Game-Changing Focus: Play the World’s First FDA-Approved Video Game

Dr. Adam Gazzaley

If you struggle with straying focus or have been diagnosed with ADHD, you won’t want to miss this one. We talk about an out-of-the-box solution to attention training with Dr. Adam Gazzaley to learn about a game called Endeavor Rx, the world’s first FDA-approved video game treatment.

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In this Episode of The Human Upgrade™...

If you struggle with retaining sharp focus or have been diagnosed with ADHD or other conditions that impede your brain from functioning at its optimal level, this is the podcast episode for you. We learn about a (literally) out-of-the-box solution to attention training—video games. Yes, you read that right.

Our guest today, Dr. Adam Gazzaley, holds an M.D. and Ph.D. in Neuroscience from Mount Sinai School of Medicine and completed Neurology residency at the University of Pennsylvania, followed by postdoctoral training in cognitive neuroscience at UC Berkeley. He’s currently the David Dolby Distinguished Professor at UC San Francisco and the Founder/Executive Director of Neuroscape, a center focusing on technology-driven scientific research. So it’s safe to say that Adam is not your prototypical basement gamer.

As someone who struggled with focus and attention due to Asperger’s syndrome and brain fog due to the effects of toxic mold exposure, figuring out how to retrain my brain to be able to retain more information and focus longer was one of the first areas of biohacking I ever explored. This is why I’m so excited to be talking all about Endeavor Rx today, the world’s first FDA-authorized prescription video game treatment for pediatric ADHD—and Endeavor OTC, for adults who struggle with ADHD, focus, attention, and distraction.

We explore how we can measure attention and improvement in focus, the biological systems that control what we focus on consciously and subconsciously, the role of nutrition in our ability to focus, the underlying technology of Endeavor, measuring its effectiveness, and Adam’s vision for how we can use biosensing technology—now and in the future—to optimize awareness, focus, mood, and more.

“When you play this video game for long enough, around 70% of adults feel that they are better able to focus their attention.”


(03:07) Addressing Modern Attention Challenges

  • Defining our attention systems and how to measure them
  • How I learned how to pay attention, even with ADHD
  • Read: The Distracted Mind by Adam Gazzaley and Larry D. Rosen
  • Tools we have for addressing attention challenges
  • What I use now for brain function and focus
  • The role nutrition plays in being able to focus
  • What typical of video games can aid in training attention 
  • The potential negative effects of shooter games 

(20:37) Understanding Endeavor: How to Train Attention Using a Video Game

(49:21) Exploring Potential Costs & Opportunities of Biosensing Technology

  • Understanding the potential adverse effects or downsides of this technology
  • Join the Live Audience: ourupgradecollective.com
  • The exhaustion factor in playing Endeavor
  • What video games would be likely to reduce cognitive function
  • Using Lion’s Mane for increasing brain function
  • What this system could look like in 10 years

Enjoy the show!

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[00:00:00] Dave: You are listening to The Human Upgrade with Dave Asprey. Today we’re going to talk about using video games to treat ADHD. Okay, well, maybe not, but maybe. We’re going to talk about distraction and focus and how video games, not all of them, not used unconsciously, though, might be a benefit to you.

[00:00:25] And I wanted to do this interview because years ago, I’m going to disclose my calendar age, even though my lab tests don’t agree with them, when I was in college in the early ’90s, I was the only person who had a laptop because I spent $5,000 in 1990, which is the equivalent of like $5 million of today dollars because inflation is real.

[00:00:49] And it was the first time I had one, and I started playing a game called FreeCell, which is basically solitaire. And I played it all day, every day in class, while I was taking a double course load for the first time in my life. And I got a 3.9 GPA that semester, which was the highest GPA of my entire life because of video games. 

[00:01:09] And what I realized was that my brain stayed engaged because I was just doing a mindless card game, and I was still listening, and I would just switch over to type out whatever was important and then go back to the video game. And then all the other people in class would get really offended, and they’d say, Dave, how disrespectful to play a video game during class.

[00:01:31] And then I would look at them, and I’d say, how disrespectful to look at my screen that was private? Uh, which created usually seizures in those people. But then I would say, would you like a copy of my notes? And magically, my notes were better than their notes because I had a computer, but I could only pay attention because I was playing a video game because, yes, I did have ADHD. 

[00:01:52] So that is one case that I maybe wrote about in one of my books I talked about early on in a blog post, but it’s the real deal. And so there are many other things, like Lumosity and things like that. So I wanted to go into some details on distraction and focus, and I want you to learn some things from this episode.

[00:02:12] Our guest is the co-founder and Chief Science Avisor of the Akili Interactive and Jazz Venture Partners, and he’s the David Dolby Distinguished Professor of neurology, physiology, and psychiatry at UCSF. Welcome to the show.

[00:02:32] Adam: Thanks for having me here. Really excited about it.

[00:02:35] Dave: I guess I should also say your name is a professor or Dr. Adam Gazzaley, although you go by Adam.

[00:02:41] Adam: Yes, Adam is fine.

[00:02:42] Dave: I was too distracted. I saw a squirrel. 

[00:02:49] All right. Let’s get right into the details here. Do you like ice cream? Oh, sorry. ADHD, it just happens. How do you measure attention?

[00:03:02] Adam: Yeah, that’s a great question and a challenging one. And I can tell you the main reason why it’s so challenging is, what do we mean by attention? Attention is one of these tricky things in that if you use the word, everyone feels pretty comfortable that they know what you’re talking about. But I could easily spend an entire hour now and break down attention in so many different ways and from so many different perspectives.

[00:03:26] And each one of those ways of looking at attention has a different metric and measurement tool. So attention’s actually incredibly complicated, of course, and I think everyone appreciates this is built into using the word that it’s important. Really, really, really important.

[00:03:42] I would say, it may be the most important human function. Uh, without it, we’re essentially incapacitated by an inability to filter out all the irrelevant information around us and focus on what we’re intending to. So I just want to preface that, and I’d love to spend an hour talking about attention, but we want to talk about a lot more than that.

[00:04:02] Usually, when people are talking about attention and they just use it quickly, what they’re talking about is top-down selective attention. And so we have attention systems that allow us to pay attention to things that we’re not trying to all the time. Our survival depends upon that type of attention.

[00:04:20] But when people are like, how do you measure attention? They’re usually talking about top-down. That’s goal-directed attention and not necessarily sustained attention, although that’s another aspect of attention. But how effectively do we focus our limited resources in space and time and resist the distracting information that threatens to derail that focus?

[00:04:42] So let’s just define attention that way. Um, it’s one of many ways. And there’s lots of different tools, so you can measure it in a lab with quantitative tests. We use many of them. One of them that we use in a lot of our research, including our video game research as an outcome measure, is called the sustained focus test or the test of variable attention.

[00:05:02] And it’s looking at two important aspects of attention, both your ability to focus on what’s relevant and resist what is irrelevant, and also sustaining over time because it’s built into attention as some type of temporal dimension that if you’re not holding it, it’s barely attention.

[00:05:21] And so there’s lots of laboratory tests to do that and quantify that, how fast you respond. Also, your response time variability. People are familiar with heart rate variability. I’m sure a lot of your listeners. There’s also RTV, RT variability, which is a metric of not just how well you deploy your attention but how variable is it over time, how well can you maintain that focus of attention? And then of course, there are ways of using neural and physiological recordings to also understand the mechanistic underpinnings of how well you’re focusing your attention.

[00:05:54] Dave: This can be miraculous to understand. I came across this when I got myfirst brain scan from Dr. Daniel Amen. Today I’m on his board of directors for Amen Clinics, and I had a spec scan in my brain because I was failing out of Wharton Business School, and I could tell something was wrong.

[00:06:13] It was actually really scary. And I was ashamed at the time because I qualified to get extra time on my test because, as soon as I started taking a test, I’d get a 100% on the first question, 80% on the second. And after that, it was 30%, then zero. And it was like, no matter how hard I tried to think, there was just nothing in there.

[00:06:32] And what we learned was that I was literally shutting down activity in my prefrontal cortex. There was no metabolic activity there. I had mold toxin-induced brain damage. And so I went and did a battery of tests, including how variable is my attention, what’s the response time on the tension? Um, what’s my TOVA score?

[00:06:54] And I got really into hacking that so I could learn how to pay attention. And I did partly, I had Asperger’s, partly had ADHD. And you can train your ability to pay attention, just like you can retrain your vision, you can retrain your hearing, all of which I’ve had to do. And magically, I can pay attention at least to things I care about for long periods of time.

[00:07:18] And if I don’t care about it, instead of just being unable to care, I choose to go do something else. But it’s a choice. I’ll not finish the book because I didn’t think it was worth the time versus I can’t finish the book, or the lecture, or whatever it is. How common is it that people consciously train their attention?

[00:07:39] Adam: Well, I really liked what you said. And in some ways, it’s the journey I’ve been on for the last 15 years, is to apply both rigorous and intentional design of tools to help you accomplish that, and then do deep-dive research studies to figure out, does it work, and how can it be better?

[00:07:56] And so what you described was my mission. Prior to the last 15 years, I had been working on understanding attention using functional brain imaging, both fMRI, and EEG, and all sorts of tests. And my conclusion was the one that many scientists have reached, is that our attention is really vulnerable and fragile to all sorts of interference.

[00:08:15] And our modern world is not making it any easier. I wrote an entire book on this called The Distracted Mind, and it’s not a cheery topic. It’s like, wow, we are struggling. And then I was like, man, I do not want to tell that story for the rest of my life because it is a bummer, and it’s not, um, in any way activating people besides just alerting them to the challenges.

[00:08:38] So being aware of your challenges is critical for all sorts of change, but it’s not enough in itself. And so can we design tools that selectively target these networks and have the ability to adapt so that you’re really challenging at the highest possible level? And that’s what I’ve been working on.

[00:08:56] So to answer your question specifically, I’d say most people don’t train their attention even when they recognize that their attention is suboptimal for what they’re trying to accomplish in life. And many people, first, are aware of their attention challenges maybe through a teacher at school, or their friends, or their significant others, and then get a little more clarity maybe through a doctor that did a TOVA and an evaluation, and then they discover these letters, ADD or ADHD. And all of a sudden, they’re like, wow. I think I know why I’ve been struggling.

[00:09:35] And as we all appreciate, um, one of the main things that we then do is give a drug, uh, usually a stimulant, something like Adderall, to try to restore that. Sometimes is behavioral therapy if you can afford it and have access to it. And those are the tools that we have that most people have access to.

[00:09:54] That’s, I would say, the status quo, the paradigm of medicine for the mind in general, and certainly for attention challenges, is a pill. And that doesn’t really train attention. If you strip away that chemical boost, you’re back to where you are almost immediately. And so there’s no real enduring plasticity in the brain that’s leading to sustainable effects.

[00:10:18] And so most people don’t do what you do. They don’t have quantitative metrics of their attention that they could follow over time and engage in a program to strengthen those abilities like they may strengthen their endurance, or their physical muscles, or their hearing. And so, yeah, I think it’s actually really rare and a missed opportunity, which is why I do everything I do.

[00:10:39] Dave: Hopefully, we can get a million or so people paying attention to this episode for at least a portion of it. That’d be wonderful. Now, you mentioned Adderall. Uh, when I was at Wharton, I did go on Adderall. In fact, it was funny. The psychiatrist who had been trained by Dr. Amen, he looked at me like, oh, tech bro wants Adderall. I’ve seen this before. 

[00:11:05] When he saw my brain scan, he just looked at me, shook his head, and said, Dave, inside your brain is total chaos. I don’t know how you’re standing here in front of me. You have the best camouflage I’ve ever seen. And by camouflage, he meant that I could look and act normal like a warden school attendee, even though my brain was scrambled. And I was really, really struggling to pay attention.

[00:11:31] I’d bite my cheek until it would bleed, or pinch my thigh, or something, and just really effort my way in. But eventually, willpower didn’t work. What I found, though, was increasing mitochondrial function, actually, the ability of the cells in my brain to make energy really helped me pay attention.

[00:11:51] And in Bulletproof Coffee, I’ve had countless people tell me they went off Adderall when they started drinking butter in coffee. Today I do Danger Coffee, is my new coffee brand because it’s got minerals and electrolytes that I think make a different experience. But what’s interesting is the MCT oil makes ketones which power mitochondria in a different way.

[00:12:13] And it felt like with that, I didn’t necessarily need something like Adderall, but I couldn’t take Adderall because it made me want to punch people. It was really a gross feeling. So I switched to modafinil, which I popularized as a smart drug in nootropic circles over the last 10 years, and went on ABC Nightline about it.

[00:12:31] And I don’t have a problem using drugs or supplements. Today, I use modafinil about half the time just because I like it, but I use 50 milligrams or a 100 milligrams of low dose, and it feels like it helps me with smoothness and it probably lowers my variability. And in fact, I measured it once, that it lowered my variability and my attention. But overall, I’m happy with how my brain works on or off the drug as long as I get good food. Do you think nutrition is a major variable that people overlook when it comes to paying attention?

[00:13:06] Adam: 100%. There’s lots of variables, and we all have our focus areas, and you have yours. And mine has largely been using interactive experiences both through video games and other approaches in order to fine tune these operations. But that’s just one sliver of the conditions that are necessary to be optimized in any way.

[00:13:29] And so nutrition, 100%. Physical fitness, 100%. Adequate and efficient sleep, also critical for these type of functions. Everyone’s probably nodding right now because we’ve really grown to, uh, recognize how important that is for attentional function. And then stress management. I would say not no stress.

[00:13:53] I think stress is really good to some degree, to push the body. That’s how we were built, both physically and cognitively. We respond to stress. We would not do well in an environment that was completely passive with no challenges, but there is a type of hopeless, helpless, chronic stress that’s also very damaging to the brain.

[00:14:13] So somewhere in there is the sweet spot for each person. And I think dialing all of those things in, including social interactions, I would say, time and nature. There’s a long list. And that’s why as I’ve moved technologies from my lab and center at UCSF into companies and now we have products, and still trying to be very careful and deliberate with my messaging that this is not some holy grail, like play this video game and you’re fixed.

[00:14:40] This is one tool on a whole belt that you should be wearing. And we intentionally limit the amount of gameplay to just 25 minutes a day, five days a week. Even what we consider a dose is just a month dose, because it’s not meant to be a replacement of all the other things, proper nutrition, sleep, physical exercise, and time in nature, social interactions, that are all important for being a comprehensive, well-rounded human being and having good attention.

[00:15:11] Dave: Does it matter what video game you play?

[00:15:15] Adam: For sure.  And I would say it’s the same logic of, does it matter what drug you take? That’s a perfect one. I’ll just leave it to that. Does it matter what drug you take? Oh yeah. There are some drugs that’ll kill you in a second and other drugs that may change your life or open up your perspective to the world. And there’s the full host. 

[00:15:36] And games are just like every other category. There’s an incredible amount of variability within them. Some will be fun, but won’t necessarily have a positive and enduring impact. And that’s fine. There’s plenty of drugs that are fun too that might not have that impact.

[00:15:52] And there is also different types of interactive experiences. We’re talking about video games, but video games are not magic. They’re a fun, engaging, hopefully digital, interactive experience. That’s what they are. And so from that perspective, they’re an experience like any other that can change your brain for good or for bad.

[00:16:15] There’s no ethical force in how these things change you. They put pressure depending on how you engage with them. So there are some games that may have certain benefits in some domains of your activity and how you function, and others that may have different ones. Um, and basically, anything could be built into a video game and back. At Neuroscape, we have just published our third paper on a game that’s essentially concentrative meditation.

[00:16:41] You play with your eyes closed, all the reward cycles. And the mechanics are very much in a line what people would think of as vipasana. Um, but it’s a game. It has game elements to it, at the very least. So we have physical fitness games, games in VR that allow you to navigate three-dimensional worlds. And so the devil’s in the details. What game is it? How is it designed? What is it targeting? And then what’s the data that it does what it was intended to do? So all those go into it.

[00:17:12] Dave: Lt. Col. Grossman came on the show a few years back. He wrote the books On Combat and On Killing and studied how first responders respond to traumatic situations and school killings. And what he found was a common variable in all of the really bad school shootings was heavy experience with first in the shooter video games. In fact, he calls them mass murder simulator training. Uh, so the rule for my kids is you can play games where you shoot at robots, but you don’t play games where you shoot at humans because it’s bad for your soul. Good advice or bad advice?

[00:17:49] Adam: It’s a complicated one, and it’s not my area of expertise. All of the games that I have ever built and put out there and studied, have no violence in them because I don’t think it’s a necessary ingredient for the effects that we’re trying to yield. So why add in something that’s so complicated and may have negative benefits, may have negative effects?

[00:18:10] I think that the data is mixed, and it’s not necessarily because it doesn’t have harmful effects in some people. It’s just that there are so many people consuming all sorts of things, from violent TV to all sorts of things, and it’s very hard to really dial in with conviction what those effects are. But I’m on the same page as you. When we actually met many years ago, I don’t know if you remember this, we were at a conference together. MindBodyGreen maybe. I have to at look–

[00:18:42] Dave: Oh yeah, I remember that.

[00:18:44] Adam: Do you remember that? 

[00:18:45] Dave: It was a long time ago. The one they put on before all the pandemic stuff, and they invited a bunch of interesting thinkers.

[00:18:50] Adam: It was a long– 

[00:18:53] Dave: Yeah.

[00:18:54] Adam: Exactly. We sat–

[00:18:55] Dave: That’s why you look so familiar.

[00:18:58] Adam: We sat at lunch together. That was the first time we met each other. I think we haven’t seen each other since. And, um, the reason I brought that up is I did not have children in those days. Um, I do now. I have two little kids. Yes. 

[00:19:10] Dave: Oh, congratulations.

[00:19:11] Adam: Thank you. Little ones during COVID. Um, so you can’t help but have your perspectives, even as a scientist, colored by your life. And I’ve talked publicly about video games for so many years, and the question of violence and video games comes up. I don’t have a super strong opinion on it. It’s not what I do in my own work.

[00:19:30] But I present what I said to you, the data is mixed. But now I have kids. Now I actually have to make a personal decision, not just an academic one. And I feel similarly personally to you that it’s nice to have games that are engaging, and challenge you, and reward you, and get your adrenaline going. But extreme violence towards other human-like characters is not something that I’d be putting on the list for my little girls, uh, anytime soon.

[00:20:01] Dave: I think I would be okay as teenagers if my kids wanted to shoot at zombies because it turns out, there are actual real zombies in the world walking around right now. And you should be able to call them out automatically with your nervous system, so you can avoid them. Some of them even vote. Oh my God. 

[00:20:19] Now, in your work, and I think this is really helpful for listeners, uh, to understand how their brain works, how focus works, you talk about top-down and bottom-up thinking and how it relates to paying attention. Talk to me about those kinds of thinking and what they do for your attention.

[00:20:39] Adam: Sure. So bottom-up is the more ancient type of attention. So if you pretty much look across any animal, even animals that have not very well developed brains, they have this bottom-up attention. And what bottom-up attention is it’s sensitivity to the environment that automatically reflexively triggers you to direct your resources, whatever they may be at.

[00:21:07] And you could imagine the survival advantage and why it was evolutionarily selected for in that you need to find food, you need to avoid toxins. If you’re evolved enough, you need to find mates and have babies. And so it’s fundamental to the nervous system, is this type of attention, like a flash of light, a loud sound. You are orienting to it even if you didn’t have the goals. That’s bottom-up. It’s still part of our system. You go across the street. It’s measurable.

[00:21:35] Dave: Someone on drugs or on toxins will have a much– someone who smoked a lot of pot, it’s going to be slower, right?

[00:21:41] Adam: Yeah. There’s so many things that alter this from lack of sleep. It varies. It’s a state-like effect, but you know it. When you’re crossing a street, you’re looking at your phone, you’re engaged in thought, someone hits the horn, you activate. Hopefully. And that’s bottom-up.

[00:21:56] That’s bottom-up. Top-down is looking in your phone being lost in thought. It is goal-directed attention. It’s not necessarily related to survival. It’s not necessarily directed at the things that are most important or most salient in the world. It’s how you direct your attention based on choice and decisions.

[00:22:14] And that’s what humans pretty much do very uniquely, is that type of attention. And also top-down attention can be switched, and moved, and navigated in all sorts of ways. And a lot of our challenges with technology and the modern world in general is a collision of top-down and bottom-up.

[00:22:33] Because technology companies and the people that design for them are smart people, and whether or not they were aware of bottom-up and top-down are certainly aware of tools that they have that can create bottom-up sources that pull your attention. Whether it’s notifications from buzzes to vibrations, to lights, to sounds, these are still very powerful sinks for us, and they’re used very effectively that way. And we have to combat against them if we’re going to maintain our top-down attention.

[00:23:09] Dave: Okay. Is it more helpful to train top-down attention or bottom-up attention?

[00:23:16] Adam: I think that there’s value for both. Most people, when they feel that their attention abilities are not as good as they should be when they’re struggling with it, what they’re largely talking about is their top-down attention. They might be highly sensitive to the environment, but what is getting them in trouble at school, or work, or in their relationships is they’re not holding their top-down attention at the level that they want to for as long as they want to. So that’s usually what people with ADHD are suffering from, is the top-down attentional deficits. And that’s the type of things that I’ve worked on, especially in our video game that’s out there now as a ADHD treatment is really targeting that specific type of attention.

[00:24:04] Dave: It’s scary. I’ve seen those videos of classes in China where young kids, I’m guessing seven or eight, all have, it looks like HEG devices on monitoring, whether they’re bringing blood to their prefrontal cortex and notifying their parents if they’re not paying attention enough so they can get yelled at later, notifying the teacher. I’ve often thought as a teacher– I was at the University of California Santa Cruz for five years.

[00:24:30] I taught working engineers how to build the first version of the web, and so I would love to know if I’m losing track of my class so I could throw something at them, or talk differently, or do something like the feedback loop would be great, but it seems like that could be toxic. Can you overtrain attention in kids so that they lose their ability to play or experience joy?

[00:24:53] Adam: It’s a good question. I would say that it’s probably unlikely with just training approaches itself. Can you do it with drugs? Sure. And we probably do already accomplish that by overmedicating. There are certainly reports of kids on Adderall that feel that it does impact their joy or their personality in the goal of improving their attention.

[00:25:17] The powerful thing about training attention, whether it’s through a video game or another approach like the video game, is that is something I know well because we’ve been studying it for 15 years, is that when you play it for long enough, you feel, a certain percentage of people, around 70% in adults feel that they are better able to focus their attention. That’s after a month or six weeks. It certainly does not happen as quickly as a single dose–

[00:25:43] Dave: Of playing any– or you’re saying–

[00:25:44] Adam: Of playing this game, of playing our game Endeavor.

[00:25:47] Dave: This is the game called Endeavor specifically. 

[00:25:49] Adam: Exactly.

[00:25:50] Dave: Okay. And what platforms is Endeavor on?

[00:25:52] Adam: So, um, maybe I’ll just slide back for one second and tell you a little bit about the Endeavor story. When we met all those years ago, I had a game that we had published in Nature showing that we can improve attention in older adults. That game was called NeuroRacer, and that’s what I was there speaking about.

[00:26:10] Dave: I played it. 

[00:26:11] Adam: Yeah. So since then, Akili, the company that I co-founded, licensed the technology, the patent, essentially, behind NeuroRacer, and built a game called Endeavor. And it’s been a decade now, and over those years, dozens of research studies have been done in different populations. They kept replicating the original finding in nature that playing the game improves your ability to sustain attention outside of the game.

[00:26:36] So your TOVA gets better.  And also, now what we’ve shown in ADHD studies is even your real life focus as subjectively measured by how well you’re able to engage in tasks of daily life, also improve as well. And so that game, after many, many years of clinical trials, including a phase three trial, so a double-blind, placebo-controlled, randomized multi-site trial in children presented to the FDA, was approved during COVID as a class two medical device. So this was the first video game ever approved by the FDA for any medical condition, and in this case, it was for children, specifically eight to 12-year-olds with attention deficit disorder.

[00:27:20] Dave: Hold on a second, though. If the FDA approved it, doesn’t that mean that it doesn’t work and has massive side effects?

[00:27:27] Adam: This is an exception to that.

[00:27:29] Dave: Okay. Just checking. 

[00:27:30] Adam: I can tell you that taking a video game to the FDA was a unique experience for myself as well, because you’re right. They don’t tend to look at what I define as experiential treatments. Uh, this is a very, very new submission for them. And it actually went into a category called De Novo submissions, meaning that there’s no predicate to fall on.

[00:27:50] It’s a completely new category, and thus it’s spent two years in the review process of going through the data and understanding from hundreds of children that have played it, and it was eventually approved, so now a doctor can prescribe it. So that game is called EndeavorRx. It’s our prescription game. It’s for children. It is only available via prescription, and they can play this with Adderall or as an alternative to it.

[00:28:16] Dave: So you can actually now get insurance to pay for video games, which is why you went to the FDA, which is brilliant, by the way. Insurance companies should do something useful. Maybe this is one of the few things that they’ll do.

[00:28:26] Adam: You just really hit a very triggering point to me in a good way. Um, let me tell you about that. So I spent over a decade designing this game, and then dozens of research studies published in great journals, two years at the FDA to get that approval, and then we bring it to the world. And what do we find? Insurance companies really don’t want to reimburse for it.

[00:28:55] Dave: Insurance companies don’t want to reimburse for anything. Let’s face it.

[00:28:59] Adam: Exactly. And there’s nothing about FDA approvals that makes an insurance company have to approve for it. It’s a big problem. And so we’ve struggled there. Um, we have, I think, over 15,000 prescriptions written by doctors for children.

[00:29:13] And we have lots of success every month. More and more children are playing their medicine essentially. But we still struggle with widespread insurance reimbursement, and that is a real burden for any company. A giant drug company can push through this phase, this valley of death between re-regulatory approval and insurance reimbursement.

[00:29:33] But for small companies, it’s very hard to do that. And so that’s been an area of struggle, one that we continue to try to push on, is the need for insurance companies to say, hey, we have children in need. We have a game that’s been through a lot of research, that’s FDA-approved, that has essentially no side effects. This should be something that’s reimbursed, and that’s something that we are still pushing on.

[00:29:57] Dave: Guys, it’s called EndeavorOTC, and I’m actually installing it right now on my phone. And I actually knew about NeuroRacer, but I didn’t understand that was the tech in EndeavorOTC. So I’m installing it right now to see if I notice a difference because my intention is very well trained at this point, but I’d be willing to spend–

[00:30:15] Adam: Yeah, that’s great. It is exactly the same as NeuroRacer. And from the mechanic’s point of view, that has a much better game envelope around it. But I want to point out a difference there. So what you’re downloading now is called EndeavorOTC, which stands for Endeavor over the counter. 

[00:30:31] And so what happened several months ago is that given the slow adoption of the prescription treatment for children because of the insurance reimbursement delays and the doctor gateway, we did a study on adults and found that it actually improved their attention seven times the level of what we saw in children. 

[00:30:53] And it also has 70% reporting some improvements in a well validated metric of quality of life. And we also know that the number of adults with ADHD has continued to increase, especially through COVID. And what we released there that you’re downloading is the same game as EndeavorRx, but does not require a prescription and is targeted for adults. So it has the same core mechanics, but it doesn’t have all the connections with the parent and the doctor and all the other elements that go into the prescription version of it.

[00:31:29] But the core ingredients, the engine of the game is all there in EndeavorOTC. So we just released that. We’re really excited. We’re getting great traction on that. And I’m happy that after a decade of writing back to people from their emails and saying, how do I get NeuroRacer, I’m like, well, here it is. It’s now available. 

[00:31:49] Dave: Thank you. I consider it unethical when the trade union of physicians and drug companies requires you to get a permission slip to buy something you want to buy. I didn’t sign up for having my daddy, uh, or my mommy be my government or my doctor telling me what I can and can’t do with my own biology.

[00:32:09] I am a biohacker, and if I want help or consulting, then I hire the right experts. Sometimes they’re world-class doctors, and sometimes they’re not. And that’s up to me. So thank you for breaking through that. People are asking what the price is. Um, it is 25 bucks a month, or it looks like $10.83 a month if you do a year’s subscription.

[00:32:31] So not crazy expensive. I am going to do the year version. And guys, this isn’t prearranged or anything. I didn’t realize this was NeuroRacer because I liked it. It was just too much of a pain in the ass, and we don’t have a license for 40 Years of Zen, which is my neuroscience company, and I have, I don’t know, a $100,000 worth of neuroscience gear in my house. 

[00:32:47] Dave: So this is cool because it’s an affordable way to train your attention. What if you don’t have ADHD, though? Does it still help your attention if you’re already normal or you think you’re normal?

[00:32:58] Adam: It’s a great question. So we have lots of data that convinces me that this is a tool that improves attention pretty much across the board. And it just so happens that people with ADD, as the name would imply, and ADHD have a lot of attention problems, but we have data from all sorts of healthy populations.

[00:33:16] Our Nature paper was healthy, older adults that were in that study. We’ve had data from depression, and MS, and many different clinical indications. So we took one through the FDA, but yes, I would think of this as a way of improving attention abilities, and I’m really curious what your listeners think about it when they play it.

[00:33:36] I do want to note that you might not feel the effects immediately. It’s not a drug that’s just dumping and changing neurochemistry dramatically. Picture training for a marathon. You got to do a little bit of work here. I could also tell you that game is hard.

[00:33:53] It’s a game. You’ll see. You’ll tell it’s a game. It’s cool-looking. It’s lots of rewards and characters, but it uses a closed-loop system. So it’s constantly adapting the level of challenge based upon your abilities in real time. It’s like the ultimate personal trainer, and it’s going to kick your butt like a personal trainer would. So bear with that. One other little tidbit, I’ll tell you– it’s funny, Dave. I expected you to say what you did about the firewall of someone else making a decision. And I actually didn’t want to have this conversation with you until we had the OTC.

[00:34:28] Dave: By the way, that’s the beginning of the game, so I have already installed.

[00:34:31] Adam: Nice. 

[00:34:32] Dave: I’ll figure out how to turn it off now. Didn’t mean to interrupt you. It just started.

[00:34:35] Adam: No, I loved it. Yeah. No, I wanted to have this conversation with you because I knew that this is the direction we’re going as we released it from that prescription firewall because I remember our discussions. I remember meeting you. I know what you do, and I wanted to talk about it when it was available.

[00:34:50] This would’ve been a really frustrating conversation for me, and probably for you, a year ago. And so that’s out there. The other thing that I wanted us to include that wasn’t there until a month ago that has also wanted to do before talking to you was that we now have embedded in the game a focus score.

[00:35:08] Dave: Oh, cool.

[00:35:09] Adam: Yes. See, I do. That uses gameplay data on your first visit to give you a baseline, and then it uses data to predict where you’ll be in six weeks from now. And I could tell you that that focus score, although it is an engagement feature, is not just an engagement feature update your– a high score or anything like that.

[00:35:29] We worked a year for that to find a metric that we could pull from game data that predicts the clinical outcomes in our research studies. So that score, the change in that score correlates with the change in TOVA, in our trials, in the change in reports of improvements and functions. So it’s a meaningful measure, not just a cool thing to see change over time. And you’ll get reports in the game now about how that’s changing. So if you happen to be someone that likes to quantify and not just hack and improve yourself, we now have both of them in there. So that’s very recent.

[00:36:05] Dave: You want to know if your hacks work. So doing a hack without a measure of success isn’t much of a hack. And the good news is today things like heart rate variability, if you woke up in the morning and you were better recovered, you could probably say that something you did worked or didn’t. Um, but when you have really precise measures of your focus and your attention, you can just more easily hack.

[00:36:27] And if you have a closed-loop biofeedback system, so the original days of quantified self, these are like stamp collectors. Oh look, I have all these stamps. You ever going to send a letter? No, I just like them. They’re pretty. And gathering data about yourself that isn’t actionable, whatever.

[00:36:44] But if you have a week’s worth of data, at the end of the week, you could say, I noticed a pattern. But if you’re getting feedback in under 350 milliseconds for the average brain, or maybe 240 milliseconds for my brain, then all of a sudden the brain changes and you can change your body really, really quickly.

[00:37:03] And so I know you’re doing some work on this front, and there’s a bunch of neuroscience people, doing stuff that you wouldn’t imagine. I was at Burning Man, as we’re recording this, literally two days ago, and I woke up at 5:00 AM uh, for, uh, a Daybreaker. This is a drug-free morning dance thing with my friend Radha dJing.

[00:37:26] So we’re out there dancing, and then this black ambulance that’s been modified to be an art car pulls up, and this guy gets out and goes, hey, do you want a neurological experience? And I’m like, heck, yeah. So I get in this thing and sit down, and he’s got a full biosensing lab there on the plan, wiring up heart rate and all this stuff, and then doing a vibrational experience with specific vibrations on different parts on the body.

[00:37:49] Adam: Mm-hmm.

[00:37:52] Dave: Okay, cool. Uh, he didn’t know who I was until I was done. He’s like, oh my God, this is a peak experience. It was cool, but the idea is he’s doing the same stuff that you’re doing, same stuff that I’m doing at 40 Years as Zen. What are the different things we can measure on the body that we could then provide feedback on? And you’ve gotten really into this. So talk to me about multimodal biosensing and how you use that even in the context of developing your game.

[00:38:15] Adam: Yeah. Um, we actually use a lot of the same technology that was in that black ambulance. There’s a company down south called BioPak that makes some brilliant physiological recording, like research grade that’s used in labs all over the world. And during, um, one of my, COVID projects, when data collection slowed down for obvious reasons, uh, I was like, let’s build stuff in preparation for today, when our labs are open.

[00:38:40] And one of the things that I’m interested in, and I think you’ll appreciate this, is that if you use one recording modality, let’s say EEG, or fMRI, or [Inaudible] spec, whatever it is, it’s going to be limited undoubtedly, because that’s how quantitation works, is quantification of physiology is going to have inherent limitations based upon the methodology that you’re using.

[00:39:07] So you stick an electrode inside a brain of an animal, single uni physiology. It gets all this really beautiful, detailed information about a single neuron, but it doesn’t really understand the entire network phenomenon. You record information with fMRI, short understands blood flow, but it has slow timing limitations. EEGs faster, but you don’t know where it’s coming from.

[00:39:27] It’s always like, here’s the advantage. Here’s the disadvantage. So I was like, how about if we create a system and just record all the data? So where’s the limitations in putting together this dream system, what we called it, and we started this program called multimodal biosensing.

[00:39:43] We wanted to see how much data we can actually record with very high fidelity, um, and make. So that’s one challenge. And so we have, I think, over 180 electrodes now in UCSF, in our labs here, from across the brain, the eyes, heart–

[00:40:00] Dave: Not24. I’m having electrode envy right now.

[00:40:02] Adam: Yeah. Come down. We’ll hook you up. It’s quite an experience to get hooked up to. And then it all reads out in one big monitor. It’s awesome. I’m pretty confident this is the most data ever recorded from a human being in one session. And that’s great, and it’s cool, and it’s fun, and it’s scientifically interesting to record all that data, but it presents new challenges.

[00:40:23] How do you interpret so much data, and how do you interpret it rapidly so that it’s actionable, as you said, within hundreds of milliseconds? And so there we have team members that are experts in signal processing and machine learning, especially to be able to interpret this data. And so that’s what multimodal biosensing is.

[00:40:42] It’s a program that we’re very excited about. How can we quantify physiology across all these different channels in order for us to understand, in real time, the state of an individual? So we’re not talking about reading out specific thoughts or memories, but what is their level of stress? Where is their mood? Up or down? What’s their valence? What’s their arousal level? Can we get some reflection of their awareness? And then take that data in a closed loop and use that to guide the experience that we’re presenting to them.

[00:41:14] Dave: What’s emerging is that when you get a picture of someone’s pulse wave, which is an interesting thing that happens inside, how quickly can you carry a wave from one side of your body to another through your circulatory system? And you get heart rate variability, and you get something called GSR, which is galvanic skin response.

[00:41:33] This is a very old biofeedback thing. And you get respiratory rate, whether it’s from heart rate or it’s real. And you measure exhaust gases and breaths per minute. And each of those individuals, you can train and gain control of. And we have all these control systems that aren’t labeled that you wouldn’t know were there until you start biohacking.

[00:41:51] But when you take all of those and put them together, and especially with AI, you see these weird things. When I was, um, CTO of the first company to get heart rate from the wrist the way your Apple Watch will do today, just effortlessly. 10, 15 years ago, that was hard, what you end up realizing is that when you put the signals together, you could use heart rate to really predict breath. You could also use breath to predict heart rate. 

[00:42:17] Dr. Love who was on the show, Paul Zak with oxytocin, said he dropped 80% of the blood tests that he was doing because using multimodal sensing, he could predict your levels of oxytocin with 95% accuracy. So you’re at the very cutting-edge of saying, this signal is coming off the body if you combine them, which we’ve never done before because we didn’t have the compute power. We’re cracking the code of being human, it sounds like.

[00:42:42] Adam: We’re super excited about it. Combining them in a way that’s interpretable and actionable is an immense technical challenge. And it’s going to take us years to do that. And then the goal is to reduce it down to, say, where’s the most information density? And do we really need all of this?

[00:42:59] Because right now, no one’s going to hook up 180 electrodes at home. Of course not. So what we want to do is say, okay, let’s bring it all on at the highest level we can in a lab. This is what labs are good at. And then figure out what do we actually need to get the most important data and figure out what we can then deploy in the real world, in people’s homes, in clinics, in schools, in gyms, and things of that nature. So that’s one direction that we’re going in we’re really excited about.

[00:43:30] Dave: I’m imagining that there’s a day coming where you gather all the data, which is hard. You’re going to have people submerged in tanks with tubes coming down. It’s going to be pretty heavy-duty stuff, but you don’t need that many people where you do that, where all of a sudden you go, oh, if you boil all that down, and you can blink a light in the left eye, in the upper left quadrant, four times while simultaneously playing a 2,000-hertz tone in the right ear.

[00:43:57] No, 2,600 hertz for my computer hacker friends. All of a sudden, oh, in most people, it snaps them into a different state, like EMDR was discovered by watching tennis without moving your head and noticing a new mental state. So instead of accidental discoveries, you’re going to be digging in. What is the holy grail for you with biomodal sensing? What do you want to be able to do with this?

[00:44:21] Adam: I want to be able to use it in the millisecond level. I want that data to be fed into a real-time multi-sensory immersion system. That’s where I am. So we actually have that lab too. So we built our multimodal biosensing system, and then we built a sensory immersion lab with really beautiful, giant screen, surround sound, scent delivery, wind stimulation.

[00:44:50] And the goal is, can we use real-time data at the level that we’ve just been discussing to then guide environments that challenge you, reward you, stimulate you, relax you, based upon your own data? So create these personalized fully real worlds. This is what excites me about AI.

[00:45:13] And once you start really pushing on what we’re saying here, it can get a little weird and scary, and that’s only because it has, I think, the power to make positive change. And positive change can always come with negative change. But it is a great potential application of artificial intelligence, of multisensory environments, of multimodal biosensing, to be able to use real, rich, comprehensive data to guide an environment that helps you become the best version of yourself.

[00:45:50] Dave: The original definition of biohacking when I wrote it is, change the environment inside and around yourself so you gain full control of your own biology. What you’re talking about doing is measuring your biology in an unprecedented way so that you can use that data to change the environment around you, which changes the environment inside you really rapidly, way more than drugs would when we get [Inaudible].

[00:46:15] Adam: This is what I want my legacy to be. If you think about it, this is what Endeavor and NeuroRacer does on a really simple level. Your data in is just like your accelerometer, you’re tapping, and the environment out is the rewards and challenges in the game. So it’s the same closed loop.

[00:46:34] It doesn’t use sophisticated AI, but the idea is there. It’s the same idea. It’s just that now the data that flows in is so much more richer and meaningful and more comprehensive, and the environment that’s fed back to you and the speed at which it is so much more real and immersive. And so I think that the changes that we can invoke will be much more powerful and enduring.

[00:47:00] And I think that this is future medicine. This is how we help ourselves when we are struggling and debilitated by some type of damage to our brain, and also the type of tools that people would use when they’re not suffering but they want to elevate themselves and think at a higher level.

[00:47:20] Dave: Yes. Upgrading humanity and elevating human consciousness are core operating principles for all of the things that I do because it feels like if we don’t consciously take control of this environment around us, we have enough tech and enough big companies optimizing for outcomes that aren’t in our best interests that if we don’t consciously take control of it, it’s not the world we want to live in. 

[00:47:44] And I’ve noticed, through my career in Silicon Valley, that the technologies that have the most potential for enhancing freedom and human thriving have universally been co-opted, I’ll say, for darkness. Things like the very beginnings of the web and the ability for information to be free.

[00:48:06] It’s been completely sucked into first just advertising, and then convincing you to buy stuff you don’t need, and then making everything cheap, and crappy, and disposable instead of good, and now as a surveillance and control platform for people. That’s not why we built it at all. So this time, and one of the reasons this is biohacking is that hackers are the people who say, we need to see the source code, or we’re not doing it. 

[00:48:32] Uh, it was hackers who built Linux, which is the operating system that runs still a lot of the internet today, because they didn’t like that Bill Gates knew what Windows did and we didn’t. So I want us to know what’s going on in our brains. This is one of the reasons I’m interviewing you. I knew about the old, uh, NeuroRacer, but I did not know that

[00:48:52] now there’s a phone version, but people listening can decide, why are you doing this? Are you putting evil malware in their brains, uh, the way social media does? I don’t think so. How would you misuse multimodal biosensing technologies and feedback if you were a big, bad, social media company, for instance? Maybe more with a strap to your face getting biosensing data.

[00:49:16] Adam: It’s such a good exercise. It’s like a scary exercise to go through, but I believe that as a scientist, it’s responsible for us to do this exercise, to picture the worst use of the things you create. Think from nuclear technologies. Right across the board, technology can always go in both direction.

[00:49:36] Fire could cook your food. It could burn your house down. We always have to be intentional about how we design technology, picture the worst-case scenario, and build protections around it. So, sure, with a multimodal biosensing system coupled with a sensory immersive experience with AI guiding that flow, that closed-loop flow of this data, there is all sorts of potential to change the brain in almost any way you choose to.

[00:50:04] And so you can drive people towards being less high performing, or decrease their attention, or decrease their mood, and it may not be the goal to do that, but if the goal is something tangential to the goal of optimizing abilities and care is not taken to do the research and monitor for a adverse effects, you might be unintentionally doing it, even if you’re not evil. And I think that’s a lot of what happened over the last 15 years with our technology. So we monitor for all sorts of things that are unexpected but possible.

[00:50:39] Dave: 

[00:50:39] So it would actually be a lot cheaper to use this new multimodal biosensing and biohacking to put people into a stupor instead of just forcing a plant-based diet on them. Don’t you think?

[00:50:51] Adam: It could certainly be used to guide people in a negative way. I feel so gross even saying that out loud because it’s something that I’ve worked so hard on and love, and really think it’s going to help so many people and children. So I want it to be that solution, and we still have so much work to do, but it would just be irresponsible to not say that it could not be abused, because it can.

[00:51:18] Dave: We have to talk about risks with all new technologies because about 4% of people are sociopaths or psychopaths, and this is provable. And another substantial percentage of people are narcissists, and that’s getting worse. And these are the people who will actually do this, and they won’t– the narcissist won’t know they’re doing harm because they can do no harm in their little mental story. And the sociopaths, they know they’re doing harm. They just get off on it. So that means we need to turn this around. Can we use this technology to identify the narcissists and sociopaths?

[00:51:57] Adam: That’s a good question about, let’s just say, the interpretive value of the multimodal biosensing system outside of the closed loop, which is where we put a lot of our attention. So once we have a system that could capture such rich data and interpret it in a meaningful way, we’ll also learn a lot about people’s abilities, and their motivations, and their mood, and how they regulate and how it changes. 

[00:52:24] So it has some basic neuroscience contribution as well. There’s a dark side to just the monitoring aspects of it. And tests have been used in great ways, but they’ve also been used to segment people in a way that’s probably harmful. So again, how do we use this data in a way that elevates us as humans and doesn’t diminish us is a good question.

[00:52:50] Dave: When people play Endeavor, your new game, they’re giving you a ton of data about their nervous system. Who owns the data?

[00:53:00] Adam: Right now, it’s really a closed loop system. The data’s just being used directly to change the game.

[00:53:06] Dave: And you don’t save the data.

[00:53:08] Adam: No, it’s staying in that system.

[00:53:10] Dave: Okay, cool. So there is no persistent data, so you don’t have a picture other than probably my focus score over time. So you could identify people who focus better than others and people who don’t.

[00:53:17] Adam: Exactly. So we have anonymized snapshots of what is being generated, but not at that level where we could say, oh, Johnny did this or that. It’s a really good area of questioning because we’re just releasing this now, and we’re trying to not just work on data, who’s saving it, but privacy, and cannot be hacked, and things of this level is so important for us to pay attention to.

[00:53:42] Dave: One of the guys in the Upgrade Collective– by the way, guys, you can be in the live studio audience for this. You go to ourupgradecollective.com. It’s cheap, and then you get access to say things like Brandon just did. Please don’t let the credit rating agencies access my focus score. Thank you.

[00:53:57] Adam: Yes. No one will get your data, we promise.

[00:53:59] Dave: Or maybe you’re hiring manager. And right now, it’s actually legal to do that. And frankly, I’d rather hire people who can focus. And I have sent other technologies to some of my employees, like Mindy, where I’m an investor and advisor. Mindy lets you do HEG training to move more blood to the front of your brain. I did the great grandfather of that 10 years ago.

[00:54:19] I’m used to selling it with a hand-built system of that just because I noticed I could focus much better when I trained my brain to put blood in the focus parts on my brain. Who would ever imagine? Um, and you can use infrared light and other things like that on your brain to do that. So it’s helpful. If you’re an entrepreneur, you might consider getting subscriptions for the game to people who seem to have a hard time with it.

[00:54:41] Um, but you also might want to hire people who’ve already played the game. Like, what’s your focus score on the game? Call me when it’s 97, or whatever. I don’t even know the– like I said, I haven’t played this version. I played the prescription version years ago that was part of your R&D, so I’m super excited to try this.

[00:54:55] Adam: Thank you.

[00:54:57] Dave: One thing I’ve noticed– I haven’t talked that much on the show about this. I mentioned it a little bit earlier. Because I had Asperger’s syndrome, probably as a result of toxic mold and maybe some genetics, I grew up with a very different version of reality than most people. I believe our body creates a user interface on reality based on it’s programmed by the environment as you’re growing up and all that.

[00:55:20] So I had to go through and reprogram how my eyes work. It was exhausting work. And I’ve done a couple podcasts a while ago about that. I would do the training, and I would just fall asleep and just be a zombie for the rest of the day. And then I did auditory training on my ears to fix parts of the sound spectrum where I didn’t hear evenly. Same thing. Oh my God. It was so exhausting. And even when I started doing EEG in the very early days, 25 years ago, before I started all this, I felt like my brain was cooked sometimes. I was just so tired. When people play Endeavor, is it mentally exhausting?

[00:56:00] Adam: Yes.

[00:56:02] Dave: Play in the morning or you at night?

[00:56:05] Adam: I think it’s similar to what you described and similar to going to the gym and getting a workout in. We hear a little bit of both, so there’s no doubt that there’s an exhaustion factor because it is driving you to fatigue just like any good workout would. But people also report a little bit of an activation after it as well. I’m curious what you think. That they do feel not quite like they just did a big shot of coffee or espresso, but they do feel activated by it as well. So there’s both. We’re trying to understand that a little bit more now that we have so many more users than we did in clinical trials.

[00:56:44] So that data is harder to collect in a study because you need lots of numbers to understand those type of subjective phenomena. But it does seem that there’s a bit of activation. I’ve even thought about, how might it be to play it before a meeting? Would that activation affect– because people report that right after, they feel like their focus is very heightened.

[00:57:05] Yeah, so there is some recency effects to the training. So it’s an area that we don’t know a ton about. Outcomes in our studies was really, how’s attention improving? How’s the long-term effects on how you’re living your life? More immediate subjective effects are really interesting and something that we’re looking to understand more. So your listeners here are a great audience to be introspective enough to notice that. I would love to hear from them about what their experience is.

[00:57:39] Dave: I’m sure you will. And it’s interesting. When I go into writing mode for my books, and I’m working on a new book about neuroscience actually, what I do is it takes me about 45 minutes. And I usually do this around 9:30 at night, and I’ve got the room all red lit, so I don’t ruin my circadian biology.

[00:57:58] I’m writing on a dim red monitor, and I just have to do something stupid. I’ll play FreeCell, that game, and it’s a slow process of shifting into this. And sometimes I’ll run electoral current over my brain or do specific other practices that get me into a specific neurological state where I can hyperfocus, and then I can write, usually, 15 to 20 pages of epic good book before 3:00 AM or something. 

[00:58:26] And then I go to sleep and wake up, and it’s actually pleasurable, but getting in that state is hard. So I’m going to try using Endeavor and see if that cuts the time it takes me to get in the state. I’m pretty sure I could do it faster if I had to. There’s some inner resistance that everyone has. 

[00:58:44] Adam: Yeah. I’m curious about it because there is this dual effect of the fatigue, but also the activation you get from using your brain in this way. And I’ll be curious to see how it impacts these things that you’re trying to do afterwards. It’s interesting.

[00:58:59] Dave: There’s also the notion of a pre-workout, and a lot of people have heard about these. These are basically caffeinated or similar kinds of things that you do before you lift or before you thatget you hyped up so you can push harder. I would be sorely tempted to do a pre-workout, uh, before I was going to do Endeavor so my brain has the electrical functioning it needs, so I would take mitochondrial supplements, MCT oil, or ketones, or even minerals and electrolytes, and probably even a little bit of glucose, some sugar or honey. Uh, just to really have the brain in the energized state so that you can go deeper on the focus. I know that you [Inaudible] cup of coffee.

[00:59:42] Adam: It’s really interesting research questions of, how does a high-level closed-loop training tool, like Endeavor, intersect with nutritional components that may give you more access and allow you to reach higher levels? That’s a really interesting research question.

[01:00:03] Dave: I’m taking a note on that idea. So we know that you can intentionally alter your state with Endeavor. What video game would you guess, again, you don’t have a study, would be most likely to reduce your cognitive function?

[01:00:26] Adam: I think a lot of games are more likely to be neutral than to reduce function. I bet I could design a game to reduce it.

[01:00:35] Dave: And then give it all politicians from all parties. The world be so much better if we could [Inaudible] that a bit.

[01:00:42] Adam: Uh, that’s funny. Yeah. I don’t know of any that I would say this reduces cognitive function, but I can imagine, um, that– 

[01:00:50] Dave: There a type of game, maybe ones with those loot crates, something that’s just constantly triggering dopamine over and over?

[01:00:58] Adam: Yeah, games that have a lot of bottom-up stimulus that are causing you to react reflexively may make you more sensitive to bottom-up stimuli that may act to make you more distracted. I don’t know. I can’t think of a particular game right now, but that makes a lot of sense that that would happen.

[01:01:18] Dave: Got it. I could see that. At the same time, at least I’ve seen, in my own experience, there’s something called P-300D, uh, which evokes potential score. You know what it is, but listeners don’t yet. So this is something I wrote about in Smarter Not Harder. By the way, guys, if you haven’t read that book, it’s epic, if I can say so myself, from a biohacking perspective. 

[01:01:42] What P-300D is, either your ears, or your eyes, when something happens, how quickly does your brain get notified that it happened? And there’s a delay that, as you age, it gets slower and slower, up to about 350 milliseconds. When it goes much beyond that, you have early-onset cognitive decline, which is reversible.

[01:02:03] So because of my probably 40 Years of Zen, six months of neurofeedback training, and the supplements I take, and the fact that I played ping pong for seven years, and the fact that I do play of highly reactive, arcade-style game on my phone that’s all about reaction time, I still have a 240 milliseconds P-300, which is what about an 18-year-old would have. So I have a young reaction time on reality, which is remarkable. 

[01:02:32] So I think fast-twitch video games have a place in keeping your brain fast, but you may also have to take things that increase BDNF, and I’ve written about that in my big brain book, which is called Headstrong. So BDNF is a brain drive nootropic factor. So it seems like if you’re going to do your game, Endeavor, you would also want to increase BDNF.

[01:02:52] But the fast-switch games, you might also want to, but not too much of them. I would suggest possibly, there’s a coffee fruit extract that raises it. I’m an investor in Paul Stamets’s new company that’s studying what they call the Stamets Stack, which is niacin plus a small microdose that you can’t feel of psilocybin along with specific extracts of lion’s mane.

[01:03:15] Most lion’s mane on the market actually doesn’t work. It’s not extracted the right way. So when they take the cheap lion’s mane, uh, roots from China and mix them in coffee, you’re not going to feel the lion’s mane. It just makes the coffee taste different and maybe not as good. But any other things like that that would increase neurological flexibility so you could train better on Endeavor or any other game? 

[01:03:38] Adam: I don’t know. It’s an area that I haven’t done a lot of work in. We actually did start doing scientific literature, uh, reviews to ask the questions if we were going to do a combined game, nutritional supplement study, which we have not done, what would we do? And we actually really liked lion’s mane.

[01:04:01] Interesting. Uh, a lot of our researchers really presented the story that given the data that exists and what we think is going to give the most benefits in terms of plasticity, low risk lion’s mane was actually on the top of our list of something that we might do a large scale study to see how it inter interfaces with the game.

[01:04:22] Dave: Good deal. I think Lion’s mane has great promise. I was frustrated because in the early days, 12 years ago, in biohacking, I was really excited. So I bought a bunch of lion’s mane, and I could not get any noticeable difference from it. And then I switched to a heat and alcohol dual extracted thing.

[01:04:39] So you actually get the active compounds out where they can hit your metabolism. And I noticed a big difference from that. And I’ve had a couple companies on with specific types of lion’s mane extract on the show, and those work. But just the general, oh, it’s lion’s mane, and, uh, it was a $9 bottle. That stuff, I don’t think does anything.

[01:04:57] Adam: Interesting. That’s really helpful to know. If we advance with that project, we’ll definitely talk to you about it. Again, it’s outside of our expertise. We’ve never done any nutritional work.

[01:05:07] Dave: Bring me in as an advisor. Let me help. I’ll dial you in with all the good brain stuff. This is what I know and love because my own brain was so broken that I had to become a pro. And I’ve taught a million people different stuff to do there, so I would be more than pleased to help you because your game is actually improving human. That’s really important. We need focus and attention. One of the things that I believe focus brings to you is it makes you unprogrammable.

[01:05:32] And I joke that my Danger Coffee, my new brand, it’s called Danger because who knows what you might do. But one of the goals there is to give people the brain energy to be unprogrammable. So when you get programmed, you weren’t conscious. When you were focused, you were conscious. And when someone tells you to do something stupid, you can be like, that’s stupid, instead of just reacting and doing it, because that’s what everyone did. 

[01:05:56] And I think we need people who are just critical thinkers, which the first step to being a critical thinker is being able to focus.

[01:06:03] And the second one is being curious. Are there games that increase curiosity?

[01:06:09] Adam: That’s a good question. You know, I’ve largely focused on focus, for the last decade. We have other games that we’re now targeting empathy, some work on decision making, some work on long empathy, game in development, get getting ready to release for the first study, um, long-term memory. But I haven’t done anything on creativity and I.

[01:06:32] I love the topic. It’s not for lack of loving it, it’s just that there’s only so many things that, uh, that you can do. But that is definitely, an area that I would, would approach after we move all these games into research, for sure.

[01:06:47] Dave: Beautiful. Adam, I’m really enjoying our conversation, and I’m grateful that you’ve put so much time, and it’s so serendipitous. Uh, I did not put your name now with our meeting, I think it was eight years ago, maybe nine years when we met at MindBodyGreen. Um, those guys have been long time friends. So I’m really curious. And our final question, put on your 10 years from now hat, what does it look like?

[01:07:16] Adam: I would say in 10 years, my goal for my own contribution is that we have a system where we could capture all this real time physiology across the body. The multimodal biosensing system is now established. We’ve done a decade of data so we can interpret in a meaningful way your state in the moment, and we can do it rapidly enough within a couple hundred milliseconds that it could flow into a closed loop system to then present, you probably using some future version of what generative AI could be, an environment that’s maximally designed to optimize you in the moment, your mood, your arousal, your awareness, um, your focus, and that this is what technology can offer us. 

[01:08:13] They can offer us tools to upgrade ourselves if we feel that we’re already healthy but want to go further, or for people that are suffering and are not being relieved by the current treatments that medicine offers, new types of medicine. I think that’s obtainable in 10 years from now.

[01:08:33] Dave: Wow. I think we are on the cusp of replacing a lot of drugs with multimodal biosensing and biosensing feedback. And, uh, right now, I’ve got seven patents in neuroscience that are backing what we’re doing at 40 Years of Zen. And I know there’s so much more that can come out of university labs. You’re spend on R&D far dwarfs mind, and I’m very focused on human consciousness and cognitive enhancement and the ability to increase focus.

[01:09:00] My look on that is, let’s remove distractions that are generated automatically in your body. We can do that already. Then the next thing is increasing voltage in the brain, and we can train that up as well. So I feel like you have a hotter spark, the ability to make more electricity, the ability to have more neurological control and less distractions is working, but that isn’t the root of focus. There’s something else going on with what you’re doing, and I’m very, very interested to try out Endeavor and to just see where the world is going. Uh, you’re doing really cutting edge research, and I genuinely appreciate it.

[01:09:30] Adam: Thanks, Dave. It’s been fun talking with you about this. I’ve been excited for this conversation because I saw where my work was going and where your interests have lied converging for a while. I saw this convergence happening, and this is a fun conversation for me because it has happened now.

[01:09:47] Dave: This was always the goal for biohacking. It is, we’ve got to get all the data, and we’ve got to get it in our hands, not just in some big company’s hands, so that we can dial in the signal that makes our bodies and our minds do what we want. And you’re honing in on the signal in a really beautiful way. So guys, Endeavor OTC, lets you bypass the medical industrial complex. If you have a highly flexible insurance company who actually wants you to be healthy, you don’t exist. But if you did exist, you could use Endeavor Rx there. Did I say that right?

[01:10:18] Adam: You said it right.

[01:10:19] Dave: Uh, one final little question. It says you have to be over 18 to use Endeavor OTC. I’m assuming that that is for regulatory compliance.

[01:10:27] Adam: Correct.

[01:10:28] Dave: Okay. And if someone did choose, uh, to offer it to their kids, like I do, um, it’s not allowed, um, because it’s not allowed. Is that a good way of saying it?

[01:10:39] Adam: That’s the great way of saying it.

[01:10:41] Dave: All right guys. You can read between the lines I just wrote there, and I want to make it really clear. Adam didn’t say anything right here.

[01:10:47] Adam: Thank you.

[01:10:49] Dave: Whew. That was smooth. All right. Thanks, again, my friend. Guys, I will see you on the next episode. Upgrade Collective, thank you for your insightful questions during this. Guys, go to ourupgradecollective.com if you’d like to be in the live audience. And if you’d like to read Adam’s book, it’s called The Distracted Mind, and I highly recommend it because if you can focus, if you have an hour to improve yourself and you’re capable of focusing for an hour, you’ll get a lot more improvement done in an hour. That would be smarter, not harder. See you next time.

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