Eric A. Storch, PhD

“What if a game of peek-a-boo could change the world?” Seven-year-old Molly Wright, one of the youngest-ever TED speakers, posed this profound question in her July 2021 viral video.

 Why peek-a-boo? Because, as Molly so clearly articulated in her UNICEF and Minderoo Foundation-supported talk, this simple game captures the essence of what we know about young children’s healthy brain development: All of the everyday, back-and-forth interactions between caring responsive adults and babies serve to stimulate their senses, build social interaction skills, foster language development, and teach object permanence. These are all foundational brain-based skills.

Games like peek-a-boo are thus invaluable when it comes to brain building and supporting strategies that will help prepare today’s children to navigate a rapidly changing, increasingly complex, and globally connected world. With respect to the developing brain, early childhood is a time of particularly rapid change, with up to 90% of brain growth taking place by age 5. In other words, when it comes to strategic brain- and skill-building, these early years are critical for lifelong learning and well-being.

Building brains in the very earliest stage of life may ultimately be the best way to brace our societies for and empower our children to face a panoply of future challenges. Complex issues already impacting our societies today only stand to become more difficult as our children grow older.

Presently, rates of stress, depression, and anxiety are spiking due to the vicissitudes of COVID-19 (which still seems to have no end in sight for the globe).

 Further, COVID-19 seems to have exacerbated advanced cognitive skill deserts—areas characterized by low scores in standardized tests and poor educational infrastructure.

 This is concerning given that jobs are becoming increasingly knowledge-intense as automation subsumes lower-skilled roles. 

Current and future challenges related to climate change

 present issues to where we live, work, play, and eat. Taking action to tackle these issues is harder due to misinformation propagation, a global phenomenon spreading virally and accelerating radical and radicalizing conspiracy theories.

 Political and social divisions are increasingly stark and volatile. All in all, we have a collision of issues which, at their core, seem to be worsened by the overwhelming, overloading, or dysfunction of our brains and minds.

Of course, in the immediate term, one of the best strategies for ensuring the conditions needed for healthy early childhood brain development is rapid, global, vaccine-based herd immunity from COVID-19. This would allow economies, families, and communities to return to a normal life where, among other things, the mental health and safety of both young children and their caregivers is protected. But it is imperative that we are prepared to address what many predict will be the long-term detrimental 

 on our children, adolescents, and their families as well.

We are buoyed by the US President’s planned human infrastructure agenda, which both recognizes the importance of and provides supports for the boosting of brain-based skill development in early childhood.

 These proposed investments include childhood poverty reduction, universal pre-kindergarten, a child tax credit for low- and middle-income families, and a national paid leave program. If funded and executed well, these large-scale programs will facilitate early childhood brain development. We hope other 

 around the world take note of these ambitious plans.

Aligned with the planned human infrastructure agenda, poverty reduction is of the utmost value to early child brain development. 

 (ACEs) are associated with alterations in psychological, cognitive, and neurobiological development. From a brain-based skills perspective, executive function skills (encompassing skills such as cognitive flexibility and critical thinking), are clearly recognized to be of lifelong importance. Given that their most rapid rate of development occurs between the ages of 3 and 5, it is particularly concerning, but no surprise, that poverty has been found to increase the risk for executive functioning difficulties.

 Thus, efforts to better brain health go hand in hand with strategic investments in early childhood and measures to reduce childhood poverty, as well as other ACEs.

In considering the interplay between mental health, adversity, and early brain development further, research on the neural mechanisms underlying emotional processing in individuals of differing socioeconomic status (SES) point towards differences in brain structure and function as a link between mental health and SES.

 Innovative studies like the NIH- and philanthropically-funded Baby’s First Year Study aim to understand the impact of monthly, unconditional cash transfers to low-income 

 in the first 3 years of the child’s life.

 Currently underway, the Baby’s First Year Study is examining how poverty reduction affects early childhood development and the family processes known to support children’s healthy development.

Highlighting the cross-sector nature of this work, others suggest the need for social work to critically engage with the first 3 years, shifting focus from the individual and family to a more systems-level community and public health focus. Based on the old but sturdy Bronfenbrenner concept of socioecological influences on child development, we believe it is important to build skills at all levels: individual, family, community, service provision, policy, and systems. Targeting multiple levels of influence fosters mutually reinforcing positives effects on child development.

In addition to poverty reduction, interactional behaviors like serve-and-return (well demonstrated in a game of peek-a-boo), conversational turn-taking (see Harvard University’s 

), and child-directed speech are particularly important in early life. These early relational health behaviors build core life skills such as executive function/self-regulation, self-efficacy, trust, and resilience that serve to help buffer against adversity and better equip children (and their brains) to take advantage of future learning opportunities.

 It is worth noting that parenting behaviors like serve and return do not happen in a vacuum. Studies show that social and structural factors affect parental behaviors. We know that ongoing stress makes it difficult for parents to strengthen and use the executive function skills so central to providing nurturing, responsive, safe, and stimulating environments in which children and adolescents can thrive.

 In contrast, we also know that the presence of a caring responsive adult stands to serve as a protective buffer against the neurotoxic (and other harmful) effects of poverty.

Given the significant importance of the caregiver to early relational health, adequately addressing postpartum depression is also critically important. Simply put, better prevention, identification, and treatment of postpartum depression is key to boosting baby’s brain health and development. Not doing so proves to be both economically and individually quite costly. A recent study found that the state of Texas alone is losing $2.2 billion by not treating mothers’ mental health from pregnancy through their child’s first 5 years.

 Postpartum depression has also been found to have both maternal and infant consequences, including negatively affecting physical health, sleep, motor, cognitive, language, emotional, social, and behavioral development in the infant.

The impact of healthy brain development during the early years applies not only to physical and mental health, but early learning as well. Early childhood sets individuals up for lifelong learning. With converging accelerations in technology, globalization, and climate, lifelong learning is no longer desirable, lifelong learning is essential.

 The Organisation for Economic Co-Operation and Development (OECD) recently released the 

OECD Skills Outlook 2021: Learning for Life.

 This report noted that lifelong learning starts in childhood and youth, continuing throughout adulthood and old age. It encompasses formal learning in settings such as schools and training centers, informal and nonformal learning derived from colleagues and workplace trainers, and unintentional learning stemming from spontaneous social interactions.

In recognizing the impact of the early years to what ultimately becomes lifelong learning, the Minderoo Foundation’s Thrive by Five program engages with government, research institutes, and other stakeholders to advocate for effective policy and investment in early learning systems.

 This representative program has initial activities in Australia, with global ambitions. And while little formal research has been done to understand the effects of different parenting styles such as free range, helicopter, authoritative, or permissive parenting on brain development, in the brain-building context of early relational health and serve-and-return interactions, what is increasingly clear is that interactions shape brain development, and parents stand to serve as chief architects. With this in mind, The Minderoo Foundation’s Thrive by Five program also recently launched a new parenting app which leverages ground-breaking research into the early years to assist parents in developing their child’s life skills while going about their daily routines.

Though there is also an intrinsic link between education and early childhood brain development, more research is needed to better understand, build, and optimize education innovations that may bolster development. For example, German forest schools, known as 

, began in 1960 and encourage children to play, explore, and learn in a forest environment where adults assist rather than lead.

 The forest school model has spread to many locations around the world. Though research has elucidated the benefits of this model of education,

 little has been studied on the neurological affects.

Similarly, the Montessori method, developed in the 1900s by prominent psychiatrist and pediatrician Maria Montessori, MD, promotes independence through self-directed activities in a specially prepared environment and discourages conventional measures of achievement like tests and grades.

 Extensive connections between the Montessori method and early childhood brain development have been described and theorized, and research points towards many benefits of this model of education.

 However, more research is needed to understand the neuroscientific grounds of the Montessori method and how education can better facilitate brain development.

Better understanding is also needed for high-tech approaches to brain development in childhood. For example, leading baby-brain researcher Patricia Kuhl, PhD, demonstrates, through her research, how neuroscience can better inform our understanding of brain development, how children learn, and the way children are taught. One of her studies made use of magnetoencephaography (MEG) scans to monitor sensory and motor-sensory brain activation in infants from English-speaking families who were exposed to Mandarin.

 only when they were exposed to the novel language in live interaction, but not from television or audio-listening. This study suggests that neuroscience can guide us—both as to how and when technology should (or should not) be leveraged in education, and with respect to important aspects of foundational language development and bilingualism.

The value of investing in early childhood is unequivocal. Led by Nobel laureate and economist James Heckman, PhD, “The Lifecycle Benefits of an Influential Childhood Program” determined that high quality birth-to-5 programs for disadvantaged children can deliver as much as a 13% per year return on investment.

 Significant gains were realized for both children and mothers through better outcomes in education, health, IQ, crime reduction, social behaviors, future earnings, and employment.

 These early childhood programs work, in part, because they provide children with the skills they need to learn and socialize in primary school.

Developing transformative neuroscience insights which can generate new ways to understand, screen, diagnose, and treat brain disorders is also key. In this regard, we applaud new projects such as Advanced Research Projects Agency for Health (ARPA-H), which is a large-scale effort to accelerate medical innovation in areas such as autism.

Another of ARPA-H’s first 3 focus areas is Alzheimers disease—further exploration is needed into the value of starting dementia prevention strategies in childhood, which emerging evidence points to as promising.

Now more than ever, as nations across the globe are looking to build back better in a world facing globally complex challenges—from 

 to climate change and beyond—it is important that we do so strategically. According to International Monetary Fund Managing Director Kristalina Georgieva, PhD, the best investment in times of rapid change are investments in human capital.

 We agree. Based on all that the neuroscience now tells us about the importance of early brain and child development, we believe that achieving the goal of building back better must therefore include investments in child human capital. Actually, make that our children’s brain capital.

is a director at the PRODEO Institute, an Atlantic Fellow in Brain Health Equity at the Global Brain Health Institute (GBHI) at the University of California, San Francisco (UCSF) and a Thiel Fellow at Stanford University.

is a senior advisor to the Organisation for Economic Co-Operation and Development (OECD) Secretary General, head of the New Approaches to Economic Challenges Unit (NAEC), and co-lead of the OECD-PRODEO Institute Neuroscience-inspired Policy Initiative (NIPI).

is an economist, researcher at the IESE Business School, and president of the Venezuelan Alliance.

Paul Ramsay Foundation Fellow and Adjunct Professor, Queensland University of Technology (QUT) and convenor, Thriving Qld Kids Partnership.

is an advisor to ARACY (Australian Research Alliance for Children and Youth) and convener of the Brains Builders Alliance.

adjunct professor in engineering at Stanford University.

is professor and head of psychology at Baylor College of Medicine.

is a child and adolescent psychiatry fellow at UCLA.

is a pediatrician and professor with the Penn State Edna Bennett Pierce Prevention Research Center.

is Alfred Deakin Professor of Psychiatry at Deakin University and director of IMPACT at Deakin University (Institute for Mental and Physical Health and Clinical Translation).

s cofounder of the PRODEO Institute, co-lead of the OECD NIPI, and holds adjuncts roles with IMPACT at Deakin University, BrainLat, GBHI at UCSF and Baylor College of Medicine.

1. Wright M. TED and Minderoo Foundation: How every child can thrive by five. TED Talks. July 2021. Accessed September 24, 2021. 

https://www.ted.com/talks/molly_wright_how_every_child_can_thrive_by_five?language=en

2. Taquet M, Geddes JR, Husain M, et al. 

6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records.

3. Hoxby C. Advanced cognitive skill deserts in the US: Their likely causes and implications. 

. March 24, 2021. Accessed September 24, 2021. 

https://www.brookings.edu/bpea-articles/advanced-cognitive-skill-deserts-in-the-us-their-likely-causes-and-implications/

4. Letzing J. Are we at a turning point for tackling online extremism? World Economic Forum. April 12, 2021. Accessed September 24, 2021. 

https://www.weforum.org/agenda/2021/04/are-we-at-a-turning-point-for-tackling-online-extremism/

5. Behrmann S, Garrison J. Senate Democrats reach $3.5 trillion deal for Biden's 'human infrastructure' agenda, Medicare expansion. 

. July 13, 2021. Accessed September 24, 2021. 

https://www.usatoday.com/story/news/politics/2021/07/13/senate-democrats-reach-3-5-trillion-deal-reconciliation-package/7960565002/

Associations of early-life threat and deprivation with executive functioning in childhood and adolescence: a systematic review and meta-analysis.

The affective neuroscience of socioeconomic status: implications for mental health.

Baby’s first years: design of a randomized controlled trial of poverty reduction in the United States.

9. Willis D. Early Relational Health: Community Level Strategies for Supporting the Psychosocial Health of Infants, Toddlers, and Caregivers. June 2019. Accessed September 24, 2021. 

https://cssp.org/resource/early-relational-health-community-level-strategies/

10. Ellwood-Lowe ME, Foushee R,. Srinivasan M. What causes the word gap? Financial concerns may systematically suppress child-directed speech. 

. January 17, 2020. Accessed September 24, 2021. 

11. Center on the Developing Child at Harvard University. Building adult capabilities to improve child outcomes: a theory of change. May 14, 2013. Accessed September 24, 2021. 

https://www.youtube.com/watch?v=urU-a_FsS5Y

12. Villalpando N. Texas losing $2.2 billion by not treating mothers' mental health, report says. 

. March 21, 2021. Accessed September 24, 2021. 

https://www.statesman.com/story/news/healthcare/2021/03/21/untreated-mental-health-care-moms-costs-texas-2-2-billion/4740751001/

13. Slomian J, Honvo G, Emonts P, et al. 

Consequences of maternal postpartum depression: a systematic review of maternal and infant outcomes.

Thank You for Being Late: An Optimist’s Guide to Thriving in the Age of Accelerations.

15. Organisation for Economic Co-operation and Development (OECD) Skills Outlook 2021: Learning for Life. June 15, 2021. Accessed September 24, 2021. 

https://www.oecd.org/education/oecd-skills-outlook-e11c1c2d-en.htm

16. Weatherill J. Every child deserves to thrive by five. Bedrock. 2021;26(1):6-7.

17. Minderoo Foundation. Thrive by five: new app to help children reach their full potential. October 27, 2019. Accessed September 24, 2021. 

https://www.minderoo.org/thrive-by-five/news/new-app-to-help-children-reach-their-full-potential/

 Dimensionen eines pädagogischen Ansatzes. Neuwied, Kriftel, Berlin. 2001.

19. Nixon C. Remembering why forest schools are important: nurturing environmental consciousness in the early years. McGill University (Canada). March 2015.

Montessori education: a review of the evidence base. 

22. Kuhl P. The baby brain. BrainMind Summit. April 10, 2020. Accessed September 24, 2021. 

https://www.youtube.com/watch?v=ErPPXfsY6a8

23. García JL, Heckman JL, Leaf DE, Prados MJ. The life-cycle benefits of an influential early childhood program. IZA Institute of Labor Economics. December 2016. Accessed September 24, 2021. 

24. Westervelt E. How investing in preschool beats the stock market, hands down. NPR. December 12, 2016. Accessed September 24, 2021. 

https://www.npr.org/sections/ed/2016/12/12/504867570/how-investing-in-preschool-beats-the-stock-market-hands-down%20/

25. Vradenburg G, Sigal E. Created correctly, the Advanced Research Projects Agency for Health will accelerate medical innovation. Stat News. May 27, 2021. Accessed September 24, 2021. 

https://www.statnews.com/2021/05/27/create-advanced-research-projects-agency-for-health-correctly/

Association between adverse childhood experiences and dementia in older Japanese adults.

27. Georgieva K. Transcript of International Monetary Fund Managing Director Kristalina Georgieva's Opening Press Conference, 2021 Spring Meetings. April 7, 2021. Accessed September 24, 2021. 

https://www.imf.org/en/News/Articles/2021/04/07/tr040721-transcript-of-imf-md-kristalina-georgievas-opening-press-conference-2021-spring-meetings

A brain capital grand strategy: toward economic reimagination.

Articles

In order to face the rapidly changing, increasingly complex, and globally connected world, we need to focus on the importance of early brain and child development.

Let’s Build Brains Better! Brain Science-Inspired Policies for the Future 

“Brain health conditions are a key contributor to the global burden of disease and disability. The devastating impact of these conditions is even more apparent as the world faces global challenges such as the COVID-19 pandemic, climate change, societal inequity, and more. To make progress, we need a fundamental shift in our approach. Convergence Brain Health deftly makes the case that a convergence approach is urgently needed to tackle the global brain health crisis and provides a roadmap for change.”

— Victor Dzau MD, President, National Academy of Medicine

Even before the COVID-19 pandemic, the world was in the midst of an escalating global brain health crisis with severe physical, social, and economic ramifications. According to a recent World Health Organization report, around 450 million individuals were suffering from mental health conditions, marking mental health disorders among the leading causes of ill-health and disability worldwide.

 The Organisation for Economic Co-operation and Development (OECD) estimates that the consequences of mental ill health cost up to 

Due to social and physical distancing, unemployment and underemployment, stress and other factors, there have been significant increases in issues such as depression, anxiety, social isolation, substance abuse, loneliness, and cognitive decline in older adults.

 In addition, as observed after the SARS pandemic, it is expected that COVID-19 survivors may endure long term cognitive and psychiatric consequences, including suicide, posttraumatic stress disorders, and depression.

 Furthermore, brain health is a prototypical 

 in that it is extremely complex and textured by innumerable variables from biology, sociology, genetics, psychology, and the natural environment to economics and beyond.

 Compounding these issues are challenges at all levels of innovation around brain health, listed in 

Table 1. Challenges and Opportunities for the Brain Health Field

Progress in the 21st century will be molded by our collective response to the global brain health crisis.

 Fortunately, beacons of hope are beginning to shine. Stigma has been reduced in high-income country settings, allowing individuals to overcome the barriers to seeking care.

 The COVID-19 pandemic has—in a positive sense—lowered the perceived and actual barriers to technology adoption, ushering in a new era of technology-driven brain health care. Some governments are beginning to increase spending on brain health, and venture capital funding for brain health start-ups has never been more in vogue. PitchBook data shows that 146 deals generated nearly $1.6 billion in venture capital investments as of December 10th, 2020. A decade ago, there were only 3 deals, worth $6.6 million, whereas last year saw a total of 

However, these advances on their own cannot solve the myriad global challenges posed by the brain health emergency. A paradigm shift is needed to address the unprecedented complexities associated with the current global brain health crisis—a crisis now inextricably linked to concurrent interacting crises surrounding discrimination and inequality, mass misinformation, environmental catastrophes, accelerated climate change, entrenched economic models, population displacements and immigrant status, and more.

 Governments, employers, and healthcare systems around the world need to acknowledge the scope of the problem and embrace solutions to empower consumers to take charge of their own brain health and to protect existing levels of health, well-being, and social inclusion.

In response to the evolving issues, convergence science integrates knowledge, tools, and thought strategies from diverse fields to address challenges that exist at the interface of 

 Convergence science not only recognizes the need to respond to apparent societal problems, but also emphasizes approaches which allow us to consider a myriad of the known unknowns and improves the odds of us quickly adapting to newly identified gaps.

 Acknowledging the serendipity of accidentally obtained knowledge permits 

 Taking these approaches when investigating solutions to brain health challenges permits greater flexibility and utility when unforeseen challenges are inevitably met.

Brains are the indispensable drivers of human progress. Why not invest more heavily in them? There are currently 

 allocated to Environment, Sustainability, and Governance investing around the world.

 If only a portion of this amount were invested in brain health, we could produce major improvements for our society.

 note that this present moment is a clarion call for the philanthropic community, which is uniquely positioned to lead an approach in 2 distinct ways. In the short term, the immediate mental health crisis can be mitigated by supporting interventions for the most vulnerable, the development and deployment of rapidly available mental health tools and technologies, and research to drive evidence-based responses to COVID-19-related mental health challenges. Much work is needed to address the long-term mental health impacts caused by the pandemic. There is an ongoing and urgent need for targeted investment in research to better understand and treat mental health conditions, build capacity and diversity within the mental health system, and advocate for social and policy solutions to improve the ecosystem of mental health care.

Given the critical need to nurture healthier, more resilient, and increasingly flexible brains worldwide, we have introduced the concept of Brain Capital—broadly defined as a form of capital which prioritizes brain skills and brain health.

The OECD Neuroscience-inspired Policy Initiative seeks to place Brain Capital at the center of a new narrative to fuel societal resilience in mitigating economic shocks, and to create preparedness should future societies fundamentally transform, for instance through irreversible damage to the environment. The OECD’s New Approaches to Economic Challenges Unit has created the Neuroscience-inspired Policy Initiative. This initiative seeks to reconceptualize and revitalize the economy, laying the groundwork to identify relevant metrics while building a transdisciplinary network of stakeholders. The initiative will rapidly refine and advance the concept of Brain Capital via a series of research projects, economic modelling, seminars, and clear policy analyses and recommendations.

In this context, our Brain Capital Grand Strategy supports the focus of the OECD initiative. The Grand Strategy has 3 main components: considering Brain Capital in all policies, developing a comprehensive investment plan to support Brain Capital, and generating a Brain Capital Index.

Brain health issues should be addressed in the context of improving performance within the fields of innovation and entrepreneurship. Because most 

 are created by firms less than 5 years old,

 creative and innovative entrepreneurs are needed to drive social and economic growth at the regional and national levels. In many ways, together with unprecedented government investment in many countries, entrepreneurs stand as a critical firewall against recession and deprivation. They serve as economic first responders when (exogenous) catastrophic events produce national and global economic shocks. 

In the United States, deaths due to suicide, opioid overdoses, and other addictions and poisonings (deaths of despair) are a barrier to complete economic recovery from COVID-19.

 Approximately 20% of prime-aged males who have dropped out of the labor force are 

 in these deaths, and many of them will not take up jobs even when available due to the severity of their addiction.

A senior economist at The Brookings Institution is leading an initiative to coordinate the many efforts to deal with this crisis. An important role for the task force would be to coordinate with the many burgeoning local level efforts to address addiction and despair, and these local organizations could greatly benefit from ties to a federal-level coordinating agency. Among other things, this agency could serve as an 

 Without addressing the linked issues of mental health and labor market drop-out simultaneously, it will be difficult to solve the tragic mental health crisis or achieve the goal of widely shared economic prosperity.

It is also essential that, given the complexity of the challenges being addressed, freedom to fail is offered liberally. Flat organizational structures, which are agile and empower individuals to make decisions in their specific areas and roles without need to constantly consult with managers at higher levels, are important. However, these decisions should be aligned with the mission and not deviate from the already traced goals and strategy. In 

, we provide examples of organizations and buildings which foster Convergence Brain Health activities.

Table 2. Infusing Convergence Brain Health Practices Into Various Levels of Innovation

Existing models of innovation are not adequate—suffering from siloing and a lack of speed. There are now a number of more contemporary models which may propel the brain health field forward more quickly and effectively. 

For example, The Davos Alzheimer Collaborative (DAC) is a public-private partnership committed to a collective global response against the challenges Alzheimer disease presents to millions of families around the world.

 The DAC aims to raise around USD $700 million for a 6-year plan to accelerate and diversify innovation in Alzheimer disease research. The 3 main components of DAC include a global cohort developed to identify new targets for potential treatments, a global clinical trial support platform to reduce the cost and time to bring new treatments to market, and a healthcare system prepared to get new treatments to patients. The DAC project will enable novel biomarker development, connect global researchers using the data platform provided by the Alzheimer Disease Data Initiative, and keep individuals with the lived experience of Alzheimer disease at the center of its efforts.

The first big data wave occurred over a decade ago, fueled by the reduced cost of -omics techniques (eg, genomics, transcriptomics), increased access to neuroimaging equipment, and the transition to electronic medical records. Insights from this data, however, have not translated into dramatically improved outcomes for patients. Diagnostic clarity is often elusive and treatment selection remains primarily trial-and-error. A second wave of big data proliferation is already underway with the increased implementation of mobile applications and wearable devices.

 Solutions are desperately needed to resolve current bottlenecks in transforming data into insights and action. 

Furthermore, according to economist Klaus Schwab, PhD, we are on the verge of the Fourth Industrial Revolution, which will see a rise in cyber-physical systems that blur “the lines between the physical, digital, and biological spheres.”

 Virtual reality environments, brain-computer interfaces, wearable or implantable devices, and mobile applications will continue to contribute to the current data explosion. Artificial intelligence integrates knowledge from a myriad of disciplines, including computer science, data science, mathematics, engineering, physics, statistics, linguistics, signal processing, ethics, and philosophy. Artificial intelligence is no longer a novelty, but a requisite set of convergence tools for navigating the future.

As psychological disorders are mediated by complex interactions between genetic and environmental factors it will be imperative to dedicate significant effort to understanding the modifiable risk factors emerging from the environment.

 Since the environment includes biological, psychosocial, and ecological components, it is likely to be more complex than the genes, proteins, and metabolites that are currently analyzed by a variety of tools. Therefore, within the framework of convergence brain health it will be necessary to develop highly powerful and complex tools that record, measure, and analyze the myriad environmental factors. This effort will be pursued as it has been with the omics technologies but with a much larger scope, ranging from psychophysiological data collected from millions of individual smartphones to satellite tracking of air pollution in big cities. Important ethical issues, however, will have to be addressed with some urgency.

Operationalizing a convergent clinical framework will require effective direction and utilization of the continuing data explosion.

 The role of digital clinical operating systems is therefore critical for allowing effective patient care, as well as ongoing research. These clinical operating systems house data from clinical encounters, imaging, pathology, personal medical devices, wearables, and finance. Analytics methods include the use of mathematical and algorithmic-based processing of data resources, including subfields of artificial intelligence, such as machine learning, natural language processing, and visual analytics to generate descriptive, predictive, and prescriptive models to analyze and derive insight from data. Machine learning has been utilized in predictive risk assessment, clinical decision support, home health monitoring, finance, and resource allocation.

Convergent approaches often require consideration of many different data types. Data harmonization involves creating a single consistent macro-data source from multiple, potentially disparate micro-datasets. Contributing datasets are structured to remove inconsistencies, creating harmony, such that the final dataset provides a cohesive view of a subject from many different perspectives. Machine learning enables automatization of this process, permitting integration of clinical, behavioral, -omic, imaging, neurosignals, and other datatypes for data mining and predictive modelling. Deep learning in combination with multidimensional biological data (eg, genomics, proteomics) enables examination of the impact of genetic variation or other system disturbances on transcription, translation, signaling, and resultant phenotypic variation. 

Perioperative brain health is an emerging example of the need for a convergence approach in brain health science. The average individual undergoes 9 surgical procedures in his or her lifetime, typically at an older age when the brain is more vulnerable to perioperative insults such as stress, illness, and immobility.

 As such, the perioperative period is a very high-risk period for older adults, and brain health impairments are abundant with considerable negative impacts. For example, the US National Health and Aging Trends Study found clinically significant depressive and anxiety symptoms in 39% and 24% older adults in rehabilitation facilities, respectively, in older adults recently in rehabilitation facilities (vs. 10% and 9% for older adults in the community).

Similarly, a study in the UK of postoperative Intensive Care Unit patients found rates of 40% and 46%, respectively.

 Depression and anxiety are connected to poor postoperative outcomes, including persistent pain, delirium, longer hospital stays, poor functional recovery, lower quality of life, and increased chance of both falls and rehospitalization.

A new field of perioperative mental health is responding to the need to integrate mental and cognitive healthcare with surgical and postsurgical care. The increasing number of older adults undergoing surgery creates high demand for this innovation, so that care can move beyond an emphasis only on surgical success and anesthetic safety, to a convergent brain health view of outcomes, such as improved functional recovery, reduced rehospitalization, and decreased long-term morbidity. These innovations are further driven by bundled care models, which include preoperative optimization, in-hospital care, and postoperative rehabilitation. With the recent genesis of the Center for Perioperative Mental Health, funded by the National Institute of Mental Health (P50MH122351), surgeons, anesthesiologists, nurses, physical and occupational therapists, and surgical patients will work together with psychiatrists in an accelerated laboratory for translating scientific advances to practical clinical care that improves the lives of older adults.

With the emergence of so many digital innovations, care providers are presented with more tools than ever. However, such a crowd of novel options adds complexity and uncertainty. To be clinically useful, such point solutions must first be vetted and then clustered into symphonies shown to play well together to optimize collective benefit for specific conditions. In the dementia field, for example, it is encouraging to see multidomain interventions being deployed.39 In the future, a therapeutic guidance system may make sense, similar to those used to advance precision medicine, such as oncology and neurosurgery.

To develop a workforce that can harness and deploy a convergence brain health framework, increased inclusion and empowerment of women and other traditionally under-represented populations is required. Building institutions that are both inclusive and meritocratic is health promoting in its own right. But more importantly, it is a powerful mechanism for producing the additional talent, fresh perspectives, and new ideas that are needed.

Meanwhile, certain behavioral characteristics among individual innovators should be cultivated. MacRae and Furnham

 articulated 3 dimensions of a high-potential individual suited to convergent teamwork building on Silzer and Church’s model of potential.

 There are 3 core dimensions: foundational, growth, and career dimensions. These dimensions explain how personality traits are foundational to potential because they represent fundamental and stable individual differences. Personality traits, especially conscientiousness and adjustment, contribute to success in nearly any type of work and have, “higher predictive ability of potential in roles that are more complex, challenging, and demanding such as that of the convergence practitioner.”

Career dimensions are the unique and specific skills, expertise, and occupational knowledge required for success in a specific career or role: “Convergence practice requires sublimating one’s own objectives into the vision and the objectives of the team.”

 MacRae and Furnham explain in detail how personality traits fit within a model of convergence practitioner potential and expand on 10 behaviors that are related to career dimensions of potential.

 These behavioral and workplace cultural characteristics allow us to formulate screening criteria for potential new entrants into convergent brain health work, identify those who are high potential convergence practitioners, as well as consider training approaches for those within our existing brain health structures.

Leaders must assume a critical role in optimizing transdisciplinary collaboration and facilitating the emergence of discoveries from these endeavors.

 Gray outlined 3 responsibilities of transdisciplinary leaders: cognitive leadership, structural leadership, and processual leadership:

. Effective cognitive leadership provides a vision that links and motivates transdisciplinary researchers to step beyond their disciplinary lens, relax old assumptions, and search for creative frame-breaking solutions.

. Effective structural leadership adds value by creating bridges and links among unconnected individuals, labs, groups, or departments.

- Processual Leadership: Effective processual leadership encourages trust and turns conflict into constructive interactions.

These leadership approaches should be kept in mind when fostering Convergence Brain Health within an organization. Other 

 of a convergence workplace include a flat organizational structure with minimal discipline silos, a culture of trust and mutual respect, and an open acceptance of the need to respectfully challenge entrenched ways of thinking.

 Teams should be humble in acknowledging that nobody has cracked the many complex problems to date, and likely never will due to unsolvable uncertainty. However, being open to novel and seemingly eccentric ideas may help navigate such problems and identify ways for their best possible management.

Teams in a convergence workplace must embrace the three somehow radical tenets outlined in Jim Dator, PhD’s 

: 1) The future cannot be predicted because the future does not exist; 2) Any useful idea about the future should appear to be ridiculous; and 3) We shape our tools and thereafter our tools shape us.

 An optimal convergence science environment should have a strong guiding vision, will be capable of identifying myriad possible alternative futures, and better guide the organization toward the desired future.

Convergence Brain Health provides direction for transformational change in how teams could work and how organizations need to be built and operated. As we embark on building the new normal of our post-COVID-19 world, Convergence Brain Health will play a key role in this rapidly unfolding change. Indeed, Convergence Brain Health provides an opportunity to grow global Brain Capital and enter a new era of innovation and progress, leading to greater health justice for all people and preparing for the unprecedented brain health challenges of the 21st century.

is cofounder of the PRODEO Institute, adjunct associate professor with IMPACT at Deakin University, instructor in brain health diplomacy at the Global Brain Health Institute, and co-lead of the OECD Neuroscience-inspired Policy Initiative.

is Director of Innovation at a major mental health association and expert in residence at Georgetown University, and the author of Wired This Way.

is an associate with the PRODEO Institute and Thiel Fellow at Stanford University.

is a professor of psychiatry at University of California in Los Angeles (UCLA).

is Distinguished and Emeritus Professor of Psychiatry, University of Pittsburgh, Pittsburgh, PA.

is the global head of Science for Minds at Johnson & Johnson.

is a health policy researcher at the Global Brain Health Institute.

is a social gerontologist at the Global Brain Health Institute.

is a research professor and Director of Chambers-Grundy Center for Transformative Neuroscience at the University of Nevada, Las Vegas.

is a venture partner at Alsop Louie Partners.

is professor and vice chair of Psychiatry & Behavioral Services at Baylor College of Medicine.

is special advisor to the OECD secretary general and head of the OECD New Approaches to Economic Challenges Unit.

is the Wallace & Lucille Renard Professor of Psychiatry and the Director of the Healthy Mind Lab at Washington University School of Medicine in St. Louis, Missouri.

is head of strategic projects and alliances at Delix Therapeutics.

How can we face the current pandemic while addressing the brain health crisis?  

Eric A. Storch, PhD

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