A brain-training video game shows promising signs for the treatment of ADHD in a new randomized clinical trial.

In the game, from developer NeuroPlus, children wear an EEG monitor and additional sensors that measure movement and muscle tension. The readings from those sensors actually control the game — in one game, the player rides a dragon that speeds up the more they focus and slows down when their attention wanders. The game also includes a variation on the go-no go test, meant to help with the development of impulse control.

“What we’re trying to do is put a lot of the evidence-based strategies forward into one product that is engaging and fun to use,” Jake Stauch, CEO of NeuroPlus, told MobiHealthNews. “Because one thing we’ve noticed is if you have the best strategy in the world and it’s not fun for the user, whether it’s a child or an adult, you’re not going to have a lot of clients.”

In the trial, 60 children with ADHD, aged 8 to 13 years, were randomly assigned to groups. One received usual care, while the other played NeuroPlus games for half an hour, three times a week.

Researchers measured the children’s attention and impulse controls using both a subjective questionnaire given to their parents (the well-regarded Conners Index) and an objective test called the Quotient ADHD System. The system delivered statistically significant improvemenrs on both.

“What’s really important here is that we saw significant improvement not just in the Conners, but also in the objective test,” Stauch said. “And we have that strong data from both what parents are seeing and what the child is actually doing, which makes this strong and convincing for us to investigate this further.”

ADHD is also one of the target areas for Project EVO, formerly called NeuroRacer, a therapeutic game from Akili Labs that also has some impressive validation under its belt. But Akili Labs’ games right now have traditional control schemes, as opposed to the biofeedback aspect of NeuroPlus, where users directly control the game with their EEG readings.

NeuroPlus is currently in the market, but it’s not labelled for the treatment of ADHD — that labeling would require FDA clearance. Instead, the company offers it as a general means to improve attention.

“Everyone can benefit from attention training,” Stauch said. “We don’t think it’s limited to ADHD. Regardless of diagnosis attention has been shown to be a big predictor of academic achievement and a lot of other important measures.”

But its notable that the company is collecting robust efficacy data on children with ADHD, and Stauch says more studies are planned. It suggests the company may have designs on expanding its labeling, and seeking the appropriate clearance, in the future. Stauch didn’t comment on FDA clearance, but he did say the clinical space is “something we’re considering for the future”.

A cautious approach makes sense because the brain training space is somewhat fraught. A brain training game that targets ADHD was fined by the FTC back in 2015 for making unsupported medical claims.

“This is an industry that has in some cases not a great track record, and there’s a lot there that’s under the umbrella of brain training that isn’t well-supported by the evidence,” Stauch said. “What we really pride ourselves on and what we value and what we want to take with us is that we’re going to be an evidence-first company. We are going to do the research that shows this support, and always avoid claims that we can’t support with research we’ve done.”