September 4, 2013

expert reaction to brain training video game

Research, published in Nature, suggested video-game-based training may be able to repair age-related declines in older individuals’ multitasking and cognitive-control abilities. 

Alexandra Trelle, PhD candidate in the Memory Laboratory, Department of Psychology, University of Cambridge, whose area of research expertise centres on ageing and cognition, said:

Q: Do the results back up the conclusions?

“Yes, I would say they do, so long as the conclusions are interpreted with caution. It is important for the public to note that these results refer to a very limited range of tasks, namely the training task and two independent tasks, and that the game does not offer improvements on all tasks across different domains of cognition.”

Q: Is this surprising or does it fit with what we already know?

“The results aren’t entirely surprising, as previous studies have demonstrated training-related improvements in older adults’ task performance, with corresponding improvements in recruitment of task-relevant brain regions. However, it is very encouraging to see more and more studies with such results emerging, as each one lends more support to the idea that age-related declines in cognition can be ameliorated to some degree.”

Q: Is this a therapy or a tool that tells us more about our brains?

“Perhaps it can be viewed as a bit of both. This game clearly isn’t cure-all therapy, but it does represent an activity that challenges the brain and improves neural pathways, results which can be interpreted as therapeutic. However, I think to be viewed more directly as a therapy, the benefits gleaned from the activity would need to be reflected in tangible activities of daily living, rather than other similar computerized tasks. More importantly, the results from this training study highlight the plasticity of the brain well into old age, and should encourage members of the public to continue striving to improve all elements of cognition throughout their lives.”

Q: Does this mean everyone over a certain age should be encouraged to play games like this?

“I believe that people of all ages should always be engaging in activities that exercise and challenge their existing cognitive abilities and lead to improved performance. I don’t necessarily think that a game like this is the only way to go about that, but it does represent one option. It’s important for the public to be aware that there are many ways to exercise the brain, and they should choose activities that they find enjoyable and rewarding, as well as try to engage in a variety of activities that tap into different elements of cognition for an all-around benefit.”

Q: Could this help people with severe cognitive decline?

“Presently this is unclear. The adaptive nature of the game to one’s performance level is an important characteristic in this context, and appears to enable a benefit to be gained for a range of individuals. An important next step is to directly compare healthy older adults with older adults with increasing levels of cognitive decline to assess how the utility of the game-training strategy varies.”

Q: Are there other things that can be done instead to have the same/greater effect?

“This game represents only one example of one strategy, namely an adaptive, cognitively challenging computer game that can be used to enhance a particular element of cognition. I believe there are plenty of different ways that one can go about improving cognitive functions, many of which can be more social and fun than a solitary computer game, such as learning a new language, taking up a musical instrument, or engaging in any number of strategy games. I would venture to say that activities such as these, which are not so far removed from daily living and emphasize social interaction in addition to challenging cognitive functions, could provide an even greater and more generalized benefit than a very targeted computer training program.”

Dr Emil Toescu, Neuronal Network Group, School of Clinical and Experimental Medicine, University of Birmingham, said:

“This work provides important information for those studying and trying to improve the cognitive interventions for the elderly as a means of reducing their age-dependent decrease in function. It also has potential as a preventive measure against neurodegenerative diseases. The technology is not yet sufficiently proven to recommend itself for immediate adoption by older people, but, on the other hand, a moderately complex gaming experience is always good fun, whatever the age, and it cannot do damage. At best, it can improve!

“Because of previous animal and human studies we have known for some time that ‘you can teach an old dog new tricks’ as the aged brain can learn and improve. The main problem is that the improved cognitive performance is specific to the one repeated task. i.e. you can end up with specialist elders who are great at number crunching or word recognition, but don’t have a significant improvement in their daily life cognitive performance. This research is interesting because Anguera and Gazzaley’s group shows that if you multitask during a specific training routine, it improves performance with more than just that single task. The improvement is transferred to other cognitive domains. Even more importantly, and this feature has not been tested frequently enough in previous studies, the improved cognitive performances were maintained 6-months after the multitasking training schedule. However, this was only statistically significant for the tasks of being able to keep words in the working memory for a longer time (delayed recognition test) and for sustained attention. Other parameters tested showed only a suggestive ‘trend’ (always a dangerous double sword!).

“This study provides good evidence and follows from several older observations. One, stemming from work initially performed in animal studies, is that the cognitive deficits that emerge with increased age (it happens in animals as well, and it can be measured and assessed quite precisely!), can be significantly reduced when the animals are maintained or provided with an enriched environment. If one reads ‘multitasking’ for the ‘enriched environment’, a potential for cognitive intervention in the aged emerges.

“There are also some notes of caution. In the study they established a ‘neural basis’ of the training effects by monitoring with EEG on the scalp. Essentially they assessed the changes in a specific band of brain activity frequencies: the theta frequency (4-7Hz). That makes sense in the context of EEG recordings, as it is very clear and easy to detect and quantify. However, it should be mentioned that there is debate about whether activity in this theta frequency actually means greater cognitive functions. Some studies support this theory, others suggest that the theta activity is a precursor of a higher-frequency activity (gamma band: 20-80Hz) and that this region-specific gamma activity is more significant. Several studies show that this gamma activity is significantly affected by the ageing process but it’s much more difficult to examine through scalp recordings of EEG. It will be fascinating to find out if a multi-tasking training protocol could modify activity in this gamma activity.

“Despite the description by the authors of the experimental setup as a “three-dimensional immersive and fun game”, it’s really very basic and definitely no Grand Theft Auto with luxurious and detailed backgrounds. However, if this much can be done with a 1980s interface, it would be fascinating to see what a proper 21st century game environment will do for the elders of today – Vettel, beware, Einsteins are coming!”

‘Video game training enhances cognitive control in older adults’ by Anguera et al., published in Nature on Wednesday 4th September.