NeuroNation

NeuroNation and the CE-marked medical product NeuroNation MED are software applications by Synaptikon GmbH, a German healthtech company focused on research, development and distribution of proven effective personalised, multi-domain cognitive training interventions.

NeuroNation
Type of site
cognitive training
Available inGerman, English, Spanish, Portuguese, Italian, Turkish, Russian, French, Korean, Polish
HeadquartersBerlin, Germany
Created byRojahn Ahmadi and Jakob Futorjanski
URLwww.neuronation.com
Commercialyes
Users24 million
Launched2011

NeuroNation is a multi-modal cognitive training application for prevention and cognitive enhancement. NeuroNation MED is a mobile application for multi-domain computerised cognitive training based on gamified exercises, developed for users with cognitive impairments. Health literacy is conveyed via in-app psycho-education elements and information about brain health. The CE-marked medical device is intended to support patients in alleviating the symptoms of mild or moderate, acquired or neurodegenerative cognitive impairments.

Through gamified exercises the user is able to train global cognition and distinctive domains, naming processing speed, reasoning, attention, and working memory. By means of defined cognitive exercises, an individual cognitive profile of the patient is created and a personalised cognitive training is tailored to the patient in order to achieve alleviation of cognitive deficits.

Launched in 2011, NeuroNation is available as a web-app via neuronation.com, on Android, and iOS devices,  and as of 2023, is offered in ten different languages used by over 24 Million users. The core function of the training is a personal training plan created based on the cognitive profile of the user. Furthermore, users find ongoing evaluations and assessments, as well as psycho educational content, real-life benefits,and exercises to enhance or relax your brain, called NeuroBoosters.

The training was named best "App of the Year" by Apple and by Google. NeuroNation is reimbursed by several health The Deutsche BKK has recognised NeuroNation as a treatment method for stroke patients since 2014, citing several studies showing the positive effect of NeuroNation for patients with cognitive impairment. The German health insurance also reimburses the benefits of NeuroNation.[1]

NeuroNation was awarded the Leonardo Prize for digital prevention by the German Federal Ministry of Health.[2]

Evidence of NeuroNation cognitive training

NeuroNation MED represents a approach of a gamified and interactive version of computerised cognitive intervention and is designed following "best practices" in the latest guidelines on neurological and neuropsychological interventions. The medical device is designed according to guidelines of the German Society of Neurology (DGN) and the Society for Neuropsychology (GNP):

Guideline: Diagnosis and therapy of memory disorders in neurological diseases: "Patients with memory disorders should receive specific function- or strategy-oriented cognitive training (evidence level Ib; recommendation grade A). The effectiveness of the method depends on the frequency of training (at least 10 sessions are considered good clinical practice)."[3]

Guideline: Diagnosis and therapy of executive dysfunctions in neurological diseases: Cognitive exercise in general: strength of recommendation A; working memory training: strength of recommendation A".[4]

Guideline: Diagnosis and treatment of attention disorders in neurological diseases: The authors give a strength A recommendation for computer-based training batteries that address specific attentional functions.[5]

NeuroNation was also part of the scientific project “Brain Rehabilitation Assessment und Intervention” (BRAIN),[6] a collaborative project funded by the German Federal Ministry of Education and Research to develop a holistic approach of a sensitive interactive cognitive assessment and a computer-based cognitive training intervention.

In the "Intera-KT" project,[7] NeuroNation is collaborating with the Berlin University Hospital Charité and other partners to digitise paper-based cognitive tests. Our goal is to improve the diagnostic reliability and precision of the tests in order to detect and counteract diseases at an early stage.

Scientific evidence for the effectiveness of cognitive training with NeuroNation has been and continues to be collected in several studies

The most recent study is currently ongoing and recruiting patients with mild cognitive disorders (F06.7) and patients with Post COVID-19 condition (U09.9).[8]

The object of the study is to investigate the effectiveness of the training app "Neuronation MED" in relation to the cognitive performance of patients with mild cognitive disorders. The app will be used for 12 weeks of three sessions per week, each lasting approximately 45 minutes. The control group will be a group that receives app access after 3 months (waiting) and is either receiving normal care as prescribed by a physician or is not currently receiving any care.

NeuroNation as a cognitive training has been validated with healthy participants showing positive effects for working memory,[9][10] memory,[11] and executive functions.[12] One of these studies conducted by MSH Medical School Hamburg and the University of Würzburg[13] showed that NeuroNation exercises are effective. After 21 training sessions, the training group participants were able to improve their memory, concentration, and general subjective well-being as measured by the Cognitive Failure Questionnaire; other cognitive characteristics such as processing speed also increased. The improvements observed significantly exceeded the changes in the control group. A study with older participants in monotonous working environments showed effects alleviating age- and job-related cognitive decline.[14]

Several completed studies that are still in the process of scientific publishing studied cognitive training with NeuroNation in older adults investigating the effect on cognitive-motor multitasking[15] or preventing cognitive decline (Maintain Your Brain,[16][17][18] AgeWell.de[19][20]). Maintain Your Brain (MYB)[21] targets the area of "Healthy Aging" and is the world's largest study in this segment with over 8,000 targeted participants. The AgeWell.de[22] project aims to explore the best possible approaches to healthy aging and to prevent or at least delay cognitive decline in patients at increased risk of dementia. NeuroNation provides  cognitive training exercises for project participants. An earlier intervention study conducted in Finland has already shown promising results: With the right approaches of exercise, diet, and brain training, the risk of cognitive decline was reduced by up to 31%.

In a series of scientific studies NeuroNation was used in multidisciplinary rehabilitation of patients with Chorea Huntigton.[23][24][25][26] The intervention group showed significant improvements in verbal learning and memory, attention, cognitive flexibility and processing speed.[27] In addition, a positive effect on sleep outcomes,[28] dual task performance,[29] and hypothalamic grey matter volume loss was found.[30] Although these studies were based on small sample sizes due to the rare nature of the disease, the results have been promising.

Scientists from the University Clinic Cologne studied the effect of NeuroNation as a home-based working memory training on visuo-spatial working memory in Parkinson’s Disease.[31][32] They showed the effectiveness of working memory training on Parkinson's patients without cognitive impairments. In the study a small effect on verbal working memory could be proven. Additionally, the researchers came to the conclusion that CCT (computerised cognitive training) might be an effective intervention to prevent cognitive decline in this patient group. This study’s data was also analysed to predict training performance based on personal and training parameters.[33][34] In addition, an increased neural efficiency was found as a neural correlate of cognitive training.[35] An additional study on cognitive training with Parkinson’s patients is still in the process of scientific publishing.[36]

Currently, there is also a study planned at the University Clinic Bonn for the evaluation of personalised cognitive home training using the mobile application Neuronation in adults with ADHD.[37] The aim of this study is to investigate the influence of a new cognitive training program "NeuroNation MED" on cognitive impairments that can occur in the presence of attention deficit hyperactivity disorder (ADHD). These can be, for example, impairments in the ability to concentrate, memory, and planning skills. Furthermore, the influence of the cognitive training program on social participation, depressive mood, and health-related quality of life will be evaluated. Finally, it will be evaluated whether the training program is suitable for use and whether the application experience is appealing to the user group.

Furthermore, NeuroNation is currently used in neuro-rehabilitation with brain training by WideCare (Post- and Long Covid), the Red Cross, Hamm clinics, Medical Park, Alexianer.  

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