Video Game Training Can Boost Cognition

**StephL** · 11-14-2013 04:18 PM

Wall of Text Alert

My conclusion up front: Go ahead and buy a video-gaming equipment and something like Super Mario 64 for your grandparents as Christmas present!!

Letters to Nature. Published online September 4, 2013.
Video game training enhances cognitive control in older adults

Spoiler for who did the study:

Cognitive control is defined by a set of neural processes that allow us to interact with our complex environment in a goal-directed manner. Humans regularly challenge these control processes when attempting to simultaneously accomplish multiple goals (multitasking), generating interference as the result of fundamental information processing limitations.

It is clear that multitasking behaviour has become ubiquitous in today’s technologically dense world, and substantial evidence has accrued regarding multitasking difficulties and cognitive control deficits in our ageing population.

Here we show that multitasking performance, as assessed with a custom-designed three-dimensional video game (NeuroRacer), exhibits a linear age-related decline from 20 to 79 years of age. By playing an adaptive version of NeuroRacer in multitasking training mode, older adults (60 to 85 years old) reduced multitasking costs compared to both an active control group and a no-contact control group, attaining levels beyond those achieved by untrained 20-year-old participants, with gains persisting for 6 months.

Furthermore, age-related deficits in neural signatures of cognitive control, as measured with electroencephalography, were remediated by multitasking training (enhanced midline frontal theta power and frontal–posterior theta coherence).

Critically, this training resulted in performance benefits that extended to untrained cognitive control abilities (enhanced sustained attention and working memory), with an increase in midline frontal theta power predicting the training-induced boost in sustained attention and preservation of multitasking improvement 6 months later.

These findings highlight the robust plasticity of the prefrontal cognitive control system in the ageing brain, and provide the first evidence, to our knowledge, of how a custom-designed video game can be used to assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and serve as a powerful tool for cognitive enhancement.

Summary of the Nature article above:
Medscape PSYCHIATRY & MENTAL HEALTH:

Video Game Training Can Boost Cognition

Pauline Anderson, September 13, 2013

Spoiler for where the original was published initially:

Experiments involving a custom-designed 3-dimensional video game demonstrate that training using this approach can assess cognitive abilities across the lifespan, evaluate underlying neural mechanisms, and enhance cognition.

The research shows that multitask training using a custom-built video game called NeuroRacer not only boosts this multitasking ability but also enhances untrained cognitive control abilities, such as attention and working memory.

Multitasking

The NeuroRacer game involves 2 tasks: (1) driving a car using a joystick to keep it in the center of the road and prevent it from going too fast or too slow (visuomotor tracking) and (2) pushing a button only when a certain sign with a green circle pops up (perceptual discrimination ability). Doing each task separately is single tasking; doing the 2 tasks together is multitasking.

The researchers carried out 3 experiments. The first investigated how going from single tasking (driving or sign-spotting) to multitasking (driving while sign-spotting) changes over the lifespan. It included 174 participants aged 20 to 79 years, with about 30 participants in each decade of life.

To compare the decrease in performance in going from single-tasking to multitasking, researchers used what they called multitasking "costs" (performance on multitasking minus performance on single-tasking, converted to a percentage). Greater costs, or a more negative percentage cost, indicate increased interference when multitasking.

The researchers found that multitasking performance diminished significantly across the adult lifespan, with the youngest participants having the fewest deficiencies and the oldest participants the most. For example, the 20-year-olds had a –26.7% cost while the 30-year-olds had a –38.6% cost.

"Every decade of life got worse and worse, to the point where 70-year-olds had about a 63% decrease in multitasking abilities compared to single-tasking," said Dr. Anguera.

This experiment verified that multitasking performance declines linearly as people advance in age beyond their twenties.

The second experiment explored whether older adults who trained by playing NeuroRacer in multitasking mode could improve their multitasking performance (so diminished NeuroRacer costs). It also investigated whether this training enhanced cognitive abilities.

For this experiment, investigators randomly assigned 46 older adults aged 60 to 85 years to 1 of 3 groups: multitasking training (MTT; n=1), single-task training (STT; n=15) as an active control, or no-contact control (NCC; n=15).

Each participant completed a battery of cognitive tests and played the NeuroRacer while technicians took electroencephalography (EEG) recordings. The researchers specifically assessed midline frontal theta, a well-described EEG measure of cognitive control (eg, working memory, sustained attention, and interference resolution).

Then the STT and MTT groups trained at home. This training involved playing NeuroRacer on a laptop for 1 hour a day 3 times a week for 4 weeks (a total of 12 hours of training). The MTT group played the "sign and drive" condition exclusively during the training period, and the STT participants divided their time between a "sign only" and a "drive only" condition and so were matched for all factors except the presence of interference.

NeuroRacer game (The Gazzaley Lab)
All 3 groups returned for a 1-month post-training assessment and a 6-month follow-up assessment.

The 1-month analysis showed that only the MTT group's multitasking performance significantly improved from pretraining (–64.2% cost) to post-training (–16.2%), suggesting that the role of interference during game-playing was a key mechanistic feature of the training approach. The MTT group, said Dr. Anguera," improved their multitasking ability costs above and beyond both the other groups."

The multitasking performance gains remained stable without booster sessions for several months (–21.9% cost at the 6-month follow-up).

The cognitive tests found improvements only in the multitask training group. Researchers documented pre- and post-training improvement in both working memory (delayed recognition task with and without distraction) and sustained attention This experiment also demonstrated that age-related deficits in neuronal signatures of cognitive control, as measured with EEG, were remediated by multitasking training (enhanced midline frontal theta power and frontal posterior theta coherence).

"The idea is that you get better on things that were related to the underlying cognitive processes that you trained on, and you improve other abilities that you never trained on," Dr. Anguera.

Coupled with previous findings of increased midline frontal theta on a variety of cognitive control tasks, the current results support a common neural basis of cognitive control processes, which can be enhanced by immersion in an adaptive high interference environment, said the authors.

Age Comparison

The third experiment compared neural activity of the older group with 20 participants aged 20 to 29 years who had played a single session of NeuroRacer. The results showed that while the older adults generally started with reduced theta power and coherence compared with their 20-something counterparts, the post-MTT training cost improved significantly beyond the cost level attained by the untrained younger participants.

"We saw that young adults showed greater activity regardless of single- or multi-tasking, suggesting that the declines in activity are not task specific — as you get older, this type of activity declines in general — but the improvements we saw following training were specific to the multitasking condition," commented Dr. Anguera.

In real life, multitasking typically gets easier with practice, but the NeuroRacer game has built-in adaptive algorithms that make the game progressively more difficult as you get better at it, said Dr. Anguera.

And while multitasking in everyday life might also train areas of the brain, playing a video game is fun, entertaining, rewarding (you get instant feedback on your performance), and more likely to be met with compliance than taking medication, said Dr. Anguera. The games are constantly being perfected and upgraded, with new versions being "more gamified" and more interesting," but still based on strong and substantial neurocognitive research," he said.

The idea that transferring cognitive control abilities acquired through training to areas that are untrained might be beneficial to several groups that experience cognitive control deficiencies. These could include patients with traumatic brain injury, autism, attention-deficit/hyperactivity disorder, and geriatric depression, said Dr. Anguera.

Researchers are developing versions of NeuroRacer that target these deficiencies, he said. One of the next steps is to try to get this video game training into a clinical trial.

Neuroplastic Effects

Like all good science, this new study clearly builds on previous work, according to C. Shawn Green, PhD, assistant professor, Department of Psychology, University of Wisconsin-Madison.

Previously published papers have used different commercial games to improve cognitive control both in young adults and in the elderly, have shown that commercial games induce certain types of neuroplastic effects in young adults, and have included training paradigms to produce general cognitive benefits in the elderly, said Dr. Green.

"Overall, the current paper puts together a number of things that are either in the literature, or have been strongly suggested by the literature, into a very nice total package," said Dr. Green. "It ties all of these together in a really convincing way."

The new paper's strongest contribution, however, is that it represents a "real step forward" in how the field should think about designing custom training paradigms, said Dr. Green.

"Typically, when academics have tried to make 'video games' for rehab purposes, the final products have wound up being nothing more than slightly dressed up versions of classic psychology tests," he added. "But we know that simply putting in a few graphics or sounds and then labeling something a 'video game' won't be sufficient to make it a good learning tool. You need to make it immersive and engaging and fun. In other words, it needs to be playable as a video game."

One of the study authors — Adam Gazzaley — is cofounder and chief science advisor of Akili Interactive Labs, a newly formed company that develops cognitive training software. Dr. Gazzaley has a patent pending for a game-based cognitive training intervention, "Enhancing cognition in the presence of distraction and/or interruption," which was inspired by the research presented in this paper.

I have to say - time and again I find myself happy about unconventional science studies done in Germany - not only here - but see for yourselves - this is the one with Super Mario 64:

Nature - Molecular Psychiatry advance online publication 29 October 2013:

Playing Super Mario induces structural brain plasticity: gray matter changes resulting from training with a commercial video game

Spoiler for Where it was done/who did the study:

Abstract

Video gaming is a highly pervasive activity, providing a multitude of complex cognitive and motor demands.
Gaming can be seen as an intense training of several skills. Associated cerebral structural plasticity induced has not been investigated so far.

Comparing a control with a video gaming training group that was trained for 2 months for at least 30 min per day with a platformer game, we found significant gray matter (GM) increase in right hippocampal formation (HC), right dorsolateral prefrontal cortex (DLPFC) and bilateral cerebellum in the training group.

The HC increase correlated with changes from egocentric to allocentric navigation strategy. GM increases in HC and DLPFC correlated with participants’ desire for video gaming, evidence suggesting a predictive role of desire in volume change.

Video game training augments GM in brain areas crucial for spatial navigation, strategic planning, working memory and motor performance going along with evidence for behavioural changes of navigation strategy. The presented video game training could therefore be used to counteract known risk factors for mental disease such as smaller hippocampus and prefrontal cortex volume in, for example, post-traumatic stress disorder, schizophrenia and neurodegenerative disease.

Once more Medscape does a summery on the Nature paper:

Medscape Medical News > Psychiatry
Megan Brooks
November 08, 2013
Video Games a Viable Treatment for Mental Illness?

Playing a video game causes positive structural brain changes in regions responsible for spatial orientation, memory formation, strategic planning, and fine motor skills, with potential implications for psychiatric disorders, new research suggests.

In light of these findings, investigators from the Max Planck Institute for Human Development in Berlin, Germany, suggest that video game training might be therapeutically useful for patients with mental disorders such as schizophrenia, post-traumatic stress disorder (PTSD), or neurodegenerative diseases, such as Alzheimer's dementia, in which brain regions are altered or reduced in size.

"While previous studies have shown differences in brain structure of video gamers, the present study can demonstrate the direct causal link between video gaming and a volumetric brain increase. This proves that specific brain regions can be trained by means of video games," lead author Simone Kühn, PhD, said in a statement.

Video gaming provides the gamer with a multitude of complex cognitive and motor demands. There is a growing body of evidence that video game experts outperform novices on several cognitive measures of attention and perception, which has fueled interest in using video games for brain training.

"Surprisingly," however, "studies exploring the functional and structural neural correlates of frequent video gaming are scarce," the investigators write.

"This is the first study that systematically explores structural brain changes in response to training with a commercial video game," Dr. Kühn told Medscape Medical News.

The researchers had 23 healthy young adults with little or no prior video game experience play the video game "Super Mario 64" for more than 30 minutes a day for 2 months. A matched control group of 25 adults did not play video games. Brain volume was quantified using magnetic resonance imaging (MRI).

In comparison with the control group, the video gaming group showed significant gray matter increases in right hippocampal formation (HC), right dorsolateral prefrontal cortex (DLPFC), and bilateral cerebellum. These changes were more pronounced the more desire the video gamer had to play the video game.

The researchers plan to do further studies to investigate the effects of video gaming in patients with mental health issues.

"We are currently testing the effectiveness of the same intervention in patients with post-traumatic stress disorder, since they have a deficit in hippocampal structure," Dr. Kühn said.

"Many patients will accept video games more readily than other medical interventions," Jürgen Gallinat, MD, a coauthor of the study from Charité University Medicine, St. Hedwig-Krankenhaus, in Berlin, commented in a statement.

"Remarkable" Impact

This is "pretty interesting work from an excellent group of researchers," Joaquin Anguera, PhD, of the Sandler Neurosciences Center, University of California, San Francisco, who was not involved in the study, told Medscape Medical News. "I think it's clear that video games can have an influence on the brain, with this study providing that much more evidence from a structural perspective."

Dr. Anguera said the changes at the DLPFC were "pretty remarkable given that this was associated with an off-the-shelf game with little researcher supervision during training. Similarly, the observed DLPFC/desire correlation is also intriguing for future work looking to capitalize on the use of video games as an intervention, as these findings would suggest that identifying those individuals who were excited about playing would appear to have the potential for the greatest gains," he said.