By Sandra McLean

One of the NERON kiosks. Credit: York University

Dementia can be brewing in the background for years before the telltale signs of memory lapses and difficulties with wayfinding creep into people's daily lives or are detected through memory tests, but endless crossword puzzles or sudoku are unlikely to make a meaningful difference.

Decades of research as the scientific lead of York University's Sensorimotor Neuroscience Laboratory have taught Lauren Sergio that brain games are not enough to stave off dementia or recover from a concussion at any age. The missing piece is combining thinking with movement, she says. "Cognitive brain training on its own hasn't been shown to work in terms of maintaining functional independence because it doesn't incorporate movement."

Brain changes associated with mild cognitive impairment or early dementia often first appear as cognitive motor integration changes, such as changes in movement, coordination and slower reactions when having to think and move at the same time, rather than memory issues, she adds. For those with concussions, whether elite athletes, children or older adults, recovery is faster when they are given tasks that force their brains to make new connections through movement.

Her biomedical research is now being used as the basis for a new brain performance platform by NERON AI, bringing cutting-edge neuroscience from the lab into the real world. "This is a toolbox that can be used not only by people concerned about their brain health, but also by clinicians, such as gerontologists and other health care providers, to understand and potentially track brain changes in people concerned about dementia as they age or those suffering from an acquired or mild brain injury, such as a concussion.

York University Professor Lauren Sergio (R) in her lab with a participant in one of her research projects. Credit: York University

The concepts of brain health from my research could be incorporated into their work," says Sergio, York Research Chair in Brain Health and Gender in Action.

The NERON platform provides a cognitive baseline and tracks changes

and improvements over time as users complete a series of interactive brain and movement training challenges designed to develop new and stronger neural pathways. The goal is to help improve the functional ability to do everyday tasks, catch early brain changes and provide tasks to build brain resilience based on Sergio's research.

"Through dozens of studies, we found that using a cognitive motor integration approach allows us to look at movement as a window into how well the brain regions are talking to each other," says Sergio, who worked with Innovation York to get her research out to a broader audience. "This research is really important to me because it needs to be accessible to the public in a way that can benefit them, starting with a simple way to test how well their brain is functioning."

Continuing to challenge the brain with the kinds of tasks available on the platform can help build cognitive reserve, which not only helps the brain recover faster from a concussion but also provides a buffer against cognitive decline.

"Everyone is concerned about their brain health, but measuring how it performs under real load has mostly stayed inside research labs," says Reed Hanoun, CEO of NERON. "We built a way to do it in under 10 minutes, anywhere, so brain performance can finally be tracked as routinely as any other vital sign using any mobile device."

The tasks are designed to continually challenge the brain. Although they may seem simple—like moving a computer mouse to the right to complete an onscreen task when the cursor moves unexpectedly to the left—they require the brain to abandon automatic mode and really think about completing the task.

"It turns out if you are having a problem with that kind of task, it could be an early warning sign, either of a history of a brain injury or future dementia," says Sergio, who has received multiple grants for her research through the Canadian Institutes of Health Research and the Natural Sciences and Engineering Research Council of Canada.

Through her research with young athletes who have played a sport competitively for more than seven years, she has found they recover function and performance skills faster after a concussion than children and youth in recreational leagues who have played a sport for only a couple of years.

Athletes who play a particular sport for years develop visual-motor skills that help protect their brains. Sergio is also looking at older elite athletes to see whether they retain that brain resilience as they age.

Sports are not the only way to develop these brain-protecting connections. Operating a drone or a backhoe, or backing a vehicle with an RV camper attached into a parking spot, are everyday examples of how the brain is engaged while moving. "Believe it or not, that guy operating a backhoe, he's using way more of his brain when he's working than if he takes a shovel and digs something out manually, which is far less complicated," says Sergio.

"All your brain regions have to talk to each other if you're just using a little joystick to do something, like fly a drone. Those sorts of skills, it turns out, require a lot of brain communication."

The key is to force your brain out of its comfort zone so it will build new neural connections. "Take up a new instrument, learn a new language, start doing something with your left hand that you would normally do with your right, like brushing your teeth, try pickleball with your left hand or parallel park your car on the opposite side of the road, as you would if driving in the United Kingdom," says Sergio of York's School of Kinesiology & Health Science in the Faculty of Health.

"Practicing any of these kinds of skills where you're challenging your brain to think while it's doing a new activity could actually help counteract decline."

Gaming is another way. Sergio points to the brains of gamers as having well-connected neural pathways not necessarily evident in nongamers. "You want the surgeon who was a gamer as a teenager doing your laparoscopic surgery," she says. Although half-joking, she points out their brain networks are usually strong for doing the types of decoupling tasks—where they often use a monitor to guide their instruments—demanded of today's surgeons. "That's also who you want to back up your RV camper."

Her research with athletes, gamers and musicians, which has included imaging their brains while they do complicated tasks, has found they have built up some cognitive protection through brain connections in a way that doing a simpler task, like reading an email, doesn't. The brain's networks just don't light up in the same way.

The bottom line is that we need to move our bodies while thinking. "Neuroplasticity doesn't go away. You can always learn new things," says Sergio.