Abstract
Cognitive deficits are common in older adults, as a result of both the natural aging
process and neurodegenerative disease. Although medical advancements have successfully
prolonged the human lifespan, the challenge of remediating cognitive aging remains.
The authors discuss the current state of cognitive therapeutic interventions and then
present the need for development and validation of more powerful neurocognitive therapeutics.
They propose that the next generation of interventions be implemented as closed-loop
systems that target specific neural processing deficits, incorporate quantitative
feedback to the individual and clinician, and are personalized to the individual's
neurocognitive capacities using real-time performance-adaptive algorithms. This approach
should be multimodal and seamlessly integrate other treatment approaches, including
neurofeedback and transcranial electrical stimulation. This novel approach will involve
the generation of software that engages the individual in an immersive and enjoyable
game-based interface, integrated with advanced biosensing hardware, to maximally harness
plasticity and assure adherence. Introducing such next-generation closed-loop neurocognitive
therapeutics into the mainstream of our mental health care system will require the
combined efforts of clinicians, neuroscientists, bioengineers, software game developers,
and industry and policy makers working together to meet the challenges and opportunities
of translational neuroscience in the 21st century.
Keywords
closed loop - neurotherapeutics - cognitive training - neuroplasticity - personalized
medicine
