A personal trainer for your brain

An individual Brain Fit Club workout routine might involve a combination of scientifically-validated computerized cognitive training, brain stimulation, nutritional coaching, mindfulness training, sleep and lifestyle education, gait and balance evaluation and treatment, and group classes in meditation, tai chi and gentle yoga designed to target a full range of cognitive struggles or decline.

"At BIDMC we have nearly 40 years of experience in expertly diagnosing and treating disorders of cognition," says Albert Galaburda, MD, Chief of Cognitive Neurology. "Through research here and elsewhere we know that there's a lot to be gained from pairing traditional treatments like medication with special kinds of exercises, and we're very excited to offer this comprehensive approach to our patients."

The concept underlying the Brain Fit Club relies on the science of neuroplasticity, or the brain's ability to change or adapt in the presence of new experiences or obstacles. Until recently, it was thought that after the first few years of life, our brains stopped creating news cells and that once our neural connections were laid down in childhood, those brain networks were fixed for life. But research in the past two decades has shown that the brain actually never stops producing new cells, that new connections are constantly made and that there is lifelong potential for development and adaptation.

"We know that a healthy brain is better able to cope with challenges that come with injury, disease and the natural aging process," says Alvaro Pascual-Leone, MD, PhD, Director of the Berenson-Allen Center for Noninvasive Brain Stimulation. "Fundamentally there are things we could all do better for better brain health, things like making sure we get enough sleep, eating a healthy, balanced diet, participating in heart pumping exercise, and then we need to challenge our brain outside of its comfort zone in an environment like the Brain Fit Club."

Brain Fit Club members start with an evaluation by a neuropsychologist who assesses each person's cognitive abilities using objective measures. "Based on that cognitive profile, we then identify targeted interventions to address each individual's area of weakness. The 'workout' regimen will be different for a person dealing with an attention issue, say, than for a person having trouble with memory," says Bonnie Wong, a neuropsychologist and the Director of the Brain Fit Club. "Not only do we develop a program that's tailored to that particular person's needs, but we can also track their progress and adjust their program as time goes on."

"In essence, it's like a personal trainer for your brain who assesses you, follows you and challenges you," says Pascual-Leone. "And that trainer pushes you to work hard in the hopes of achieving the best benefit for your brain."

The coaching aspect is an important component of the Brain Fit Club to ensure that members stay motivated and get the workout dosage right. "We want to help people understand that it's not just about continuing to lift the same two pound weight, we want to make sure each person is working for the right amount of time at the right level and not falling back on what feels comfortable or routine," says Wong.

And while the hope is that many of the exercises can ultimately be done in the home, Pascual-Leone says that the social aspects of coming into the gym are often just as important as the actual training.

"Humans are social beings, our brains are responsive to both the number of social interactions that we have as well as our own belief of how supportive our social environment is," says Pascual-Leone. "These are very powerful mechanisms that are important factors for brain health, for brain plasticity."

Many Brain Fit Club members are already reporting benefits. They say they feel better and are able to function better.

"I have one patient who has told me she felt as though she was 'back to where she was' before she had her concussion," says Wong. "She was having a lot of difficulty at work, finding the right words, organizing thoughts, and although she hasn't been retested, she feels as though after going through this very rigorous computerized training program, she's back to where she should have been."

"We think the Brain Fit Club will be able to help a lot of people, and as we move forward, we'll be able to collect data and refine our programming to be able to help even more people with brain injury and cognitive deficits in the future," adds Pascual-Leone. "And even though we know we're not going to, for example, prevent a disease like Alzheimer's, we should hopefully be able to make it easier for the patients who are unfortunate enough to have the disease to have less symptoms of it and cope with it better."