Improving Cognition: The Basics

Cognition refers to the broad set of mental processes that relate to acquiring knowledge and understanding through thought, experience, and the senses, and it lies at the core of nearly everything we seek to accomplish. Though some may perceive their ability to acquire and absorb knowledge to be fixed, research shows that our brains are flexible due to a characteristic known as neuroplasticity. Through utilizing literature and mechanistic knowledge, we can take advantage of and even enhance this neuroplasticity, allowing us to learn and retain information more efficiently.

What Makes Us Tick?

Humans are driven creatures; we have evolved to be quite motivated to accomplish our goals by any means necessary. However, due to more recent changes in human circumstances (societal, dietary, physical, etc.), the average person has become increasingly less driven as the generations pass. Of course, increasing baseline cognition is nearly useless if one is unable to find the drive to act. So, how can we "reset" these changes and allow ourselves to be as motivated as our ancestors once were?

The primary answer lies in one crucial neurotransmitter: dopamine. Dopamine, specifically in the mesolimbic reward pathway, drives incentive salience, which entails motivation and desire for reward-based outcomes. It's responsible for the euphoric effects of drugs, sex, and gambling, and it's why so many individuals become addicted to these things as well. To increase motivation, we should look to dopamine for the answer.

Dopaminergic Interventions

Drugs involved in dopamine modulation have existed on a clinical scale for decades. Amphetamine, used to treat ADHD symptoms, inhibits the dopamine transporter (DAT), potentiates vesicular release of dopamine, and potentiates reverse transport of dopamine. Pramipexole, used to treat Parkinsonian symptoms, is an agonist of dopamine receptors. Even SSRIs, which inhibit the serotonin transporter (SERT) modulate dopamine downstream. Using "artificial" dopamine is nothing new. These drugs should be respected and understood, not feared.

We can introduce ourselves to dopaminergic compounds by starting with one of the basics: racemic amphetamine. Racemic amphetamine (brand name Adderall) has been clinically proven to increase reaction time and various other cognitive markers. Of course, being a strong dopaminergic, it should be utilized to induce motivation and to build positive associations with new habits.

Alternatively, we can introduce other dopaminergics, such as bromantane or racetams, to facilitate this response.

Dopamine is not the be all and end all of cognition - the brain is a complex and intricate wiring of different neural networks, all serving different functions. To even begin touching the tip of the iceberg, we have to look at other neurotransmitters. Namely, acetylcholine and glutamate.

Acetylcholine

Acetylcholine, named due to its chemical property of being an acetylated choline, is crucial for attention, memory, and arousal. We can observe this simply through drug action: drugs that have anti-cholinergic effects inhibit cognition, and drugs that have pro-cholinergic effects enhance it, allowing improved attention spans and memory encoding capabilities. The cholinergic system is complex, but relatively well understood by modern neurology.

When looking at improving cognition, there are a few things we can do to enhance the cholinergic system. First, and most importantly, is ensuring you have a sufficient amount of choline in your diet. Without choline, your brain will not be able to synthesize acetylcholine, and cognition will be impaired.

From this point on, we can begin to implement different compounds to enhance our cholinergic system. Starting with supplements, we have compounds like alpha-GPC, which potentiates the release of acetylcholine stores, and huperzine A, which inhibits the enzyme that breaks down acetylcholine, acetylcholinesterase.

Moving up into stronger interventions, the two most powerful cholinergic agents we have at our disposal are nicotine and donepezil. Nicotine, being an agonist of the nicotinic cholinergic receptors, has been shown thoroughly in research to improve cognition (see my article on nicotine for reference). There does seem to be a "sweet spot", as too much nicotine will actually worsen cognition. Donepezil, similar to huperzine A, is an inhibitor of acetylcholinesterase. It was originally designed and prescribed for Alzheimer's patients, who often present with cholinergic deficits.

Glutamate

Glutamate is our brain's primary excitatory neurotransmitter - it tells our neurons when to carry out an action potential. Arguably, in terms of actual neural function, glutamate is the most important neurotransmitter of all. It allows our brains to participate in long-term potentiation, a key mechanism of learning and memory, and influences neuroplasticity. For boosting cognition, increasing glutamate is a delicate process. Too much glutamatergic signalling can cause excitotoxicity, among other issues, so a balance must exist between excitatory and inhibitory transmission.

Enhancing glutamatergic signalling should be done via the use of a racetam, like aniracetam, which makes glutamate receptors more sensitive through a process called positive allosteric modulation (here, specifically, of the AMPA receptor). Other racetams do have glutamatergic effects, though generally weaker than aniracetam.

Final Thoughts

Boosting cognition, fundamentally, is not very difficult to do. Even implementing one or two of these compounds every so often can be a significant help to your cognitive abilities. However, this article only covers the basics, and is a simplified version of a nuanced subject. Neurology is an extremely complex subject, and everyone's brain will react differently due to individualistic polygenic traits.

If you'd like to dive into the more complex subjects, I'd recommend booking a call with me here.