BRAIN TRAINING AND THE EFECTS

The effects on Dementia and IQ

November 12, 2016

Table of Contents

INTRODUCTION 3

THE HUMAN BRAIN 3

PLAYING BRAIN GAMES AND THE EFFECTS ON THE BRAIN 7

DEMENTIA 9

FIG 2 17

TABLE 2 17

TABLE 3 18

RAISING INTELLIGENCE 20

CONCLUSION 21

REFERENCES 22

INTRODUCTION

To date, more than 50 studies have examined the benefits of brain training in humans but only a handful have tested whether or not the benefits persist and transfer over to real life.

One such report had reported, that cognitively normal older adults who trained their brain were able to improve their auditory information processing speed by about 58 percent (versus 7 percent in controls). This was done by Glenn Smith of Mayo Clinic and her colleagues.

The Posit Science program is premised on the idea that as we get older our brains become less efficient at processing information from the senses (not because of specific hearing or vision loss but because of degenerative changes in the brain’s associative cortex), which then leads to a decline in memory. The control group did a more conventional cognitive learning program that entailed viewing educational videos on art and history. At the end of the study the brain training group also demonstrated more gains on measures of overall cognition and memory than the control group, but the differences were less impressive (4 percent versus 2 percent improvement). Forty-eight percent of people in the active training group (versus 40 percent of controls) also reported positive changes in their daily life such as greater self-confidence, better recall of shopping lists and attending to conversations in noisy settings.

Clearly IMPACT demonstrated that both trained and some untrained cognitive abilities can improve after two months of structured sensory input training. (P. Murali Doraiswamy and Marc E. Agronin. (2009). Brain Games: Do They Really Work?)

THE HUMAN BRAIN

The brain is the most complex part of the human body. This three-pound organ is the seat of intelligence, interpreter of the senses, initiator of body movement, and controller of behavior. Lying in its bony shell and washed by protective fluid, the brain is the source of all the qualities that define our humanity. The brain is the crown jewel of the human body. It is the command center for the human nervous system. It receives input from the sensory organs and sends output to the muscles. The human brain has the same basic structure as other mammal brains, but is larger in relation to body size than any other brains.

The largest part of the human brain is the cerebrum, which is divided into two hemispheres. Underneath lies the brainstem, and behind that sits the cerebellum. The outermost layer of the cerebrum is the cerebral cortex, which consists of four lobes: the frontal lobe, the parietal lobe, the temporal lobe and the occipital lobe.

The concept of right brain and left brain thinking developed from the research in the late 1960s of an American psychobiologist Roger W Sperry. He discovered that the human brain has two very different ways of thinking. One (the right brain) is visual and processes information in an intuitive and simultaneous way, looking first at the whole picture then the details. The other (the left brain) is verbal and processes information in an analytical and sequential way, looking first at the pieces then putting them together to get the whole. The left and right hemispheres of our brain process information in different ways but functions as a whole. (Left Brain Vs Right Brain. http://ucmas.ca/our-programs/whole-brain-development/left-brain-vs-right-brain/)

Left brain thinking is verbal and analytical. Right brain is non-verbal and intuitive. Though right-brain or non-verbal thinking is often regarded as more ‘creative’, there is no right or wrong here; it is merely two different ways of thinking. One is not better than the other, just as being right-handed is not ‘superior’ to being left-handed. What is important is to be aware that there are different ways of thinking, and by knowing what your natural preference is, you can pay attention to your less dominant side to improve the same.

By consciously using the right side of our brain, we can be more creative. More so, because left brain strategies are the ones used most often in the classroom, right brain students sometimes feel neglected.

By activating the power of both hemispheres, a child will be able to retain knowledge better and become proficient in any subject, especially math. The brain’s right hemisphere controls the muscles on the left side of the body, while the left hemisphere controls the muscles on the right side of the human body. When you wink your right eye, that’s the left side of your brain at work.

Within the two hemispheres lie a certain particular set of skills in order to learn and understand information.

The left side control such functions as listed:-

• Logic
• Analysis
• Sequencing
• Linear
• Mathematics
• Language
• Facts
• Think in Words
• Words of songs
• Computation

While the right part of the brain controls such functions as:-

• Creativity
• Imagination
• Holistic Thinking
• Intuition
• Arts (Motor Skills)
• Rhythm Beats
• Non Verbal
• Feelings
• Visualization
• Tune of songs
• Daydreaming

The right hemisphere is mainly in charge of spatial abilities, face recognition and processing music. It performs some math, but only rough estimations and comparisons. The brain’s right side also helps us to comprehend visual imagery and make sense of what we see. It plays a role in language, particularly in interpreting context and a person’s tone. (What’s the Difference Between the Right Brain and Left Brain? http://www.livescience.com/32935-whats-the-difference-between-the-right-brain-and-left-brain.html)

Much of what is known about brain function is owed to Roger Sperry, whose experiments examined the way the human brain’s hemispheres operate both independently and in concert with each other. The two hemispheres communicate information, such as sensory observations, to each other through the thick corpus callosum that connects them.

The brain carefully balances and assigns control of certain functions to each side it’s all nature’s way of ensuring that the brain ultimately splits up tasks to maximize efficiency. “Brain asymmetry is essential for proper brain function,” professor Stephen Wilson of University College London told Live Science, a sister site of Life’s Little Mysteries. “It allows the two sides of the brain to become specialized, increasing its processing capacity and avoiding situations of conflict where both sides of the brain try to take charge.” (What’s the Difference Between the Right Brain and Left Brain? http://www.livescience.com/32935-whats-the-difference-between-the-right-brain-and-left-brain.html)

PLAYING BRAIN GAMES AND THE EFFECTS ON THE BRAIN

The brain is always changing, sometimes for better, and sometimes for worse. Our eyes, ears, and other sensory organs constantly send information to the brain. Our brains use this information to construct our experiences and memories, from the magnificent — a loved one’s face, a once-in-a-lifetime vacation, a wedding proposal — to the mundane — an acquaintance’s name, a grocery list, a drive to a nearby store.

The more clearly our brain registers this information, the better we can respond to it and store it, so that we can remember it and use it later. It’s important that your brain does a good job with all of the small details of what you see or hear. Missing those details results in most of the errors and confusion that can limit you — and it’s often impossible to even know what you’re missing. A brain that misses lots of details also naturally slows down quite a lot, so that it has a better chance of not making mistakes. Most importantly, if your brain is fuzzy and imprecise in its most elemental operations, all of its higher operations in thinking and acting will suffer. You can practice them forever, but they just can’t improve very much if you must always rely on fuzzy or incomplete information.

Throughout life, our brains successfully absorb a lot of information from our senses. But for most of us, including almost everyone over age 40, our brains could do better. When we’re in our 30s, six core trends begin to affect brain function. Over time, these have noticeable impacts on our memory, thinking, and focus. They include:

1. Brightness: “Tired” thinking and acting
   Our brain slowly turns down its ‘dimmer switch’ as we get older. It can take longer for us to be sharp in our mornings, and we can often find ourselves having moments of inattention or drowsiness that frustrate our getting the most out of our days. Sleep or rest does not restore our liveliness as well as it used to!
2. Speed: Slower processing
   Our brains gradually slow down — but the speed of information coming in from the senses (sights and sounds happening in our lives) does not. Over time, the brain begins to miss many details, making it more difficult to react to and remember what we saw or heard.
3. Accuracy: Missing the details
   Like the grooves of an old record, the brain’s pathways often get fuzzier, scratchier, or even distorted. You cannot expect your brain to make a good recording of what is happening when there is so much noise on your sound track, or when your brain’s recording of what you are seeing is blurred and indistinct.
4. Recognition: Poorer understanding
   We have to combine information in special ways to understand and correctly interpret those things we see or hear. Losing the ability to recognize an old friend or misinterpreting their facial expression or intent is a common problem in an older life. Retaining keen abilities to recognize and interpret what we are seeing and hearing are of high importance.
5. Clarity: Interference from a noisy world
   In our youth, our brains were astoundingly good at cancelling out all of that noise that comes from the world, or that comes, as a barrage of disruptions, from a worrisome or distracted brain itself. But with age, interference starts to get in the way. This is partly due to a loss in our ability to really concentrate. It’s the true source of a lot of frustration, anxiety and error in an older life.
6. Recording: Poorer ability to control learning, or ‘rise to the occasion’
   The brain uses chemicals called neuromodulators to determine what information is important to record and process. With each passing decade, our brains produce fewer neuromodulators. A deficit of neuromodulators hinders the brain’s ability to record new information — in other words, its ability to learn and remember. If you want to continue to grow and flourish, you need learning- and memory-control machinery that is up to the task.

(BrainHQ’s Scientific Design Principles. (2016). http://www.brainhq.com/world-class-science/brainhq-effective/science-brainhq)

DEMENTIA

For the first time ever, researchers have managed to reduce people’s risk for dementia — not through a medicine, special diet, or physical exercise, but by having healthy older adults play a computer-based brain-training game.

Such training nearly halved the incidence of Alzheimer’s disease and other devastating forms of cognitive and memory loss in older adults a decade after they completed it, scientists reported on Sunday. If the surprising finding holds up, the intervention would be the first of any kind — including drugs, diet, and exercise — to do that. (brain-training-cuts-dementia-risk, www.statnews.com)

One of the crucial questions for brain-training programs is whether or not the specific skills emphasized during training, such as improved auditory perception, actually generalize to other cognitive abilities. In other words, will practicing auditory perception lead to improved visual perception? And how long do training effects persist?

According to Sherry Willis and colleagues at Pennsylvania State University brain exercises that focus on training reasoning skills do translate into long-lasting improvements in daily life. The team looked at the effects of three non-computerized cognitive training modules (designed to narrowly target memory, reasoning, or processing speed skills) versus a no-contact control group in a sample of 2,832 cognitively-intact elders. The subjects received 10 one-hour sessions plus a booster at months 11 and 35. Surprisingly, at two years, there was no benefit on daily activities. But after five years the group trained in reasoning showed better performance on daily activities (an effect that was made more noticeable by the fact that some in the control group showed a decline). These results suggest that a short training session plus periodic boosters may induce long-lasting cognitive and functional benefits — sort of a “teaching a person to fish for life” effect. (P. Murali Doraiswamy and Marc E. Agronin. (2009). Brain Games: Do They Really Work?)

A related question is whether doctors can use brain games in ways analogous to cardiac rehab programs, to help people who already suffer from a mild memory disorder. The pioneering early work of psychiatrist David Loewenstein and colleagues at the University of Miami has demonstrated that a skills training cognitive rehab program (practicing skills such as paying bills, counting change and associating names with faces) helped individuals with early stage Alzheimer’s disease to improve on the tasks the were trained on, at least initially and for three months after the targeted intervention was completed. These benefits, though likely to degrade quickly in the face of a progressive dementia, certainly compare favorably to what has been shown with any commercial brain game. (P. Murali Doraiswamy and Marc E. Agronin. (2009). Brain Games: Do They Really Work?)

The results, presented at the Alzheimer’s Association International Conference in Toronto, come from the government-funded ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study. Starting in 1998, ACTIVE’s 2,832 healthy older adults (average age at the start: 74) received one of three forms of cognitive training, or none, and were evaluated periodically in the years after.

In actual numbers, 14 percent of ACTIVE participants who received no training had dementia 10 years later, said psychologist Jerri Edwards of the University of South Florida, who led the study. Among those who completed up to 10 60-to-75-minute sessions of computer-based training in speed-of-processing — basically, how quickly and accurately they can pay attention to, process, and remember brief images on a computer screen — 12.1 percent developed dementia. Of those who completed all 10 initial training sessions plus four booster sessions a few years later, 8.2 percent developed dementia. Such a “dose-response effect” — more intervention, more chance of avoiding dementia — is often a clue that the intervention is, indeed, making a difference. (brain-training-cuts-dementia-risk, www.statnews.com)

“It’s hard to understand how such a brief intervention could have a long-lasting impact,” said Dr. Howard Fillit, executive director of the Alzheimer’s Drug Discovery Foundation, which supports pharmaceutical research on the disease. “But you have to respect the data.”

There is growing evidence that remaining intellectually engaged (“lifelong learning”) and certain forms of cognitive training can reduce the risk of plain old cognitive decline. But the new ACTIVE findings “are evidence that [that] may hold true for dementia, as well,” said Maria Carrillo, chief science officer of the Alzheimer’s Association.

Training in one skill did not improve the others, suggesting that overall brain function wasn’t getting better. And five years after training, there was no effect on their risk of dementia. Even then, however, there were hints that speed-of-processing might be different, Rebok said, targeting underlying brain activity and physiology rather than skills, as a 2006 study suggested. In 2013, researchers found that speed-of-processing training might improve such “executive functions” as planning and reasoning. A study published last month reported that it improved brain connectivity and cognitive ability in a way that might slow the descent into dementia.

Improving processing speed “changes fundamental processes in the brain,” said Henry Mahncke, CEO of Posit Science Corporation. “It’s not that one particular link in the brain gets improved, but that the whole brain is rejuvenated,” (brain-training-cuts-dementia-risk, www.statnews.com)

Scientists not associated with Posit or the new study said they would be more persuaded if it were clear how speed-of-processing training works its magic.

One possibility is a bootstrapping effect. Maybe people who received speed-of-processing training “did something different over the years,” said Laurie Ryan, who oversees Alzheimer’s research at the National Institute on Aging. “Maybe they changed their lifestyle in some way,” with the training giving them a little cognitive boost that they parlayed into more reading, more travel, more social engagement, and more of other activities that boost “cognitive reserve,” the brain’s cushion against dementia.

The COGITO study is the largest and probably most convincing study in the field of brain training. 101 young adults aged 20–31 years and 103 persons aged 65–80 years trained for 1 hour every 2–3 days, for a total of 100 sessions. A single training session was comprised of 12 exercises: 6 for comprehension and speed; 3 for working memory; and 3 for information recall. The brain training exercises were adjusted at the beginning of the study to suit the participant’s performance, as indicated by the pre-tests.

The study was designed to test whether the observed improvements in the trained cognitive areas also had an effect on other cognitive abilities — and to see if age influences these improvements. In addition, the researchers wanted to evaluate if progress in brain training is transferrable to everyday life.

Significant improvements in cognitive abilities were observed — especially for working memory. We need working memory in order to understand complex topics, solve problems, and store new information. All participants — regardless of their age or sex — showed improvements in their working memory following the training. The researchers believe that the training strengthened the neuronal connections between the two frontal lobes of the brain, which subsequently led to an improvement in working memory — for both young and older participants. (://www.neuronation.com/science/brain-training-works

One study was conducted by André Aleman of the University of Groningen, The Netherlands, use the brain training game called Brain Age published by Nintendo in 2005. The study used double-blinded intervention. Participants and testers were kept blind to the experimental hypothesis. Participants in both the Brain Age and the Tetris groups played each game for about 15 minutes per day, at least 5 days per week, for 4 weeks.

To evaluate the effects of the brain training game, they assessed a broad range of cognitive functions. The measurements of the cognitive functions included four categories (global cognitive statuses, executive functions, attention and processing speed). Global cognitive statuses was measured by Mini-Mental State Examination (MMSE). Executive functions were measured by Frontal Assessment Battery at bedside (FAB), and Trail Making Test-B (TMT-B). Attention was measured by Digit Cancellation Task (D-CAT), Digit Span Forward (DS-F), and Digit Span Backward (DS-B). Processing speed was measured by Digit Symbol Coding (Cd) and Symbol Search (SS). (Nouchi R, Taki Y, Takeuchi H, Hashizume H, Akitsuki Y, Shigemune Y, et al. (2012) Brain Training Game Improves Executive Functions and Processing Speed in the Elderly: A Randomized Controlled Trial.)

Participants were blind to the treatment and control designations of these two groups, and were informed only that the study was designed to investigate the effects of two different training programs. Testers were blind to the group membership of participants. The researcher (N.R.) randomly assigned participants to either of two groups (Brain Age, Tetris) by the random draw using a computer. After the random assignment, the sex, age and education level (years) in the Brain Age group were similar to the Tetris groups. The scores of MMSE and FAB in the present study were similar to that in the previous community-dwelling the elderly studied in Japan.

Game performance was recorded for each participant. At the end of each training day, participants reported the scores of the played games. The Brain Age group listed the titles of trained games and a score for each trained game at the end of each training day. The Tetris group only reported the best total score at the end of each training day. The measures of cognitive functions were conducted before and after training. On the first day of training (pre), all participants were tested on a series of neuropsychological and behavioral tests. After these tests, participants received the instruction to play one of the games for 30 minutes. To play the video game, participants were provided the portable console (Nintendo DSi) and one of the video games (Brain Age or Tetris). The following day, participants started 4 weeks video game training. After 4 weeks of training (post), all participants were re-examined on some neuropsychological and behavioral tests. Finally, the portable console and the video game were returned at the end of the study. The procedures for this study were approved by the Ethics Committee of the Tohoku University Graduate School of Medicine.

MMSE.

MMSE is the most widely used screening instrument for the detection of cognitive impairment in older adults. MMSE is a 20-item instrument. The items of MMSE measure orientation for place and time, memory and attention, language skills, and visuospatial abilities. MMSE is scored from 0 to 30. Lower scores of MMSE indicate greater degrees of general cognitive dysfunction. The primary measure is the total score of this task (max = 30).

FAB.

FAB evaluates executive functions. FAB consists of six subtests, namely, those for similarities (conceptualization), lexical fluency (mental flexibility), motor series (programming), conflicting instructions (sensitivity to interference), go–no go (inhibitory control), and prehension behavior (environmental autonomy). FAB is scored from 0 to 18. Lower scores of FAB indicate greater degrees of executive dysfunction. The primary measure is the total score of this task (max = 18).

TMT-B.

TMT has been employed widely as a measure of executive function. TMT consists of two parts (TMT-A and TMT-B). TMT-A requires participants to link in ascending order series of 25 numbers (1–2–3 …) randomly distributed in space. TMT-B is similar, although instead of just linking numbers the subject must alternately switch between a set of numbers (1–13) and a set of letters (A–L), again linking in ascending order (1–A–2–B …). We used only TMT-B in this study. The primary measure of this test is the amount of time (seconds) required to complete the task. The score of TMT-B measures executive function.

D-CAT.

D-CAT evaluates attention. The test sheet consists of 12 rows of 50 digits. Each row contains 5 sets of numbers 0 to 9 arranged in random order. Thus any one digit would appear 5 times in each row with randomly determined neighbors. D-CAT consists of three such sheets. Participants were instructed to search for the target number(s) that had been specified to them and to delete each one with a slash mark as fast and as accurately as possible until the experimenter sent a stop signal. There were 3 trials, first with a single target number (6), second with two target numbers (9 and 4), and third with three (8, 3, and 7). Each trial was given 1 minute, hence the total time required for D-CAT was 3 minutes. In the second and third trials, it was stressed that all of the target numbers instructed should be cancelled without omission. The primary measure of this test is the number of hits (correct answers). We used only the number of hits in the first trial.

DS.

DS is a subtest in WAIS-III. This test evaluates attention. Digit Span has two subsections (DS-F and DS-B). For DS-F, participants repeat numbers in the same order as they were read aloud by the examiner. For DS-B, participants repeat numbers in the reverse order of that presented aloud by the examiner. In both, the examiner reads a series of number sequences in which the examinee is required to repeat the sequence in either forward or reverse order. DS-F has sixteen sequences. DS-B has fourteen sequences. The primary measures of this test are raw scores which refers to the number of correctly repeated sequences until the discontinue criterion (i.e., failure to reproduce two sequences of equal length) was met. The maximum raw score of DS-F is 16. The maximum raw score of DS-B is 14.

Cd.

Cd is a subtest of WAIS-III. This test measures processing speed. For Cd, the participants are shown a series of symbols that are paired with numbers. Using a key, the participants draw each symbol under its corresponding number, within a 120 second time limit. The primary measure of this test is the number of correct answers.

SS.

SS is a subtest of WAIS-III. This test measures processing speed. The SS contains 60 items. For this subtest, the participants visually scan two groups of symbols (a target group and a search group) and indicate if either of the target symbols matches any of the symbols in the search group. The participants respond to as many items as possible within a 120 second time limit. The primary measure of this test is the number of correct answers.

Figure 2. Cognitive function scores at before and after training in both groups.

Table 2. First and last game scores in both Brain Age and Tetris training groups.

Table 3. The score of change in cognitive functions measures of both groups.

The Results of these MANCOVAs for change scores showed that the effects of playing Brain Age were higher than that of playing Tetris in the all measures of the executive function (FAB, F (1, 12) = 17.16, η2 = 0.13, p = 0.001); TMT-B, F (1, 12) = 11.16, η2 = 0.13, p = 0.006) and to two measures of the processing speed measures (SS, F (1, 12) = 8.22, η2 = 0.12, p = 0.014; Cd, F(1, 12) = 11.74, η2 = 0.19, p = 0.005). These results indicated that effects of playing Brain Age were transferred to the executive function and the processing speed. However, there were no significant differences between effects of playing Brain Age and Tetris in a measure of the global cognitive statuses (MMSE, F (1, 12) = 0.24, η2 = 0.00, p = 0.63) and all measures of the attention (D-CAT, F (1, 12) = 1.30, η2 = 0.06, p = 0.28; DS-F, F (1, 12) = 0.14, η2 = 0.00, p = 0.72; DS-B, F (1, 12) = 0.18, η2 = 0.00, p = 0.68). These results suggested that playing the Brain Age did not improve the global cognitive statuses and the attention.

In the study, the Tetris group played only one training game, whereas the Brain Age group played 8 types of games that included some components (e.g. calculation, reading aloud, memory). Thus, the multiple components in the Brain Age could contribute to the improvement of other cognitive functions after the training. Other possible explanations for the mechanisms of the transfer effect have been applied in previous studies. For example, previous studies have proposed the possibility of feedback processes or experiencing new things to explain the possibility the transfer effects. However, these possibilities could be unavailable in our results. In the study, they recruited participants who had no experience of any video games, and employed an active control group who played the Tetris game. Thus, both groups in the study equally shared the feedback or the experience of new things from games. The difference between two training games could be effective in generating the transfer effect by the brain training game. Further studies are needed to test whether or not far transfer effects as well as near transfer effects could be elicited by playing the brain training games.

There are some limitations. First limitation is that we did not measure memory performance. The prevalence of memory complaints in community-based samples of the elderly is estimated to be 25% and 50%. One important future direction is to examine whether or not the brain training game would improve the memory performance in the elderly. Second limitation of our study is that we did not assess the real world task or every day cognitive abilities such as driving abilities. Future research would assess not only whether brain training game improves performance on laboratory-based tasks, but whether the brain training game improves performance on everyday cognitive abilities and real world tasks (e.g. driving skills or shopping). (Nouchi R, Taki Y, Takeuchi H, Hashizume H, Akitsuki Y, Shigemune Y, et al. (2012) Brain Training Game Improves Executive Functions and Processing Speed in the Elderly: A Randomized Controlled Trial.)

RAISING INTELLIGENCE

According to the Association for Psychological Science, intelligence is generally divided into two categories: fluid intelligence and crystallized intelligence. Fluid intelligence is the ability to reason in an abstract way and solve problems, whereas crystallized intelligence is more related to the acquisition of intellectual skills, or the ability to read and comprehend. Although our crystallized intelligence generally increases with age as we learn new skills, fluid intelligence is meant to be stagnant.

Working memory is correlated with complex learning, problem solving, and general attention control, The Scientist reported. So, naturally, increasing your memory capacity would help to increase your ability to problem solve and learn complex skills, or at least that’s what some experts believe. For example, a 2008 study published in PNAS found that training for just 10 hours on a working memory task known as the adaptive dual n-back task resulted in improved fluid intelligence. What’s more, not only did the participants improve in working memory, but participants were also able to transfer this gain and improve their scores on a completely unrelated cognitive task.

While most of us are relatively proficient in basic relational skills, we are actually quite deficient in solving more complex relational problems. To address this deficiency, a form of online brain training called SMART training (Strengthening mental abilities with relational training) was developed by Relational Frame Theory researchers at Maynooth University.

The Cassidy et al. study is the second such study to be published by the Maynooth University team to show that SMART training can increase general intelligence as measured by standardized IQ tests, such as the Wechsler Intelligence Scale for Children (WISC). This new study, however, provides additional evidence that scholastic ability, as measured by a gold standard aptitude test known as the Differential Aptitude Test (DATs), also increases as a result of this very particular form of intellectual skills training.

CONCLUSION

So-called ‘brain-training’ programs are a huge commercial success. However, empirical evidence regarding their effectiveness and generalizability remains equivocal. However, it has been proven on few studies that some form of brain training improve the participant day-to-day life as it helps people with some forms of dementia. The old motto “practice makes perfect” has been applied to many kinds of learning, from high school physics and music to sports and public speaking. While scientists debate how many hours of practice really do make you perfect, one thing is clear: practice does contribute to success by improving your performance.

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