Cognitive Performance Programmes in Marylebone, London
Twelve cognitive domains, continuous heart rate variability and grip strength, measured before you start and repeated during a programme. If the numbers do not move, we tell you and stop. Optimise is the pathway for people at or above their baseline who want measurable cognitive gains.
Overview
What we measure, and what we found
You already track sleep, resting heart rate and heart rate variability. Cognition is the input you have never had a number for, which is why it gets managed on feel. Optimise exists to put it on the same footing as everything else you measure.
The baseline is a NayaScore assessment: grip strength, continuous heart rate variability from a wearable ring, and computer-based cognitive testing across twelve domains, reported as percentiles against people of your age and sex. NayaScore is a measurement tool rather than a diagnostic test, and results are interpreted alongside clinical judgement.
Then the same tests are repeated during the programme. That is the whole design. Percentiles are used because a raw score means nothing without knowing what is typical, and repeating the identical battery is what turns an impression into a trend.
One case study, with its limitations. Greg Smith, chief executive of IP Group plc, consented to publication of his results in May 2026. He completed five sessions of three minutes of stimulation each, spread over seven weeks, with three NayaScore assessments across that period. Response inhibition moved from the 86th to the 93rd percentile. Attention moved from the 62nd to the 89th. Planning moved from the 70th to the 90th. Mental rotation held at 113 across all three sittings, which was included deliberately as a stability check: a domain that should not move, and did not.
Now the caveats, and they are not small. Three assessments over seven weeks is a short series. Practice effects cannot be excluded, because repeating a cognitive test tends to improve the score on its own. Regression to the mean cannot be excluded either. These are one person's results, they are individual, and they are not representative of typical outcomes. We publish them because they are real and consented, not because they prove anything.
One consented case is a starting point, not a finding. Bring that scepticism to the free consultation and ask what the numbers would have to do before you believed them.
Why it happens
What actually moves your cognitive numbers
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Sleep debt, which degrades attention and working memory before it changes how alert you feel
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Sustained cognitive load with no recovery block, visible as heart rate variability trending down across a quarter
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Alcohol, which fragments sleep architecture even at volumes that do not feel like much
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Long-haul travel and irregular schedules, which desynchronise the circadian system
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Untreated sleep apnoea, which is common in men over 40 and is frequently missed
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Ordinary ageing, with processing speed declining gradually from the mid-thirties onwards
Treatment approach
How an Optimise programme runs in Marylebone
NayaScore assessment
On enquiryThe baseline, and the only sensible first step. Twelve cognitive domains reported as percentiles for your age and sex, plus grip strength and continuous heart rate variability from a wearable ring. It is a measurement tool rather than a diagnostic test, and results are interpreted alongside clinical judgement. Some people stop here, because the numbers turn out to be fine.
See treatment detail →Optimise programme
On enquiryOptimise is the pathway for people at or above baseline who want measurable cognitive gains rather than treatment for a condition. Session count, the domains you are targeting and the reassessment points are all set before you start, so success is defined in advance instead of negotiated afterwards.
See treatment detail →Precision rTMS
From £350 a sessionStimulation is aimed at the dorsolateral prefrontal cortex, the region handling attention, planning and response inhibition, at a dose set as a percentage of your own motor threshold. Optimise session counts are typically low: Greg Smith completed five sessions of three minutes of stimulation each.
See treatment detail →Heart-brain coupling
On enquiryThe target is not a fixed scalp coordinate. Candidate sites are tested and the one producing the clearest slowing of your heart rate is chosen, which indicates the frontal-vagal network has engaged. It is grounded in published research, including work from our own scientific advisor, and we believe we are the first in London to make it standard practice for every patient.
See treatment detail →Accelerated protocols
From £350 a sessionAn accelerated protocol delivers several sessions a day over a small number of days rather than one a day over weeks. The total dose is similar and the calendar is compressed, which is the practical option if your diary cannot absorb a weekly appointment. Suitability depends on your circumstances.
See treatment detail →Progress tracking
On enquiryThe identical battery, repeated. It is what lets you see response inhibition move while also seeing whether a domain that should be stable stayed stable, which is the check that keeps a result honest. Without repeated measurement, an Optimise programme is a story rather than a result.
See treatment detail →FAQ
Cognitive performance questions
What exactly gets measured, and how?
Grip strength, continuous heart rate variability from a wearable ring, and computer-based cognitive testing across twelve domains including attention, planning, response inhibition and mental rotation. Results come back as percentiles against people of your age and sex, so you can see where you sit rather than just a raw number.
How do I know this is not just a practice effect?
You cannot fully exclude it, and anyone who tells you otherwise is selling. Repeating a cognitive test tends to improve the score on its own. That is why stability domains are included: a measure that should not move if the effect is real. Mental rotation held at 113 across all three of Greg Smith's sittings.
How many sessions does an Optimise programme take?
Fewer than a Restore course, and the number is set after your baseline rather than before it. The published case study on this page ran to five sessions of three minutes of stimulation each, over seven weeks. Your own figure depends on what your assessment shows and which domains you are targeting.
What happens if my numbers do not move?
We tell you and we stop. Because the same battery is repeated during the programme rather than only at the end, that answer arrives early enough to matter. Not everyone responds. We would rather lose the rest of a booking than keep selling sessions against a flat line.
Is stimulation safe if there is nothing wrong with me?
It is non-invasive and has been used clinically for more than twenty five years. Seizure is the serious risk and it is rare. We screen for metal in the head, cardiac devices and any seizure history before anyone is treated, and being well does not exempt you from that screening.
Related What we treat
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Naya • 1 Orchard Street, London W1H 6HJ
BookAppointments typically available within 1–2 weeks