Cognitive Training and Brain Health

class AdaptiveDifficultyEngine {
  constructor(
    private performanceAnalyzer: CognitivePerformanceAnalyzer,
    private difficultyCalculator: DifficultyCalculationEngine,
    private motivationTracker: MotivationTrackingSystem
  ) {}

  async calculateOptimalDifficulty(
    user: UserProfile,
    cognitiveTask: CognitiveTask,
    recentPerformance: PerformanceData[],
    currentMoodState: MoodState
  ): Promise<DifficultyParameters> {
    
    // Analyze current cognitive state
    const cognitiveState = await this.performanceAnalyzer.analyzeCognitiveState({
      user,
      recentPerformance,
      timeOfDay: new Date().getHours(),
      fatigueLevel: await this.assessCognitiveFatigue(user),
      motivationLevel: await this.motivationTracker.getCurrentMotivation(user)
    });

    // Calculate target performance zone (challenging but achievable)
    const targetPerformance = this.calculateTargetZone(cognitiveState);
    
    // Determine specific difficulty parameters
    return {
      complexity: this.calculateComplexity(targetPerformance, cognitiveTask),
      speed: this.calculateSpeedRequirement(targetPerformance, cognitiveTask),
      workingMemoryLoad: this.calculateMemoryLoad(targetPerformance, cognitiveTask),
      distractorLevel: this.calculateDistractionLevel(targetPerformance, cognitiveTask),
      sessionLength: this.calculateOptimalSessionLength(cognitiveState, user.preferences)
    };
  }

  private calculateTargetZone(state: CognitiveState): TargetPerformanceZone {
    // Aim for 70-85% success rate (optimal learning zone)
    const baselineAccuracy = state.currentAccuracy;
    const motivationModifier = this.getMotivationModifier(state.motivationLevel);
    const fatigueModifier = this.getFatigueModifier(state.fatigueLevel);
    
    return {
      targetAccuracy: Math.max(0.7, Math.min(0.85, 
        baselineAccuracy * motivationModifier * fatigueModifier
      )),
      targetResponseTime: state.averageResponseTime * 0.9, // Slightly faster than current
      confidenceInterval: 0.15 // Allow for natural variation
    };
  }

  // Real-time difficulty adjustment during tasks
  async adjustDifficultyRealTime(
    currentPerformance: RealtimePerformance,
    taskParameters: DifficultyParameters
  ): Promise<DifficultyAdjustment> {
    
    const performanceTrend = this.analyzePerformanceTrend(currentPerformance);
    
    if (performanceTrend.accuracy < 0.6) {
      // Too difficult - reduce complexity
      return {
        adjustment: 'decrease_difficulty',
        magnitude: this.calculateDecreaseMagnitude(performanceTrend),
        parameters: {
          complexity: taskParameters.complexity * 0.85,
          speed: taskParameters.speed * 1.15,
          hints: 'enable_additional_hints'
        }
      };
    }
    
    if (performanceTrend.accuracy > 0.9 && performanceTrend.responseTime < taskParameters.speed) {
      // Too easy - increase complexity
      return {
        adjustment: 'increase_difficulty',
        magnitude: this.calculateIncreaseMagnitude(performanceTrend),
        parameters: {
          complexity: taskParameters.complexity * 1.15,
          speed: taskParameters.speed * 0.9,
          distractors: taskParameters.distractorLevel + 1
        }
      };
    }

    return null; // No adjustment needed - in optimal zone
  }
}

class ComprehensiveCognitiveAssessment {
  
  async conductFullCognitiveAssessment(
    user: UserProfile
  ): Promise<CognitiveProfile> {
    
    const assessmentBattery = this.createPersonalizedAssessmentBattery(user);
    const results: AssessmentResults = {};

    // Executive Function Assessment
    results.executiveFunction = await this.assessExecutiveFunction(user, {
      workingMemory: this.createWorkingMemoryTasks(),
      cognitiveFlexibility: this.createCognitiveFlexibilityTasks(),
      inhibitoryControl: this.createInhibitoryControlTasks(),
      planningAndProblemSolving: this.createPlanningTasks()
    });

    // Attention Assessment
    results.attention = await this.assessAttention(user, {
      sustainedAttention: this.createVigilanceTasks(),
      selectiveAttention: this.createSelectiveAttentionTasks(),
      dividedAttention: this.createDualTaskParadigms(),
      attentionalControl: this.createAttentionalControlTasks()
    });

    // Memory Assessment  
    results.memory = await this.assessMemory(user, {
      episodicMemory: this.createEpisodicMemoryTasks(),
      semanticMemory: this.createSemanticMemoryTasks(),
      proceduralMemory: this.createProceduralMemoryTasks(),
      prospectiveMemory: this.createProspectiveMemoryTasks()
    });

    // Processing Speed Assessment
    results.processingSpeed = await this.assessProcessingSpeed(user, {
      perceptualSpeed: this.createPerceptualSpeedTasks(),
      cognitiveEfficiency: this.createCognitiveEfficiencyTasks(),
      psychomotorSpeed: this.createPsychomotorTasks()
    });

    // Language and Communication
    results.language = await this.assessLanguage(user, {
      vocabularyKnowledge: this.createVocabularyTasks(),
      verbalFluency: this.createVerbalFluencyTasks(),
      comprehension: this.createComprehensionTasks(),
      naming: this.createNamingTasks()
    });

    return this.synthesizeCognitiveProfile(results, user);
  }

  private async assessWorkingMemory(
    user: UserProfile
  ): Promise<WorkingMemoryProfile> {
    
    const tasks = [
      this.createNBackTask(user), // Spatial and verbal n-back
      this.createDualNBackTask(user), // Combined spatial-verbal
      this.createSpanTasks(user), // Digit span, spatial span
      this.createComplexSpanTasks(user) // Reading span, operation span
    ];

    const results = await Promise.all(tasks.map(task => task.execute()));
    
    return {
      capacity: this.calculateWorkingMemoryCapacity(results),
      verbalComponent: this.extractVerbalWorkingMemory(results),
      spatialComponent: this.extractSpatialWorkingMemory(results),
      centralExecutive: this.extractCentralExecutiveFunction(results),
      strengths: this.identifyWorkingMemoryStrengths(results),
      weaknesses: this.identifyWorkingMemoryWeaknesses(results)
    };
  }

  private createAdaptiveNBackTask(user: UserProfile): CognitiveTask {
    return {
      name: 'adaptive_n_back',
      domain: 'working_memory',
      parameters: {
        startingN: this.estimateStartingDifficulty(user),
        stimulusType: user.preferences.modalityPreference || 'dual_modal',
        sessionLength: user.preferences.sessionLength || '15min',
        adaptationRate: this.calculateAdaptationRate(user.cognitiveProfile)
      },
      execute: async () => {
        // Real-time adaptive n-back implementation
        return this.runAdaptiveNBack(user, this.parameters);
      },
      analyze: (results) => {
        return this.analyzeNBackPerformance(results);
      }
    };
  }
}

class NeuroplasticityGameEngine {
  
  async createNeuroplasticityOptimizedGame(
    cognitiveTarget: CognitiveDomain,
    user: UserProfile
  ): Promise<NeuroplasticityGame> {
    
    const gameDesign = await this.designForNeuroplasticity(cognitiveTarget, user);
    
    return {
      coreMechanics: this.implementCoreMechanics(gameDesign),
      progressionSystem: this.createAdaptiveProgression(gameDesign),
      motivationSystem: this.implementMotivationMechanics(gameDesign),
      transferSystem: this.enableSkillTransfer(gameDesign),
      assessmentIntegration: this.integrateAssessmentPoints(gameDesign)
    };
  }

  private implementCoreMechanics(design: GameDesign): GameMechanics {
    return {
      // Variable ratio reward schedule (most effective for sustained engagement)
      rewardSchedule: {
        type: 'variable_ratio',
        averageRatio: 7, // Reward approximately every 7 successful responses
        variability: 0.3, // 30% variance in timing
        rewardTypes: ['points', 'badges', 'progress_unlocks', 'performance_feedback']
      },

      // Spaced repetition for memory consolidation
      spacedRepetition: {
        intervals: [1, 3, 7, 14, 30], // Days between repetitions
        difficultyWeighting: true, // Harder items repeated more frequently
        performanceAdjustment: true, // Adjust based on success rate
        consolidationTracking: true // Track memory consolidation progress
      },

      // Interleaving for enhanced learning
      interleaving: {
        taskRotation: this.createTaskRotationSchedule(design.cognitiveTargets),
        contextVariation: this.createContextVariations(design.gameWorld),
        skillMixing: this.createSkillMixingProtocol(design.targetSkills)
      },

      // Desirable difficulty for optimal challenge
      desirableDifficulty: {
        errorRate: { target: 0.25, tolerance: 0.1 }, // 15-35% error rate
        frustrationPrevention: this.implementFrustrationSafeguards(),
        flowStateOptimization: this.createFlowStateMetrics(),
        adaptiveScaffolding: this.implementAdaptiveSupport()
      }
    };
  }

  // Gamified working memory training
  private createWorkingMemoryGame(user: UserProfile): WorkingMemoryGame {
    return {
      theme: this.selectEngagingTheme(user.interests),
      mechanics: {
        spatialUpdating: {
          gameVersion: 'space_navigation',
          task: 'Navigate spacecraft through asteroid field while remembering locations',
          cognitiveLoad: this.adaptToUserCapacity(user.workingMemoryCapacity),
          visualization: '3D_immersive_environment'
        },
        
        verbalUpdating: {
          gameVersion: 'story_builder',
          task: 'Build coherent stories while updating character information',
          cognitiveLoad: this.adaptToUserCapacity(user.verbalWorkingMemory),
          culturalAdaptation: this.adaptStoriesForCulture(user.culturalBackground)
        },
        
        dualTasking: {
          gameVersion: 'restaurant_manager',
          task: 'Manage restaurant while tracking orders and customer preferences',
          cognitiveLoad: this.combineSpatialVerbalLoad(user.workingMemoryProfile),
          realWorldTransfer: 'multitasking_and_organization'
        }
      },
      
      adaptiveFeatures: {
        dynamicDifficulty: this.implementRealTimeAdaptation(),
        personalizedFeedback: this.createPersonalizedFeedback(user),
        motivationalNarratives: this.createMotivationalStorylines(user),
        socialFeatures: this.implementSocialMotivation(user.socialPreferences)
      }
    };
  }
}

class DementiaCognitiveSupport {
  
  async createDementiaTherapyProgram(
    user: UserProfile,
    dementiaStage: DementiaStage,
    caregiverSupport: CaregiverProfile
  ): Promise<DementiaTherapyProgram> {
    
    const program = {
      cognitiveStimulation: await this.designCognitiveStimulation(dementiaStage),
      memorySupport: await this.createMemorySupport(user, dementiaStage),
      socialEngagement: await this.facilitateSocialEngagement(user),
      caregiverTools: await this.createCaregiverSupport(caregiverSupport),
      progressMonitoring: await this.setupProgressTracking(user, dementiaStage)
    };

    return program;
  }

  private async designCognitiveStimulation(
    stage: DementiaStage
  ): Promise<CognitiveStimulationProgram> {
    
    if (stage === 'mild') {
      return {
        focus: 'cognitive_maintenance_and_compensation',
        activities: [
          this.createComplexProblemSolving(),
          this.createMemoryStrategiesTraining(),
          this.createExecutiveFunctionSupport(),
          this.createLanguageStimulation()
        ],
        frequency: 'daily_30min_sessions',
        adaptationStrategy: 'maintain_challenge_level'
      };
    }
    
    if (stage === 'moderate') {
      return {
        focus: 'functional_preservation_and_quality_of_life',
        activities: [
          this.createSimplifiedProblemSolving(),
          this.createAutobiographicalMemoryStimulation(),
          this.createRoutineBasedActivities(),
          this.createSensoryStimulation()
        ],
        frequency: 'daily_15min_sessions',
        adaptationStrategy: 'gradual_simplification'
      };
    }
    
    // Severe stage
    return {
      focus: 'comfort_and_connection',
      activities: [
        this.createSensoryExperiences(),
        this.createMusicTherapyIntegration(),
        this.createFamiliarVoiceInteractions(),
        this.createSimpleChoiceActivities()
      ],
      frequency: 'multiple_short_sessions',
      adaptationStrategy: 'maintain_dignity_and_engagement'
    };
  }

  private createMemorySupport(user: UserProfile, stage: DementiaStage): MemorySupportSystem {
    return {
      // Spaced retrieval training
      spacedRetrieval: {
        personalInformation: this.createPersonalInfoPractice(user.personalHistory),
        dailyRoutines: this.createRoutinePractice(user.dailySchedule),
        familyRecognition: this.createFamilyRecognitionPractice(user.familyPhotos),
        importantDates: this.createDateRecallPractice(user.significantDates)
      },

      // External memory aids
      memoryAids: {
        digitalReminders: this.createIntelligentReminders(user),
        photoAlbums: this.createInteractivePhotoAlbums(user.lifeHistory),
        voiceRecordings: this.createFamilyVoiceMessages(user.family),
        locationTracking: this.createSafeLocationMonitoring(user, stage)
      },

      // Errorless learning protocols
      errorlessLearning: {
        vanishingCues: this.implementVanishingCueMethod(),
        expandingRehearsal: this.implementExpandingRehearsalMethod(),
        supportivePrompting: this.createAdaptivePromptingSystem(),
        successfulExperiences: this.ensureHighSuccessRate()
      }
    };
  }
}

class ADHDCognitiveTraining {
  
  async createADHDTrainingProgram(
    user: UserProfile,
    adhdProfile: ADHDProfile
  ): Promise<ADHDTrainingProgram> {
    
    return {
      attentionTraining: await this.designAttentionTraining(adhdProfile),
      executiveFunction: await this.createExecutiveFunctionTraining(adhdProfile),
      impulsivityManagement: await this.developImpulsivityControls(adhdProfile),
      motivationSystem: await this.createADHDMotivationSystem(user),
      realWorldTransfer: await this.facilitateSkillTransfer(adhdProfile)
    };
  }

  private async designAttentionTraining(
    profile: ADHDProfile
  ): Promise<AttentionTrainingProgram> {
    
    return {
      // Sustained attention training
      sustainedAttention: {
        tasks: [
          this.createContinuousPerformanceTask(profile),
          this.createVigilanceGameTask(profile),
          this.createFocusedBreathingExercises(profile)
        ],
        progression: 'gradual_duration_increase',
        gamification: 'achievement_based_rewards',
        breakSchedule: this.calculateOptimalBreakSchedule(profile)
      },

      // Selective attention training
      selectiveAttention: {
        tasks: [
          this.createVisualSearchTasks(profile),
          this.createAuditorySelectionTasks(profile),
          this.createDistractorIgnoreTasks(profile)
        ],
        distractorManagement: 'progressive_distractor_introduction',
        contextualVariation: 'multi_environment_practice',
        transferActivities: this.createRealWorldTransferTasks()
      },

      // Executive attention (conflict monitoring)
      executiveAttention: {
        tasks: [
          this.createStroopLikeTasks(profile),
          this.createFlankerTasks(profile),
          this.createConflictMonitoringTasks(profile)
        ],
        adaptiveConflict: 'dynamic_conflict_adjustment',
        metacognitionTraining: 'awareness_building_exercises',
        strategyInstruction: this.createAttentionStrategies()
      }
    };
  }

  // Gamified impulse control training
  private createImpulseControlGame(profile: ADHDProfile): ImpulseControlGame {
    return {
      coreGame: {
        name: 'impulse_hero',
        narrative: 'Superhero who gains power from self-control',
        mechanics: {
          stopSignalTask: 'enemy_appears_must_stop_attack',
          delayDiscounting: 'choose_between_immediate_small_reward_or_delayed_large_reward',
          goNoGoTask: 'respond_to_allies_ignore_enemies'
        }
      },
      
      realTimeAdaptation: {
        difficultyAdjustment: this.createRealTimeDifficultyAdaptation(),
        motivationalSupport: this.provideDynamicMotivationalSupport(),
        frustrationManagement: this.implementFrustrationPreventionSystem(),
        successCelebration: this.createSuccessCelebrationSystem()
      },
      
      transferSupport: {
        realWorldScenarios: this.createRealWorldScenarios(profile),
        strategyReminders: this.createStrategyReminderSystem(),
        parentCoachingIntegration: this.integrateParentCoachingTools(),
        schoolTransferSupport: this.createSchoolTransferProgram()
      }
    };
  }
}

class CulturalCognitiveAdaptation {
  
  async adaptCognitiveTrainingForCulture(
    baseProgram: CognitiveTrainingProgram,
    culturalContext: CulturalContext
  ): Promise<CulturallyAdaptedProgram> {
    
    const adaptations = {
      contentAdaptation: await this.adaptTrainingContent(baseProgram, culturalContext),
      languageAdaptation: await this.adaptLanguageElements(baseProgram, culturalContext),
      visualAdaptation: await this.adaptVisualElements(baseProgram, culturalContext),
      motivationalAdaptation: await this.adaptMotivationalSystems(baseProgram, culturalContext),
      assessmentAdaptation: await this.adaptAssessmentMethods(baseProgram, culturalContext)
    };

    return this.integrateAdaptations(baseProgram, adaptations);
  }

  private async adaptTrainingContent(
    program: CognitiveTrainingProgram,
    context: CulturalContext
  ): Promise<ContentAdaptation> {
    
    // Example: Memory training using culturally familiar items
    if (context.region === 'east_asia') {
      return {
        memoryItems: {
          spatial: 'traditional_architecture_layouts',
          verbal: 'culturally_familiar_stories_and_proverbs',
          working_memory: 'traditional_games_and_puzzles'
        },
        problemSolving: {
          scenarios: 'family_and_community_based_problems',
          values: 'collectivist_decision_making_frameworks',
          solutions: 'harmony_focused_resolution_strategies'
        }
      };
    }
    
    if (context.region === 'sub_saharan_africa') {
      return {
        memoryItems: {
          spatial: 'traditional_village_layouts_and_markets',
          verbal: 'oral_tradition_stories_and_songs',
          working_memory: 'traditional_counting_and_trading_systems'
        },
        problemSolving: {
          scenarios: 'community_resource_management_challenges',
          values: 'ubuntu_philosophy_based_solutions',
          solutions: 'consensus_building_approaches'
        }
      };
    }

    return this.createGeneralizedAdaptation(context);
  }
}

class GlobalCognitiveHealthPlatform {
  
  async integrateWithHealthSystem(
    region: string,
    healthSystemCapabilities: HealthSystemProfile
  ): Promise<HealthSystemIntegration> {
    
    return {
      screeningIntegration: await this.integrateWithScreeningProtocols(region),
      treatmentPathways: await this.createTreatmentIntegration(healthSystemCapabilities),
      professionalsTraining: await this.developProfessionalTraining(region),
      outcomeTracking: await this.setupHealthOutcomeTracking(region),
      costEffectivenessAnalysis: await this.conductCostBenefitAnalysis(region)
    };
  }

  private async integrateWithScreeningProtocols(
    region: string
  ): Promise<ScreeningIntegration> {
    
    return {
      earlyDetection: {
        cognitiveDeclineScreening: this.createEarlyDeclineDetection(),
        developmentalScreening: this.createDevelopmentalCognitiveScreening(),
        postInjuryAssessment: this.createTraumaticBrainInjuryScreening()
      },
      
      healthcareProviderTools: {
        quickAssessments: this.create5MinuteCognitiveScreens(),
        referralCriteria: this.establishReferralProtocols(region),
        progressMonitoring: this.createProviderDashboards(),
        familyEngagement: this.createFamilyEducationMaterials()
      },
      
      populationHealthIntegration: {
        epidemiologicalTracking: this.enablePopulationCognitiveTracking(),
        riskFactorIdentification: this.identifyPopulationRiskFactors(),
        interventionTargeting: this.targetHighRiskPopulations(),
        outcomesPrediction: this.predictPopulationOutcomes()
      }
    };
  }
}

class PeakStyleTraining {
  async createScientificallyValidatedTraining(): Promise<ValidatedTrainingSystem> {
    return {
      gameDesign: this.designForTransfer(),
      adaptiveAlgorithms: this.implementBayesianAdaptation(),
      outcomeValidation: this.setupRandomizedControlledTrials(),
      realWorldTransfer: this.measureEcologicalValidity()
    };
  }
}