Video games offer the potential for ‘experiential medicine’

Various digital interventions address cognitive aging in healthy older adults

By Laura Kurtzman

After a decade of work, scientists at UC San Francisco’s Neuroscape Center have developed a suite of video game interventions that improve key aspects of cognition in aging adults.

Games, which co-creator Adam Gazzaley, MD, PhD says can be adapted to clinical populations as a new form of “experiential medicine,” have shown benefits on a range of important cognitive processes, including memory at short term, attention and long term. -term memory.

Each uses closed-loop adaptive algorithms that Gazzaley’s lab pioneered in the widely cited 2013 Neuroracer study published in Naturewhich demonstrated for the first time that it was possible to restore diminished mental faculties in the elderly with just four weeks of training on a specially designed video game.

Watch a short video showing how the Neuroracer and Body Brain Trainer games, developed by the Neuroscape Center, improve cognitive function for multitasking and working memory, and may even benefit conditions like ADHD, Parkinson’s disease and multiple sclerosis.

These algorithms outperform commercial games by automatically increasing or decreasing the difficulty, depending on how someone is playing the game. This prevents less skilled players from being overwhelmed, while challenging those with a greater capacity. Games using these algorithms recreate common activities, such as driving, exercising and drumming, and use the skills each can engender to retrain cognitive processes that become impaired with age.

“All of these things take experiences and deliver them in a very personalized and fun way, and our brain responds through a process called plasticity,” said Gazzaley, professor of neurology at UCSF Weill Institute for Neurosciences and founder and executive director. from Neuroscape. “Experiences are a powerful way to change our brains, and this form of experience allows us to deliver it in a very accessible way.”

The lab’s most recent invention is a musical rhythm game, developed in consultation with drummer Mickey Hart, which not only taught participants aged 60 to 79 how to drum, but also improved their ability to memory of faces. The study is published on October 3, 2022, in PNAS.

The eight-week program used visual cues to teach people how to play a rhythm on an electronic tablet. The algorithm tailored the degree of difficulty – including tempo, complexity and level of precision required for a tap to be considered real-time – to each player’s ability. Over time, the cues disappeared, requiring players to memorize the rhythm pattern.

When participants were tested at the end to see how well they could recognize unfamiliar faces, electroencephalography (EEG) data showed increased activity in a part of the brain on the right side (the superior parietal lobule) that is involved in both sight-reading of music and visual short-term memory for other tasks. The researchers said the data indicates that the training improved the way people memorize something and then pull it out when they need it.

“This memory improvement was incredible,” said Theodore Zanto, PhD, associate professor of neurology at the UCSF Weill Institute for Neurosciences and director of Neuroscape’s Neuroscience Division. “There is a very strong memory training component to this, and it has generalized to other forms of memory.”

A second game, the Body Brain Trainer, recently published in NPJ aging, improved blood pressure, balance and attention in a group of healthy older adults with eight weeks of training. The game also improved a key signature of attention that declines as people age and is linked to the ability to multitask. In addition to the usual adaptive algorithm targeting cognitive abilities, the eight-week training included a feedback mechanism to ensure participants were exercising at the right level.

“There is a very strong memory-forming component to this, and it has generalized to other forms of memory,” said Theodore Zanto, PhD, pictured above left with Joaquin A. Anguera, PhD (right). Image by Stephen Babuljak

“We had people wearing a heart rate monitor, and we were getting that heart rate data and feeding it into the game,” said Joaquin A. Anguera, PhD, associate professor of neurology at UCSF Weill Institute for Neurosciences. and Director of the Clinical Division at Neuroscape. “If they didn’t work hard enough, the game got harder.”

Neuroscape published the results of another study last year in Scientific reports on a virtual reality space navigation game called Labyrinth that improved long-term memory in older people after four weeks of training.

All three studies demonstrated their results in randomized clinical trials, extending the 2013 finding that digital training can improve declining cognitive abilities in older adults.

“These all target cognitive control, a capacity that is deficient in older people and is critical to their quality of life,” Gazzaley said. “These games all have the same underlying adaptive algorithms and approaches, but they use very, very different types of activity. And in each of them, we show that you can improve the cognitive abilities of this population.

Gazzaley is a co-founder, shareholder, advisor, and board member of Akili Interactive Labs, a company that produces therapeutic video games and owns a Body Brain Trainer license.


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