PRODUCTION NOTE

This documentary follows the United States trials of the "Learning Therapy" method of dementia treatment. In 2002, both the Japan Science and Technology Agency and Socio-technical Research Center adopted our "Learning Therapy" research proposal as a public research project.

At Tohoku University, we conduct research into the workings of the human brain. By using a variety of scientific measurement devices, we image the movements in the brain caused by feelings and aim to determine where in the brain, and in what way, they occur. The part of the brain that performs the most advanced functions such as memory, learning, reasoning, prediction and judgment is called the dorsolateral prefrontal cortex. The functionality of the dorsolateral prefrontal cortex has a direct correlation to a person's quality of life and the functionality of this part of the brain begins to decrease as we reach adulthood - continuing to do so as we age. The significant decrease in functionality of this part of the brain in patients with dementia is one of the leading causes of their inability to lead healthy daily lives.

A core function of the dorsolateral prefrontal cortex is a type of memory called "working memory". This working memory is used when performing cognitive tasks such as reasoning, learning and comprehension. It temporarily holds information for you to manipulate. However, the working memory can only store a very small amount of information and the information disappears when used. It is a well-known fact that your ability to use your working memory as an adult can be increased through training.

From the results of psychology and cognitive science, it is known that working memory training leads to significant improvements in working memory capacity. Those who have participated in training can remember more information at once, have a greater ability to judge situations, can learn many new things and even have a higher ability to predict the consequences of future events. Furthermore, doing intensive working memory training everyday has been proven to give a plethora of indirect effects ranging from the ability to suppress your emotions, improve creative and logical thinking ability and improve your ability adapt to new situations. In a number of trials that we conducted with university students, it became clear that the volume of the dorsolateral prefrontal cortex of the left and right cerebral hemisphere actually increases as a result of working memory training.

It was at this point that we began to explore how to apply this working memory training in daily life. We researched easy everyday activities that anyone can do and thought about which activities would give the best results if used in training, by looking at the load that the actions place on the dorsolateral prefrontal cortex. The degree of load being placed on the dorsolateral prefrontal cortex by a certain activity could be quickly determined by using our original research technique, which involves imaging the how feeling causes movement in the brain.

The problem we faced was whether or not a simple everyday task that places a load on the dorsolateral prefrontal cortex actually exists. It is well known in brain science that the more difficult a task, the heavier the load and the more movement is required in the brain to achieve it. According to this rule, there is not a simple, easy task that places a large load on the brain. People who believe in this rule may, even after seeing Evelyn's dramatic recovery due to her use of the learning therapy method, not be able to accept it. From the time when we suggested learning therapy, to today when over 15,000 dementia patients in Japan have experienced significant improvement thanks to the therapy, there have been many experts skeptic of the system.

We, at first glance, realized the presence of a solution to an impossible problem in existing research. From the results of various studies measuring human brain activity, we found that when working with symbols such as letters and numbers, regardless of the level of difficulty, many areas of the cerebral left hemisphere, including the dorsolateral prefrontal cortex work actively. In other words, without working memory, we cannot perform calculations or read or write logically. As to why the previous misconception remained in existence, this is probably because most brain science research up until now has been conducted on animals such as rats, cats and monkeys. In these tests, it is impossible to see how the brain functions when dealing with symbols or numbers.

The results of working memory training using symbols and numbers (Learning Therapy) far exceeded our expectations. Watching Evelyn's dramatic improvement in the film, there were many "miracles" that not even I, who proposed the learning therapy method could have predicted. For example, I remember how I felt goose bumps when I saw a dementia patient who had been bedridden for three years get into a wheelchair and return to a normal life. Even Dr. Tomo from a certain national university, someone who is less emotional than me, was brought to tears when he witnessed that event. Those of you who are interested in learning more about the stories that have resulted from learning therapy should take a look at the publications that we have produced.

As time progressed, we became convinced that these miracles were universal facts. We felt a strong sense of responsibility to make learning therapy available to those suffering from dementia around the world, however we faced a number of barriers in trying to achieve this. Learning therapy can be conducted with just paper learning materials, a pencil and the enthusiasm of carers. However, in reality, not everyone is happy to pay a few dollars a month for learning materials for dementia patients. There was an impression that the costs could not be covered by nursing insurance. even though there was proof that it could result in significant health benefits. We contacted a variety of people from the Ministry of Health, Labor and Welfare, but were only met with red tape. And so, we began this plot of trials in the United States.

The official reason we decided to conduct the study in the United States was that we felt that it was possible that the Japanese people have a unique familiarity with reading and writing thanks to their continued use of the abacus. Therefore, we wanted to see if the learning therapy method could have similarly positive results in a country with a culture that is completely different to Japan. In other words, see whether working memory training based on reading, writing and arithmetic could give results regardless of cultural background. We also wanted to conduct trials in the United States based on the fact that Japanese officials and government agencies listen closely to information from abroad, and if the learning therapy method gained approval for widespread use in the United States, we believed that the Japanese Ministry of Health, Labor and Welfare would give similar permission for its use in Japan.

I'd like people to witness the outcome of the United States trials for themselves in the film. I'd also like to add that in 2014, we aim to have the learning therapy in use at large number of nursing facilities across the U.S. under the U.S. brand name SAIDO Learning. I have been very impressed by the United States' willingness and openness to our ideas, and the speed at which they were adopted. I sincerely hope that in the near future, all patients suffering from dementia have the opportunity to use the learning therapy method freely.