Technology and Innovation, Vol. 15, pp. 53–62, 2013
Printed in the USA. All rights reserved.
Copyright  2013 Cognizant Comm. Corp.
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DOI: http://dx.doi.org/10.3727/194982413X13608676060574
E-ISSN 1949-825X
www.cognizantcommunication.com
ONLINE COGNITIVE BRAIN TRAINING ASSOCIATED
WITH MEASURABLE IMPROVEMENTS IN
COGNITION AND EMOTIONAL WELL-BEING
Evian Gordon,* Donna M. Palmer,*† Helen Liu,* William Rekshan,* and Savannah DeVarney*
*Brain Resource Inc., San Francisco, CA, USA
†Brain Dynamics Center, Westmead Millennium Institute and University of Sydney Medical School at
Westmead Hospital, Sydney, New South Wales, Australia
The extent to which brain training is beneficial for both cognition and emotional well-being is explored
in a naturalistic study design capturing users of the online brain training program MyBrainSolutions
over a 2.5-year period. A total of 2,752 users trained to a minimum required level and completed a
validated assessment battery of cognitive and emotional states before and after training, which compared their performance to a large database of healthy norms. Both the games and the assessment were
designed to tap both cognitive (thinking) and emotional domains, with emotional functioning broken
out into nonconscious reactions (emotion), conscious experience (feeling), and conscious regulation
(self-regulation). The relationships between game play and improvement in assessment scores were
established using linear regression models. Games within the domains of thinking, emotion, feeling,
and self-regulation were found to have beneficial effects in improving measured scores on the assessment within these same domains. The most significant benefits were found for games training positivity
to improve scores within anxiety, stress, and depression (feeling scores). In addition, training in selfregulation was found to be beneficial in terms of improved memory, attention, and executive function
and reduction in anxiety, stress, and depression levels. While follow-up studies are needed to further
elucidate these findings, initial results from a snapshot of naturalistic use indicate a beneficial effect of
brain training on cognitive skills and emotional well-being. Furthermore, results suggest a synergistic
effect of cognitive and emotional training.
Key words: Brain training; Cognition; Cognitive training; Emotional well-being; Stress
INTRODUCTION
optimal cognitive function and emotional wellbeing. The unique ability for these online self-guided
technologies to be readily disseminated without the
requirement of face-to-face visits with health professionals means that their potential is high for broadly
benefiting individuals at an affordable cost. As such,
advancing the science of cognitive brain training has
become a global priority agenda endorsed by the
National Institute of Mental Health (NIMH), with
the first international workshop held in April 2012 in
Bethesda, USA, for leaders in the field.
As Internet accessibility and web 2.0 interactive
technologies have scaled and the financial and social
burden of disease has escalated, there has been an
explosion in online technologies developed to prevent disease and promote wellness in the physical and
behavioral health areas. Similar to our understanding
that we maintain physical health through proactive
exercise and dietary strategies, it is increasingly being
recognized that mental health can be maintained and/
or improved through training the brain to develop
Accepted November 5, 2012.
Address correspondence to Dr. Evian Gordon, Brain Resource Inc., 1000 Sansome Street, Suite 200, San Francisco, CA 94111, USA.
Tel: 415-499-7990; Fax: 415-852-5198; E-mail: [email protected]
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GORDON ET AL.
Research to date provides early evidence that
online training is efficacious in boosting core cognitive capacities such as working memory and attention (2,6,9) as well emotional well-being (3). The
majority of evidence to date has been shown for the
separate training of specific cognitive skills, particularly the ability to improve working memory (6),
with a smaller amount of evidence pointing to similar improvements in other skills such as memory
recall, attention, and executive functions (1,10,12).
To date, cognitive training programs have been
developed to target core capacities of general cognition that have a basis in functioning of brain circuitry.
For example, working memory is a core capacity that
has been linked to the functioning of the frontal brain
circuits and their connection with parietal attention
circuits. In this sense, cognitive training can also be
thought of as “brain training.” Cognitive capacities are
important to train because they are needed to perform
everyday tasks in our occupational and social worlds.
For example, to perform even the simple task of making a telephone call at work, we rely on working memory; the capacity to hold a name or telephone number
in our mind for a short time while we transfer it to the
keypad or use it to do a contact search. The complementary importance of “social” and “emotional”
cognition is increasingly recognized. The effective
interaction of occupational and social functions, for
instance, arguably relies on the effective interplay
of both general and emotional cognitions. To date,
cognitive (or brain) training programs have not,
however, incorporated training for these social and
emotional aspects of cognition.
The online brain training program MyBrainSolutions (www.mybrainsolutions.com) is particularly targeted toward strengthening skills across the breadth
of cognitive and emotional functioning domains, with
a goal of achieving overall brain health. Stemming
from the theoretical context that the brain is a highly
interconnected system, particularly in the interplay
between traditional cognitive and emotional functioning systems, the games of MyBrainSolutions are
designed to train both cognitive and emotional functioning domains, using the contextual framework of
the INTEGRATE model (4,5,15), in which traditional
cognition is conceptualized as a “thinking” domain
(conscious rational processing of memory, attention,
and planning) and emotional functioning is broken
out into “emotion” (nonconscious awareness of face
and body cues), “feeling” (bodily experience of the
emotion via heart rate, breathing, and sweat rate
changes), and “self-regulation” (positivity, resilience,
and social capacity, which additionally act to regulate
thinking, emotion, and feeling). This interconnected
design means that training in one specific skill would
be expected to not only improve that skill itself (such
as training working memory to improve memory
skills) but will have flow on effects to other aspects
of brain function (such as reduced anxiety, improving
attention, and, consequently, improving memory).
In this study, we evaluate the benefits of brain training within each of these four core domains of thinking, emotion, feeling, and self-regulation, within a
naturalistic use of a brain training program designed
to target these skill areas. By employing a validated
online assessment battery of cognitive and emotional
function to assess the level of capacity within these
domains, both before and after several weeks of
training with games specifically designed to improve
these same capacities, we evaluate both the direct
benefit of training games on capacities within each
domain (e.g., thinking games on thinking skills) as
well as the extent to which this integrated approach
to brain training provides additional indirect benefits
of training in one domain on capacities in a different
domain (e.g., emotion games on thinking skills).
METHODS
Study Design
The current study employs a naturalistic design
in capturing data from individuals normally using
the brain training website MyBrainSolutions within
the period from January 2010 to August 2012. This
design approach was taken so as to capture as close
as possible the amount of benefit that would be
derived from training in a typical real-world situation, and from as broad a subject pool as possible.
However, there are also substantial limitations to
this approach in regard to participant self-selection
factors and the absence of a comparative control
group. The intention of this approach here is therefore to provide initial data indicating the extent of
benefit that is derived from these games in a realworld situation, and further studies employing a
more rigorous and controlled study design will be
needed to further elucidate these relationships.
COGNITIVE BRAIN TRAINING
Brain Training Program
Users of the MyBrainSolutions program have
access to 22 brain training games within the website, each designed to train skills within one of the
four key domains of thinking, emotion, feeling,
and self-regulation (Table 1). Users are provided
information about the skills trained by each game
and are free to utilize each game as they wish. The
MyBrainSolutions training program also offers access
to the cognitive assessment battery WebNeuro (13).
This assessment battery, commonly used in clinical
applications, has been adapted and embedded within
the MyBrainSolutions program to report on the recommend games to users that will best train areas of
weakness and enable the tracking of improvement
over time. As such, users are encouraged to complete
the assessment when they first begin the program as
a method of guiding their training regime.
Participants
Within the time frame considered in this study,
a total of 60,607 people were registered users of
MyBrainSolutions, the majority participating as part
of embedding with employee health programs of corporate organizations and a smaller proportion as selfreferred individuals from the general community. From
these, a subset were selected who met the criteria of
having taken the cognitive assessment battery twice,
having completed no brain training prior to the first
assessment, having a minimum of 2 weeks between the
first and second assessment, having trained to a minimum proficiency level on at least one game (details
described below), and being over 18 years of age. A
total of 2,752 users met these criteria and were considered for inclusion in this study (1,696 females; age
range, 18–78 years; mean, 42.7 ± 11.3; median time
between assessments, 6 months). All individuals
included in the current study had provided consent
for their data to be used for research purposes.
Minimum Required Brain Training
For each game, a level was set, which was considered to be a minimum level of proficiency required
to have a beneficial impact on the cognitive skill
being targeted. Assessment outcomes were then
compared between those who did and did not train
to this minimum level on each game.
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This minimum level of proficiency for each game
was based on the score on that game, which for all
games reflects a combination of accuracy and speed
of game performance. By normalizing the range of
each user’s scores to their own performance and
then averaging for each trial point over all users,
a progress function was established for each individual game that reflects the average trajectory of
improvement at that game over time (Fig. 1). For
most games, this consists of initial rapid improvement, which slows over time. Each curve was then
fitted to a logarithmic function, y = A + b[log(x)],
where x is the number of trials of the game played
and y is the normalized score, and the minimum
level of proficiency is defined as the “elbow” point
of the curve or the point where improvement rate is
beginning to slow its increase, and the elbow point
is calculated by maximizing the distance between
the line connecting the first trial point and the last
point of the minimum number of trials to reach a
near-linear asymptote.
A small number of the training games are
designed as exercises to be completed a certain
number of times a week, and points are awarded
for each completion rather than speed or accuracy
of responses. For these games, the minimum level
of proficiency could not be calculated using the
above method, and was instead defined as completing the task at the minimum recommended training level of once every 2 weeks. These games were
E-Self Regulate, Relaxation Room, My Calm Beat,
Thought Challenger, and Positive Affirmations.
Cognitive Assessment Battery
The WebNeuro assessment battery (13) takes
approximately 30 min to complete and includes tests
of general cognition and emotional cognition and
questionnaires on emotional well-being and social
functioning. Across the individual tests of general
and emotional cognition, PCA analyses have previously revealed a smaller number of core capacities
that are assessed, including thinking domain capacities of memory, attention and executive functioning,
and emotion domain capacities of emotion identification, emotion recognition, and automatic reactions
(8,11). Similarly, the DASS questionnaire provides
an assessment of feeling domain functioning of
depression, anxiety, and stress states (7), and the
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GORDON ET AL.
Table 1. Overview of Games Included Within the MyBrainSolutions Program
Times
Thinking domain
e-Think Simon Says
e-Think Memory
e-Think Focus
e-Think On Target
e-Think Balance
e-Think Executive
Emotion domain
e-Motion Expressions
e-Motion Happy
e-Motion Faces
e-Motion Body Language
e-Motion Well-being
Feeling domain
e-Positive Spin
Positive Affirmations
e-Catch the Feeling
e-Find the Feeling
Self-regulation domain
My Calm Beat
e-Faces and Names
e-Tree of Life
Thought Challenger
e-Self Regulate
Thought Challenger
e-Positivity Puzzle
Description
Skills Trained
Remember an increasingly difficult string of colors and directions. Performance measured by maximum span of working
memory.
Find the matching cards and flip them over. Performance measured by speed and number of matches found.
Balance a virtual ball on a pointer while ignoring distractions.
Performance measured by success time.
Adjust the aim of a virtual bow and arrow for distance and wind
factors. Performance measured by accuracy of arrow with the
target.
Balance a ball on a beam while ignoring distractions.
Performance measured by success time.
Remember an increasingly long hidden path through a
maze. Performance measured by maximum length of path
remembered.
Memory and attention
Identify and match facial expressions.
Performance measured by response speed and accuracy.
Pick out the happy face among an increasing matrix of negative
faces. Performance measured by response speed and accuracy.
Identify nonverbal facial expressions. Performance measured by
response speed and accuracy.
Identify and train the perception of body language cues.
Performance measured by speed and accuracy of response.
Pick out the happy face in a moving train full of negative
faces. Performance measured by true positives and negatives
selected.
Emotion cues
Visual positivity training, matching words with pictures.
Performance measured by speed and accuracy.
Develop positive self-talk to reinforce positive feelings and
break cycles of stress. Performance not measured by any
metric.
Pop bubbles with positive words only, similar to a go-no go task.
Performance measured by true positives and negatives.
Timed crossword puzzle with positively biased words.
Performance measured by number of correct words found.
Positivity
Monitor breathing and heart rate variability. Performance not
measured.
Remember an increasing string of faces and names. Performance
measured by speed and accuracy.
Answer a series of questions about hypothetical real-life problems. Performance measured by correctness of response.
Write about a current adverse situation and identify negative thinking patterns while building constructive thoughts.
Performance not measured.
Associate a positive feeling with a positive visual. Performance
not measured.
Write about a current adverse situation and identify negative thinking patterns while building constructive thoughts.
Performance not measured.
Solve a puzzle of a positive picture. Performance measured by
puzzle-solving speed.
Conscious regulation
Memory
Attention
Executive function
Attention
Executive function
Positivity (facial cues)
Emotion cues
Emotion cues
Positivity (facial cues)
Positivity
Positivity
Positivity
Social memory
Conscious regulation
Conscious regulation
Conscious regulation
Conscious regulation
Positivity
COGNITIVE BRAIN TRAINING
Figure 1. Modeled progress function reflecting the average
trajectory of improvement at each game over time. The “elbow
point” was selected as the minimum training required to achieve
proficiency at each game.
BRISC questionnaire provides subscales reflecting
core self-regulation capacities of positivity bias,
resilience, and social skills (14). Assessment scores
are provided as normalized z scores in comparison
to the WebNeuro normative database. Improvement
between assessment 1 and posttraining assessment
2 is measured here as changes in these capacity level
z scores for each domain.
Data Analysis
The relationship between training on games and
improvement on assessment scores was explored
using a linear regression approach. For each domain
area of thinking, emotion, feeling, and self-regulation,
separate linear regressions were conducted to determine whether training on games (comparing users
who trained below and above proficiency levels)
improved assessment capacity scores within the
same domain and, subsequently, whether all games
contributed equally or some were more beneficial
others. In order to assess whether similar benefits
are also observed from training on games from different domains, a second set of linear regressions
were conducted including games from across all
domain categories.
RESULTS
Most capacity scores from the assessment
improved significantly as a result of brain training
57
on games within the same domain area, with the
exception of three capacities that improved at trend
level only, but with more highly significant effects at
the individual game level (Table 2). The additional
exception to this was the memory capacity, which
did not improve overall but did show significant
relationships with a few specific games (Table 3).
The regression coefficients for the individual
games revealed that not all games contributed
equally, but rather that some games had a significant
beneficial effect where others did not.
For the thinking domain, games within this domain
that showed a direct benefit for thinking capacities
included the game E-Think improving memory
skills, the memory and attention game E-Think
Simon Says improving attention capacity, and the
attention game E-Think Focus improving executive
function capacity (although with no direct influence
on the measured attention capacity score) (Fig. 2).
The executive function games within the thinking domain were not found to improve measured
executive function capacity (E-Think on Target and
E-Think Executive), but had a trend-level beneficial
influence within the emotion domain on emotion
recognition skills (Fig. 3)
In addition, training within the different domains
of self-regulation was found to have widespread benefit for thinking capacities (Fig. 3). The game E-Self
Table 2. Regression Model Summary for All Capacities, From
Regressions Assessing the Influence of Games Within the Same
Domain to Improve Capacity Scores
Regression Model
Capacity
Change
F
0.209
n.s.
0.463
1.54a
1.76b
0.081
0.762
0.342
1.54a
1.71b
1.83b
0.164
0.202
0.159
2.79b
1.92c
4.85d
0.173
0.173
0.194
4.84d
2.01c
1.41a
Thinking domain
Attention
Memory
Executive function
Emotion domain
Automatic reactions
Emotion recognition
Emotion identification
Feeling domain
Stress
Depression
Anxiety
Self-regulation domain
Positivity bias
Resilience
Social skills
a
p < 0.1, bp < 0.05, cp < 0.01, dp < 0.001.
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GORDON ET AL.
Table 3. Regression Coefficient Summary for All Games and
Capacities, From Regressions Assessing the Influence of All
Across Different Domains Games on Capacity Scores
Capacity
Thinking domain
Attention
Memory
Executive function
Emotion domain
Emotion identification
Emotion recognition
Reaction bias
Feeling domain
Anxiety
Depression
Stress
Self-regulation domain
Social skills
Positivity bias
Resilience
a
Game
Estimated
Regression
Coefficient
e-Think Simon Says
e-Self Regulate
e-Think Memory
e-Tree of Life
e-Think Focus
e-Positivity Puzzle
0.226a
0.316a
0.119a
0.142a
0.077a
0.076b
e-Motion Expressions
e-Motion Happy
e-Positive Spin
e-Motion Expressions
e-Think Executive
e-Motion Faces
e-Think Memory
e-Tree of Life
0.506a
0.116c
0.144d
0.402a
0.079b
0.179d
0.112a
0.121a
e-Positive Spin
Positive Affirmations
e-Motion Faces
My Calm Beat
e-Faces and Names
Thought Challenger
Relaxation Room
e-Positive Spin
Positive Affirmations
Thought Challenger
Positive Affirmations
Thought Challenger
0.134c
0.358d
0.168d
0.137a
0.144a
0.711d
0.460c
0.128a
0.283d
0.581a
0.283d
0.440c
My Calm Beat
e-Catch the Feeling
My Calm Beat
e-Faces and Names
e-Tree of Life
Thought Challenger
e-Positive Spin
Positive Affirmations
Thought Challenger
e-Self Regulate
e-Motion Happy
0.119a
0.068b
0.171c
0.120a
0.092b
0.676a
0.079a
0.227d
0.328a
0.096a
0.074a
p < 0.05, bp < 0.1, cp < 0.01, dp < 0.001.
Regulate improved attention capacity. Memory
capacity was significantly improved by the game
E-Tree of Life, with an additional trend-level indication of improvement from the positivity emotion
domain game E-Motion Happy and also a trend-level
indication of executive function capacity improving from the positivity self-regulation domain game
E-Positivity Puzzle.
For the emotion domain, games within this domain
improved all three measured aspects of emotion
capacity (Fig. 2). Emotion identification capacity was
improved by the Emotion domain games E-Motion
Expressions and E-Motion Happy, which both specifically train both automatic and controlled aspects
of facial expression identification. In addition, the
game E-Motion Expressions improved emotion recognition capacity, and the game E-Motion Faces
was highly significant in improving automatic reaction bias capacity level. The E-Motion Faces game
also had a strong influence on improving the feeling
domain anxiety levels (Fig. 3).
Within the feeling domain, the positivity training game Positive Affirmations produced a highly
significant improvement across the spectrum of
feeling capacities of depression, anxiety and stress
(Fig. 2). The similar positivity game of E-Positive
Spin also showed a similar pattern, indicating a general benefit of positivity training for these aspects
of emotional well-being. Training on the feeling
domain games also had an influence on selfregulation capacities, with the Positive Affirmations
game strongly improving positivity bias and the
E-Catch the Feeling having a trend-level influence
on improving social skills (Fig. 3).
Within the self-regulation domain, training on most
games led to a widespread improvement in these
capacities (Fig. 2). The positivity bias capacity was
improved by training on the self-regulation games
MyCalmBeat, E-Faces and Names, E-Tree of Life,
and Thought Challenger. Resilience was improved by
training on Thought Challenger and E-Self Regulate,
and social skills were improved by training on
MyCalmBeat. In addition, training in self-regulation
had widespread benefits across most other domain
capacities (Fig. 3).
DISCUSSION
Brain training on games aimed to build skills
within the four domains of thinking, emotion, feeling, and self-regulation were found overall to improve
these capacity levels on an independent cognitive
assessment and questionnaire battery. The strongest
direct benefits were observed for games training
positivity to improve levels of experienced depression, anxiety, and stress falling within the feeling
domain of emotional well-being. These effects of
COGNITIVE BRAIN TRAINING
Figure 2. Relationships between cognitive brain training and measured improvements in capacity
scores for games and capacities with the same core domain area.
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GORDON ET AL.
Figure 3. Relationships between cognitive brain training and measured improvements in capacity scores for
games and capacities across different core domain areas.
COGNITIVE BRAIN TRAINING
training for improving measured capacity scores
across each core domain were found in all cases
to be driven by only a specific subset of the games
targeting that skill domain, suggesting that where
training benefits were observed, they were due to
specific properties of those particular games themselves, rather than a generic effect of brain training
per se.
Evidence was also found in support of training
games from one domain having benefit for improving capacity levels within a different domain.
This was particularly true for games training selfregulation skills, which improved scores on several
capacities within the thinking and feeling domains,
although to a somewhat lesser extent than the direct
within same domain benefits. This pattern provides
support for the influence of emotional well-being
on traditional cognitive thinking skills, specifically
relating to the ability to regulate emotional functioning, and the benefit of brain training in this domain to
improve these thinking skills. This is also consistent
with the theoretical framework of the INTEGRATE
model, in which self-regulation impacts all other
domains through the highly interconnected nature
of the brain systems involved.
As an initial exploration of the benefits of training across the breadth of cognition to emotional
functioning, there are indications that within a naturalistic free use of cognitive brain training games,
there is benefit from both traditional cognitive
training games and emotional well-being games for
improving core cognitive capacities spanning thinking domains of memory and attention, through to
aspects of emotional well-being such as anxiety and
stress. However, there are also clear limitations on
the conclusions that can be derived from this naturalistic snapshot, and the training benefits indicated
from the current results should be further explored
in more rigorous experimental models designed to
elucidate the mechanism of these benefits. In particular, the current design emphasized an exploratory
approach to confirming indications of training benefits in a real-world situation, and as such utilized a
large number of statistical analyses without employing rigorous corrections and including trend-level
results for consideration in interpretations. In addition, the free use of the training games offered within
the site means that all participants played multiple
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games across multiple domain areas, making it difficult to determine precise relationships between game
training and specific measurable capacity outcomes.
Future more targeted study designs may benefit from
a stricter employment of controlled methods.
The current results provide support for a benefit
of brain training across both cognitive and emotional
functioning domains, with a goal of achieving overall brain health. The key interconnected processes of
thinking, emotion, feeling, and self-regulation clearly
show benefits of training games specifically targeting each of these skills, as well as the benefits of
harnessing the interconnectedness of this system
and training across different domains, such as selfregulation training benefits for thinking and feeling
capacities. Furthermore, these results indicate that
not only can the benefits of cognitive brain training be objectively measured across a breadth of
domains, but that the science of brain training itself
may further elucidate the nature of these interconnected cognition–emotion brain systems.
ACKNOWLEDGMENTS: E.G., D.M.P., H.L., W.R., and
S.D. all receive income from Brain Resource Ltd., which has
developed the cognitive training program, MyBrainSolutions.
MyBrainSolutions is offered as a for-profit product with financial interest for E.G., D.M.P., and S.D. as stockholders.
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