Cognitive Enhancement

Question 1

What is cognition?

Answer 1

All processes by which the sensory input is transformed, reduced, elaborated, stored, recovered, and used.

Question 2

How has Alzheimer’s Disease been attempted to be treated?

Answer 2

Acetylcholineesterase Inhibitors.
- Breaks down ACh
- Inhibitors would increase ACh levels
- Compensate for loss of ACh neurons. 
NMDA Glutamate Antagonist
- Increase signal to noise ratio for chronically overactivated glutamate receptors. 
- 2-3 points on 70 point scale in cognition
~ 2-3% overall increase

Question 3

How has ADHD been attempted to be treated?

Answer 3

Methylphenidate

• Increase attention and reduce distractions
• Far off-label use by up to 35% of college students
• Healthy subjects: increased activity in dorsal attention network, Decreased activity in default mode network typically deactivated in attention, and no improvement in working memory and visual acuity tasks.

Question 4

How have sleep disorders been treated?

Answer 4

Modafinil

• Produces wakefulness
• Approved for narcolepsy, obstructive sleep apnea, and shift-work disorder.
• Increases NE, DA, Glu, 5-HT, His
• Decreases GABA
• Increases digit span by ~1

Question 5

What about Schizophrenia treatment?

Answer 5

Cognitive impairments in excess of positive and negative symptoms commonly observed.

Question 6

What are the procedures involved in treatment?

Answer 6

Non-Invasive Brain Stimulation

• Transcranial Magnetic Stimulation: depolarizes neurons, low frequency (0.5-2 Hz) decreases excitability, high frequency (>5 Hz) increases excitability.
• Transcranial Direct Current Stimulation:

Question 7

What are some types of enhancements?

Answer 7

Dietary Enhancers
- Omega 3's
- Caffeine
Others
- Exercise
- Cognitive Enhancement Therapy
- TMS/tDCS
Nootropics
- Ampakines
Psychostimulants

Question 8

What are some dietary enhancers?

Answer 8

Omega-3’s
- Shown to improve working memory in adults with mild to no cognitive impairments.
- High DHA levels associated with lower risk of Alzheimer’s Disease
Caffeine
- Facilitates alertness, attention and memory tasks
- Best for maintaining attention when coupled with L-Theanine

Question 9

What are other methods of enhancers?

Answer 9

Cognitive Enhancement Therapy (CET)
- Used primarily in patients with Schizophrenia
- Aims to rebuild social cognition with software programs and interaction
TMS/DCS
- Anodal stimulation to the DLPFC proved to show increase in cognitive abilities. (Motor learning tasks, memory, naming of objects, mood)
Exercise
- Shown to promote hippocampal neurogenesis in adults
- Improved spatial learning.

Question 10

What are the nootropic applications?

Answer 10

Highly abused among non-prescribed users
- Many side-effects such as decrease in cognitive abilities. 
ADHD
- Amphetamines; Methylphenidates
Alzheimer's
- Memantine
Narcolepsy
- Modafinil

Question 11

What are the differences between AMPH v. MPH?

Answer 11

Both are cognitive enhancers, use for ADHD, psychostimulant.
Amphetamine (AMPH)
- Blocks VMAT1, reverts DAT/NET
- Adderall, Vyvanse, Dexedrine
Methylphenidate (MPH)
- Inhibits DAT/NET
- Ritalin, Methylin, Concerta

Question 12

What is DAT?

Answer 12

Dopamine Transporter.

• Located: presynaptic membrane of dopaminergic neurons.
• Function: reuptake of DA
• Activity: Dependent on phosphorylation

Question 13

What is VMAT1?

Answer 13

Vesicular monoamine transporter

• Location: in the terminal region of presynaptic neuron
• Function: packages monoamines (DA, NE, 5-HT) into vesicles.

Question 14

What are ampakines?

Answer 14

Compound that binds to glutamate and enhances long-term potentiation.

• Facilitate LTP to accelerate learning
• Up-regulate BDNF to improve memory consolidation.