepressants


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A new paradigm

The partially

The

The brokenThe breakingeve opebrain

healthy brain

brainstressed brain

Every day your cognitivebrain is hostage to youremotional brain


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Taking Care of the Brain


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Nutrition, Exercise and the Brain


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Its a whole new world

Train the BrainFrom The Times

Januar 26, 2009

Nintendo brain-trainer 'no better than pencil and paper'


54

A Wh l N G i Of G


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A Whole New Generation Of Games

from Uncle Milton

Mindflex from mattel


55

M B i S l ti


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MyBrainSolutions

-


56

. .which draws on new insights to develop better brain habits


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57

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My Brain

My Brain


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These are your average scores for: Emotion-Thinking-Feeling-Self Regulation.

DisclaimerThis report provides indications of general cognition and social cognition as compared directly or indirectly to a normative database. It is not to be used as a basis for actionwithout consideration by a competent relevant professional. Always seek the advice of a trained health professional or relevant specialist regarding any highlighted varianceswithin this report before any treatment or action is taken. This report is not intended to be used in any way on its own to diagnose, select treatment or cure any health

ee age to v ew recommen e ra n ra n ng rograms ase on your ra n core pro e.

See Page 3 and 4 to view the explanation and details of your scores.See Page 5 to read about the theoretical brain model which underlies these scores.


58

con on. s repor oes no es a s any p ys c an-pa en re a ons p or supp an any n-person me ca consu a on or exam na on. ppropr a e me ca a en on s oualways be sought for specific ailments. Do not disregard professional medical advice or delay seeking medical treatment as a result of findings contained within this report.Brain Resource expressly disclaims any and all responsibility for any liability, loss or risk which may be or is incurred as a consequence, directly or indirectly, of any use andapplication of this report.

Educate Motivate Set Goals


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Educate, Motivate, Set Goals


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Engage With Solutions


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Engage With Solutions


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On-line Cognitive Therapy


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On line Cognitive Therapy

Not just a rich knowledge base,but smart tools and programs

,therapy, journaling, coaching and

prevention. Embedded screeninglogic - tools adjust to member.


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Heart Rate VariabilityThe Connection


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Heart Rate VariabilityThe Connection

You have a personalized BEST BREATHING

RATE,

or Resonant Frequency,

en you are rea ng a

your Resonant Frequency,your heart and brain areworking together in

synchrony and you are calm,


62

w ere your o y s a gne or pea per ormance.focused and

in the zone.

MyCalmBeat: How it Works


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MyCalmBeat: How it Works

Low heart rate variability (and faster breathing)has been connected to worry and negativefeelin s ain and stresses at work 1-3 .

Higher heart rate variability enables people torecover more easily from stress, and boost theirositive feelin s 2 .

Higher heart rate variability is also beneficial toour ability to focus and concentrate, and to

.

1)Princi T, Accardo A and Peterec D. (2004).

2)Thayer J and Lane RD. (2000).

3)Pieper S, Brosschot JF, van der Leeden R, Thayer JF. (2007).

4)Porges S. (1992).


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Integrates with MyBrainSolutions


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Integrates with MyBrainSolutions

As a registered user ofwww.mybrainsolutions.com,

use the MyCalmBeat

.Set the breathing bar to

your Resonant Frequency.


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Human Capital Solutions


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Human Capital Solutions

Much more than managing the sickness business post eventum

Beyond sickness management to wellness and prevention (EAP/WL);

Beyond wellness and prevention to optimization (Resiliency training, social skillstraining etc,)Beyond individual optimization to team and group capability maximization;Beyond team optimization to corporate culture productivity maximization

Technomedia Partners With SBT to Accelerate Its

International ExpansionMontreal Nov. 28Technomedia, a Canadian provider of talent managementand human capital development solutions, announced itspartnership with the SBT (Scientific Brain Training) group, aEuropean provider of training and evaluation of cognitive

.portfolio and international presence through the signature of

a letter of intent to acquire Technomedia, which will enterinto effect in mid-December. For its part, Technomedia willround out its TM SIGAL technology and e-learning servicesb offerin su ort for the behavioral and co nitive


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assessment of employees.

Neuroleadership


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Neuroleadership


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EducationNBER WORKING PAPER SERIES

THE ECONOMICS, TECHNOLOGY AND


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Education CO O CS, C O OG

FORMATIONJames J. Heckman; Working Paper 13195;http://www.nber.org/papers/w13195NATIONAL BUREAU OF ECONOMIC RESEARCH1050 Massachusetts AvenueCambridge, MA 02138

Fifth, for both animal and human species, there is compelling evidence of.

readily acquired at certain stages of childhood than other traits (Knudsen et al.,2006). For example, on average, if a second language is learned before age12, the child speaks it without an accent (Newport, 1990). If syntax and

grammar are not acquired early on, they appear to be very difficult to learnlater on in life (Pinker, 1994). Different types of abilities appear to bemanipulable at different ages. IQ scores become stable by age 10 or so,suggesting a sensitive period for their formation below age 10 (Schuerger andWitt, 1989). There is evidence that adolescent interventions can affect

., .neuroscience that establishes the malleability of the prefrontal cortex into the

early 20s (Dahl, 2004). This is the region of the brain that governs emotion andself-regulation. Rutter (2006) and Rutter et al. (2006) present comprehensivesummaries of age-dependent epigenetic and other gene-environment


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nteract ons or psyc opat o ogy nc u ng aggress on. n average, t e aterremediation is given to a disadvantaged child, the less effective it is.

Focused Strategy


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gy

Mild Cognitive ImpairmentAlzheimer's DiseaseChemobrain (Emotional andcognitive deficits following

chemotherapy)SchizophreniaHIVLyme Disease


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Neuroscience in Sports Medicine


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p

Emerging Evidence and Conclusions based on data derived from CarlstedtSubliminal Attention, Reactivity, Coping Scale-A includes:Model Explained up to 50% of the Variance in Performance

qua on, ncreas ng near y as a unc on o eve o r ca yRelative Trait and State Left Brain Hemispheric Predominance Predicted

Performance on the basis of Objective Longitudinal Outcome MeasuresDynamics of Isolated Measures in Predicting Performance are Reconcilablewith Brain Localization and Functional Studies of these Traits/Behaviors(incl. Dietrichs Transient Hypofrontality Hypothesis) and EEGinvestigations of AthletesALL ATHLETES SHOULD BE ASSESSED ON THE ABOVE MEASURES* THEY ARE POTENT PREDICTORS OF AN ATHLETE'S

COMPETITION!


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Use of Neuroscience to Drive Marketing


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Pharmaceutical (physicians, patients, pharmacists, caregivers& nurses)

Pfizer GlaxoSmithKline Merck

Sanofi-Aventis Novartis AstraZeneca

Genentech (Ortho McNeil, Janssen& Scios)

Boehringer Ingelheim

Schering PloughSolvay BiogenIdec

Brain Surgery Offers 3 "Connection"ProductsCONNECTIONS BONDING

Abbott Adolor

Altana

EisaiShire KOS

emo ona m n se c us er ng, core n ng,Emotion Drivers, attribute/message testing

and final messaging)CONNECTION DRIVERS(emotional "mindset" clustering and Emotion

Wyeth Amgen Endo

Bayer Schering


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CONNECTIONS TESTING(Emotion Drivers and testing)

Consumer and Business to Business

Nextel

2 0 P e r ce n t o f Scie n t is t s Ad m it U s in g

Br a in -En h a n cin Dr u s -- Do Yo u ?


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Br a in En h a n cin Dr u s Do Yo u ?By Alexis Madrigal

Nature released the results of an online surveyin which 20 percent ofrespondents, largely drawn from the scientific community, admitted tousing brain-enhancing drugs like Ritalin (methylphenidate) and Provigil(modafinil).

Society must respond to the growing demand for cognitive enhancement.That response must start by rejecting the idea that 'enhancement' is a dirty

The Ultimate Cureby David Ewing Duncan May

, .

2008 Issue

The neurotech industry isengaged in a $2 trillion race tofix your brain. Many players will

Can everyone be an Einstein?

Science is getting ever closer tosolving the complex puzzle that isthe human brain. And its beginning


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a , u e payo w e ugefor those who succeed.

usBryan Appleyard

Modafinil


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solveproblem

1.6

1.8

Placebo

Low

High

* * **

P=0.002

ttemptstakento

correctly

1.0

1.2

1.4

rovement


72Number of moves

Mean

0.8

1 2 3 4 5 6

Modafinil improves planning inhealthy volunteers

Im

Militar uses of co nitive enhancers


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Research and Development organisation for the US Department of Defence

Eliminating the need for sleep during an operation,while maintaining the high level of both cognitive and

h sical erformance of the individual will create afundamental change in war fighting and forceemployment. Such a capability has the potential todisrupt enemy OPTEMPO [operations tempo],

forces and shorten the duration of conflict.


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Transcranial Direct Cortical Stimulation


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It is estimated that 50% of the


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will be obsolete in 6 years

NIMH sa s it takes 17 ears forinformation to get from research to

practice


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futurist perspective

Documents