Video Game Training Can Boost Cognition

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.

Published as a letter in the journal Nature, the research was led by Joaquin A. Anguera, PhD, research scientist/associate specialist, Center for Integrative Neuroscience, Departments of Neurology and Physiology, Sandler Neurosciences Center, University of California, San Francisco.

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.

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.

Nature. Published online September 4, 2013. Abstract

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Cite this: Video Game Training Can Boost Cognition - Medscape - Sep 13, 2013.