Video Game Training Research Articles

Cognitive Training: Transfer Beyond the Laboratory?

To assess the evidence of general transfer from training on abstract computer-based exercises and video games to driving and flight control. Many believe that training on abstract computer-based exercises and video games enhances cognitive capacities to the benefit of performance in operational contexts. The basic research in this area is controversial. We summarize reviews of the basic research data on transfer from training on abstract computer-based exercises and video games and undertake a detailed methodological review of flight and driving transfer studies. Reviews of basic transfer research fail to reveal evidence of general transfer, although a few applied studies are said to show general transfer to driving or flight control. Our review of these applied studies identifies issues with research methods and data interpretation that compromise the credibility of their results to an extent that they do not provide robust evidence of general transfer from abstract computer-based exercises or video games. The state of cognitive training and video game training in relation to transfer has failed to meet early expectations. Much of the research in this area suffers from inadequate experimental control and flawed interpretation of results. We call for adherence to robust experimental design, critical evaluation of data patterns, and replication of keystone results. We also call for a theoretically grounded research effort, and we outline relevant theoretical conceptions of transfer. A robust theory of transfer and better understanding of transfer effects can guide development of principles for design and use of training simulators.

Study Protocol: Does an Acute Intervention of High-Intensity Physical Exercise Followed by a Brain Training Video Game Have Immediate Effects on Brain Activity of Older People During Stroop Task in fMRI?-A Randomized Controlled Trial With Crossover Design.

Background: Elderly people are affected by processes leading to decline in various aspects of daily living that impair their quality of life. Regarding neurological aspects, executive functions have been shown to be valuable for daily life and to slow decline during aging. Most intervention studies intended to improve cognitive functions during aging specifically address long-term destructive processes and countermeasures. However, to an increasing degree, studies also investigate the acute benefits that prove to be useful for daily life, such as physical exercise or video games in the form of exercise video gaming (“exergaming”). Because little is known about the change in cognitive ability following acute intervention of a combination of physical exercise and video gaming, especially for older people, this work is designed as an attempt to address this matter.Methods: This study is a randomized crossover controlled trial to test the response to an acute bout of high-intensity physical exercise followed by a short session with a brain training (Brain Age) video game in physically active and cognitively healthy older adults (60–70 years). The response is measured using Stroop task performance (cognitive task for executive function) and related brain activity assessed with functional magnetic resonance imaging (fMRI). The control conditions are low-intensity physical exercise and Tetris for video gaming.Discussion: This study is intended to provide insight into the alteration of executive function and its related brain activity from an acute intervention with a combination of physical exercise and video gaming in older people. The protocol might not be implementable in daily life to improve cognitive abilities. However, the results can support future studies that investigate cognition and the combination of physical exercise and video gaming. Moreover, it can provide real-life implications.Trial registration: This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (UMIN000033054). Registered 19 July 2018, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000037687.

The effects of short-term musical training on the neural processing of speech-in-noise in older adults

Experienced musicians outperform non-musicians in understanding speech-in-noise (SPIN). The benefits of lifelong musicianship endure into older age, where musicians experience smaller declines in their ability to understand speech in noisy environments. However, it is presently unknown whether commencing musical training in old age can also counteract age-related decline in speech perception, and whether such training induces changes in neural processing of speech. Here, we recruited older adult non-musicians and assigned them to receive a short course of piano or videogame training, or no training. Participants completed two sessions of functional Magnetic Resonance Imaging where they performed a SPIN task prior to and following training. While we found no direct benefit of musical training upon SPIN perception, an exploratory Region of Interest analysis revealed increased cortical responses to speech in left Middle Frontal and Supramarginal Gyri which correlated with changes in SPIN task performance in the group which received music training. These results suggest that short-term musical training in older adults may enhance neural encoding of speech, with the potential to reduce age-related decline in speech perception.

Improvement potentials in balance and visuo-motor reaction time after mixed reality action game play: a pilot study

Over the past several decades, there has been much interest regarding the effects of video game play. Research has evaluated the behavioral, cognitive, and psychological effects of video game play, and found individuals who play games using complex and dynamic game settings and require focused attention with quick responses, such as action video games, demonstrate improved cognitive performance. Action video game training has also yielded rehabilitation efficacy for a myriad of patients, such as stroke patients and individuals with vestibular and balance deficits. Recently, new technology platforms have been developed such as mixed reality (MR); however, little to no research has been conducted examining the effects of advanced technology platforms. The purpose of the current study was to explore whether MR game training improved visuo-motor reaction time and balance performances. Fourteen participants (11 male; 18–50 years of age) underwent baseline and post-intervention assessments, and then complete 8 h of MR action game training. Visuo-motor reaction times were obtained via computerized Automated Neurocognitive Assessment Metric testing and balance measures were obtained via Sensory Organizational Testing. Baseline and post-intervention comparisons were analyzed using Wilcoxon signed-rank tests. Baseline and post-intervention visuo-motor reaction time and balance comparisons revealed that MR game training yielded significant reaction time improvements (p < 0.05) and vestibular performances (p < 0.05) following game training. Our results suggest visuo-motor reaction time and balance performances were significantly improved following of 8 h of action MR game training.

Maximal Oxygen Uptake Responders Versus Non-responders Show Differing Cognitive Responses to Movement-based Video Game Training

Maximal Oxygen Uptake Responders Versus Non-responders Show Differing Cognitive Responses to Movement-based Video Game Training

Intrinsic Resting-State Activity in Older Adults With Video Game Experience.

Playing video games is a prevalent leisure activity in current daily life, and studies have found that video game experience has positive effects in several cognitive domains. However, few studies have examined the effect of video game experience on the amplitude of low-frequency fluctuations (ALFF) among older adults. In the current study, we compared behavioral performance in the flanker task and ALFF activities of older adults, of whom 15 were video game players (VGPs) and 18 non-video game players (NVGPs). The results showed that VGPs outperformed NVGPs in the flanker task and that VGPs showed significantly increased ALFF relative to NVGPs in the left inferior occipital gyrus, left cerebellum and left lingual gyrus. Furthermore, the ALFF in the left inferior occipital gyrus and left lingual gyrus was positively correlated with cognitive performance as measured by Mini-Mental State Examination (MMSE) scores. These results revealed that playing video games might improve behavioral performance and change intrinsic brain activity in older adults. Future video game training studies in older adults are warranted to provide more evidence of the positive effects of video game experience on behavioral and brain function.

Interventional First-Person Video Game Training Reduces Fall Risk in Parkinson’s Disease by Improving Gait, Contrast Sensitivity, Visual Acuity and Cognition (P5.6-011)

Interventional First-Person Video Game Training Reduces Fall Risk in Parkinson’s Disease by Improving Gait, Contrast Sensitivity, Visual Acuity and Cognition (P5.6-011)

An Expectancy Effect Causes Improved Visual Attention Performance After Video Game Playing

Numerous studies in the last decade have shown the potential for video games to enhance several cognitive processes, with most evidence targeting visual attention. However, a debate has emerged in the literature pointing to flawed experimental design being responsible for such findings. For example, participants’ expectancy effects (i.e., a placebo) have been proposed as an alternate explanation for observed cognitive enhancement resulting from video game training. Nevertheless, to this day, there is no empirical evidence suggesting that video game studies are susceptible to expectancy effects. Here, we investigate whether we could induce an expectancy effect in visual attentional performance with a brief single placebo video game training session. We recruited naive participants and randomly assigned them into two groups that went through the same experimental procedure, except for the experimental instructions. The experimental procedure included a pre-test with an Attentional Blink task and a Useful field of view task, then a single 15-min video game training session, and finally a post-test with the same tasks as the pre-test. The placebo group received instructions implying that the video game would make them perform better, while the control group was told that they would play a video game to give them a break from the experiment. Our results show an overall significant increase in the Useful field of view performance uniquely for the placebo group. Together, these results confirm the hypothesis that video game training experiments are susceptible to expectancy effects.

Thalamic morphometric changes induced by first-person action videogame training.

Cross-sectional data suggest videogaming as promoting modifications in perceptual and cognitive skills of players, as well as inducing structural brain changes. However, whether such changes are both possible after a systematic gaming exposure, and last beyond the training period, is not known. Here, we originally quantified immediate and long-lasting cognitive and morphometric impact of a systematic gaming experience on a first-person shooter (FPS) game. Thirty-five healthy participants, assigned to a videogaming and a control group, underwent a cognitive assessment and structural magnetic resonance imaging at baseline (T0), immediatelypost-gaming (T1) and after 3months (T2). Enhancements of cognitive performance were found on perceptual and attentional measures at both T1 and T2. Morphometric analysis revealed immediate structural changes involving bilateral medial and posterior thalamic nuclei, as well as bilateral superior temporal gyrus, right precentral gyrus, and left middle occipital gyrus. Notably, significant changes in pulvinar volume were still present at T2, while a voxel-wise regression analysis also linked baseline pulvinar volume and individual changes in gaming performance. Present findings extend over the notion that videogame playing might impact cognitive and brain functioning in a beneficial way, originally showing long-term brain structural changes even months after gaming practice. The involvement of posterior thalamic structures highlights a potential link between FPS games and thalamo-cortical networks related to attention mechanisms and multisensory integration processing.

Feasibility of, Adherence to, and Satisfaction With Video Game Versus Traditional Self-Training of the Upper Extremity in People With Chronic Stroke: A Pilot Randomized Controlled Trial.

We compared the feasibility of, adherence to, and satisfaction with a newly developed upper extremity (UE) self-training protocol using commercial video games with a traditional self-training program for people with chronic stroke. Twenty-four participants with mild to moderate UE weakness were randomized to a video game (n = 13) or traditional (n = 11) self-training program. Participants were requested to train 60 min/day, 6×/wk. During the 5-wk self-training program and 4-wk follow-up, participants documented their self-training time and rated their perceived enjoyment and exertion. Eleven participants completed video game training; 9 completed traditional self-training. During the follow-up period, 8 participants (72.7%) continued the video game training, and 4 (44.4%) continued traditional training. Perceived enjoyment, satisfaction, and benefit for UE improvement were relatively high. Participants demonstrated high adherence to and satisfaction with both self-training programs. More participants continued to play video games after the intervention, indicating its potential to maintain ongoing activity.

Overestimation of Action-Game Training Effects: Publication Bias and Salami Slicing

Does playing action video games improve performance on tests of cognitive ability? A recent meta-analysis (Bediou et al., 2018a) summarized the available evidence and concluded that it can. Their analysis, however, did not adequately correct for publication bias. We re-analyzed the same set of studies with more appropriate adjustments for publication bias and found minimal evidence for transfer of training to cognitive ability measures. Instead, it is possible that there are little or no benefits, just publication bias — the exclusion of non-significant results from the published literature. That bias may be the cause of a lab effect reported in the original meta-analysis. The meta-analysis showed that studies from the Bavelier lab (the senior author of the meta-analysis) reported larger effects than other labs. We show that many of these original studies distributed different outcomes from the same or highly overlapping sets of participants across publications without noting the overlap. This salami-slicing might contribute to the extent of publication bias in the literature. More compelling, independent, and transparent evidence is needed before concluding that action video game training transfers to performance on other cognitive tasks.

Playing Super Mario increases oculomotor inhibition and frontal eye field grey matter in older adults.

Aging is associated with cognitive decline and decreased capacity to inhibit distracting information. Video game training holds promise to increase inhibitory mechanisms in older adults. In the current study, we tested the impact of 3D-platform video game training on performance in an antisaccade task and on related changes in grey matter within the frontal eye fields (FEFs) of older adults. An experimental group (VID group) engaged in 3D-platform video game training over a period of 6months, while an active control group was trained on piano lessons (MUS group), and a no-contact control group did not participate in any intervention (CON group). Increased performance in oculomotor inhibition, as measured by the antisaccade task, and increased grey matter in the right FEF was observed uniquely in the VID group. These results demonstrate that 3D-platform video game training can improve inhibitory control known to decline with age.

Video games as a method of training basic laparoscopic skills.

The use of video games has been proposed as an alternative to shorten the learning curve of basic laparoscopic skills. However, it is not yet clar how useful this practice is. We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. We identified three systematic reviews including eight primary studies, of which four were randomized trials. We concluded video games training could help shorten the learning curve of basic laparoscopic visuospatial skills measured in a virtual platform, but the certainty of the available evidence is low.

Non-action Video Game Training Ameliorates Cognitive Decline Associated with Sleep Disturbance

Sleep disturbance is quite prevalent among students which leads to deleterious consequences on cognitive behavior. Non-action video game training has been shown to improve many aspects of higher order mental functions; therefore, we investigated the effect of same on sleep quality and cognitive functions in sleep-disturbed university students. The study was a randomized controlled type where participants (n = 30) were assigned into two groups: control and experimental. The subjects in the experimental group completed 4 weeks of computerized non-action video game training. Pre- and post-training measures were taken for sleep quality using Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Cognitive functions were tested using PennCNP, computerized neuropsychological battery. Electrophysiological correlates of cognition were evaluated by P300 event-related potential using auditory oddball paradigm. We found significant decrease in both PSQI and ESS scores in the experimental group as compared to the control group, indicating improvement in sleep. The scores for reaction time, visual memory, and logical reasoning showed improvement in video game learners as compared to the control group. The P300 data showed a decrease in latency and increase in amplitude with video game training in sleep-disturbed students indicating improvement in cognition. Correlation analysis demonstrated that the increase in cognitive function was associated with gains in sleep quality. The present study showed that 4 weeks of non-action video game training improved sleep quality and cognitive functions in sleep-disturbed university students.

Video Games for Well-Being: A Systematic Review on the Application of Computer Games for Cognitive and Emotional Training in the Adult Population.

Background: Although several excellent reviews and meta-analyses have investigated the effect of video game trainings as tools to enhance well-being, most of them specifically focused on the effects of digital games on brain plasticity or cognitive decline in children and seniors. On the contrary, only one meta-analysis results to be focused on the adult population, and it is restricted to examining the effects of training with a particular genre of games (action video games) on cognitive skills of healthy adults.Objectives: This systematic review was aimed to identify research evidences about the impact on cognitive [i.e., processing and reaction times (RTs), memory, task-switching/multitasking, and mental spatial rotation] and emotional skills of video games training in the healthy adult population.Methods: A multi-component analysis of variables related to the study, the video games, and the outcomes of the training was made on the basis of important previous works. Databases used in the search were PsycINFO, Web of Science (Web of Knowledge), PubMed, and Scopus. The search string was: [(“Video Games” OR “Computer Games” OR “Interactive Gaming”)] AND [(“Cognition”) OR (“Cognitive”) OR (“Emotion”) OR (“Emotion Regulation”)] AND [“Training”].Results: Thirty-five studies met the inclusion criteria and were further classified into the different analysis' variables. The majority of the retrieved studies used commercial video games, and action games in particular, which resulted to be the most commonly used, closely followed by puzzle games. Effect sizes for training with video games on cognitive skills in general ranged from 0.06 to 3.43: from 0.141 to 3.43 for processing and RTs, 0.06 to 1.82 for memory, 0.54 to 1.91 for task switching/multitasking, and 0.3 to 3.2 for mental spatial rotation; regarding video games for the training of emotional skills, effect sizes ranged from 0.201 to 3.01.Conclusion: Overall, findings give evidences of benefits of video games training on cognitive and emotional skills in relation to the healthy adult population, especially on young adults. Efficacy has been demonstrated not only for non-commercial video games or commercial brain-training programs, but for commercial video games as well.

Improving action video games abilities increases the phonological decoding speed and phonological short-term memory in children with developmental dyslexia

Learning to read is extremely difficult for about 10% of the children because they are affected by a heritable neurobiological disorder called developmental dyslexia (DD). The causal role of cognitive deficits typically associated to DD can be investigated through intervention studies. It has been demonstrated that visual-attention and reading speed could be simultaneously improved by using action video game (AVG) training both in shallow and deep alphabetic orthographies. Here, in a clinical study we showed that after this general-domain behavioral intervention both the phonological decoding speed and phonological short-term memory were increased only in DD children in which their video game score was improved. These findings confirm that an AVG training enhances the efficiency of both visual and auditory processing. The plasticity of the multi-sensory attentional network could explain the reading and reading-related improvements induced by the AVG training in children with DD.

Computer and Videogame Interventions for Older Adults' Cognitive and Everyday Functioning.

This study compared older adults' gains in cognitive and everyday functioning after a 60-session home-based videogame intervention with gains seen under formal cognitive training and usual care/no intervention. Participants were randomized to one of three groups: one group played an off-the-shelf videogame (i.e., Crazy Taxi), the second group engaged in a computerized training program focused on visual attention and processing speed (i.e., PositScience InSight), and the third group received no training. Training in the two intervention conditions consisted of 60 training sessions of 1 hour each, which were completed in 3 months (5 hours a week). Participants received a broad battery of cognitive and everyday functioning assessments immediately before (pretest), after (post-test), and 3 months after (follow-up) training. Both training conditions improved on direct assessments of trained outcomes. In the InSight-trained group, we found transfer to untrained measures of visual attention and processing speed that were similar to the trained tasks, and these gains endured for up to 3 months. Participants in the videogame condition showed small additional benefits, not emerging until 3 months after intervention completion, on a measure of both attention and mood. No trained groups showed gain on visuospatial skills or memory. Training effects were highly specific to the target of training. Training effects to visual attention and processing speed were, as expected, larger for InSight-trained participants but were also seen for videogame participants. Given that past research has shown that videogame training leads to greater engagement than cognitive training, videogame interventions may represent a choice for more modest gains in a more engaging context.

Serious games may improve physician heuristics in trauma triage

Trauma triage depends on fallible human judgment. We created two "serious" video game training interventions to improve that judgment. The interventions' central theoretical construct was the representativeness heuristic, which, in trauma triage, would mean judging the severity of an injury by how well it captures (or "represents") the key features of archetypes of cases requiring transfer to a trauma center. Drawing on clinical experience, medical records, and an expert panel, we identified features characteristic of representative and nonrepresentative cases. The two interventions instantiated both kinds of cases. One was an adventure game, seeking narrative engagement; the second was a puzzle-based game, emphasizing analogical reasoning. Both incorporated feedback on diagnostic errors, explaining their sources and consequences. In a four-arm study, they were compared with an intervention using traditional text-based continuing medical education materials (active control) and a no-intervention (passive control) condition. A sample of 320 physicians working at nontrauma centers in the United States was recruited and randomized to a study arm. The primary outcome was performance on a validated virtual simulation, measured as the proportion of undertriaged patients, defined as ones who had severe injuries (according to American College of Surgeons guidelines) but were not transferred. Compared with the control group, physicians exposed to either game undertriaged fewer such patients [difference = -18%, 95% CI: -30 to -6%, P = 0.002 (adventure game); -17%, 95% CI: -28 to -6%, P = 0.003 (puzzle game)]; those exposed to the text-based education undertriaged similar proportions (difference = +8%, 95% CI: -3 to +19%, P = 0.15).

Neural correlates of video game empathy training in adolescents: a randomized trial

The ability to understand emotional experiences of others, empathy, is a valuable skill for effective social interactions. Various types of training increase empathy in adolescents, but their impact on brain circuits underlying empathy has not been examined. Video games provide a unique medium familiar and engaging to adolescents and can be used to deliver training at scale. We developed an empathy training video game, Crystals of Kaydor (Crystals), and investigated whether playing Crystals increases empathic accuracy (EA) and related brain activation in adolescents (N = 74; 27 female; mean age(sd) = 12.8(0.7) years; age range 11–14 years). Participants completed a resting state functional MRI (rs-fMRI) scan and an EA task during an fMRI scan before and after 2 weeks of daily gameplay with either the empathy training game, Crystals (N = 34), or the commercial video game Bastion (N = 40), an active control condition. There were no group differences in EA improvement following gameplay, however, engagement with training aspects of Crystals was associated with a higher increase in EA-related activation in right temporoparietal junction following gameplay. Moreover, rs-fMRI connectivity in empathy-related brain circuits (posterior cingulate–medial prefrontal cortex; MPFC) was stronger after Crystals gameplay compared to Bastion. The more individuals’ EA increased following Crystals versus Bastion, the stronger their rs-fMRI connectivity in brain circuits relevant for emotion regulation (amygdala-MPFC). These findings suggest that a video game designed to increase empathic accuracy produces behaviorally-relevant, functional neural changes in fewer than 6 h of gameplay in adolescents.

How younger elderly realize usefulness of cognitive training video games to maintain their independent living

The objective of this paper is to understand the perception that younger elderly persons have towards the usefulness of playing Xbox Kinect video games as an assistive technology that is designed to maintain their cognitive abilities. Available literature highlights two kinds of assistive technologies; the first being Supportive Technologies that provide aid for already-declined functional abilities (such as hearing aids), and the second being Empowering Technologies that maintain functional abilities which have not yet declined (such as Xbox Kinect cognitive games). The difference in the nature between supportive and empowering technologies plays an important role in perceiving their benefits. For instance, while hearing aids as a supportive technology are perceived as useful through the improvement of hearing abilities, cognitive training games as an empowering technology have a long-term usefulness for cognitive abilities. This study conducts twenty-one qualitative interviews (range 65–87 years; mean = 71; SD = 3.81) and introduces perceived transfer effect. This effect allows the elderly to perceive the usefulness of playing cognitive training video games, which are designed to cultivate the cognitive abilities. In addition, this study found that the elderly value their independent living, and through cognitive video games, the elderly may remain capable of living independently.