A study participant playing Neuroracer.

A new study from the University of California, San Francisco shows that a specially designed mobile video game could improve neural plasticity in older adults, improving their ability to multitask and to filter out distractions. A spin-off company is currently testing a version of the game for the possible treatment of ADHD, depression, or autism spectrum disorders.

The study, published in the September issue of Nature, included three different experiments with a car racing game, called Neuroracer, played on a laptop with a video game controller attached. The game tested multitasking by including two simultaneous sub-games: a 3D driving game, which required players to make left and right turns, slow down, and speed up their car, and a sign-recognition game, where players had to respond to signs on the screen differently depending on whether they included a green circle.

In the first experiment, 174 individuals between the ages of 20 and 79, with about 30 in each decade range, played an assessment version of the game, first with just the sign task and then with the sign task and the driving portion. The difference in performance between the two cases illustrated the participant's multitasking ability, which researchers found declined progressively from the youngest to the oldest group.

Another experiment was done with a group of 46 adults aged 60 to 85, split into three groups. One group trained on the multitasking game regularly for a month, one trained on a single-task version, and one didn't train at all. The multitasking group had a significantly improved performance on the game, but the study found that they also improved in other cognitive areas beyond what they practiced.

"What's most novel here is other abilities that were not directly trained, such as sustained attention, which is vigilance, and working memory, their ability to hold on to something for a short period of time, also improved," Adam Gazzaley, lead researcher on the study, said during a call with reporters.

The third experiment actually used electroenchephalograph scans to show that the game had a visible effect on the brain itself. The results showed that the multitasking group had significantly more activity in a part of the prefrontal cortex generally agreed to be associated with cognitive control.

Working with PureTech Ventures, Gazzaley co-founded a company to commercialize Neuroracer and other cognitive training games in 2011. The company, Akili Interactive Labs, has been building on the basic theory and game mechanics of Neuroracer to create Project Evo, a more visually rich game for iOS phones and tablets. The game is currently in clinical trials for a variety of different age demographics and disease cases including adult and child ADHD, depression, and autism spectrum disorders. The Nature study will form part of the clinical validation Akili needs to secure FDA clearance, and the ongoing clinical trials build on the Nature study's conclusions.

Project Evo

"Our motto is better science, better games," Acting Chief Business Officer and PureTech partner Eric Elenko told MobiHealthNews. "With an engaging platform and an engaging game, it engenders the user to engage with the game and it increases compliance, which is important from a therapeutic viewpoint. We've designed something with the look and feel of a consumer game, even though it's therapeutic."

Project Evo was partly created by Matt Omernick, Akili's executive creative director, who previously held senior positions at LucasArts and EA Games. It uses the tablet's touchscreen and accelerometer both as controllers and includes a rewards system with upgrades and a customizable avatar.

"What we think is extremely exciting about this new horizon is you can deliver that to people wherever they are," VP of Research and Development Eddie Martucci told MobiHealthNews. "It has the look and feel of something that anyone would pay money to download."

Gazzaley stressed that the study doesn't show that all video games have clinical value, but rather that carefully designed games can have value and will hopefully one day be trusted and prescribed in the way that pharmaceuticals are now.

"The devil's really in the details and we spent a lot of time designing this game in a very detailed way to address neural processes deficient in this population. So I hope rather that the message is through a careful approach of design and validation we can learn that videogames and the mechanics that underlie them can have a really big impact on peoples brains and hopefully their behavior," he said. "I think that the targeting and the care and the careful validation that it actually works in the way you hope it does are essential ingredients in really thinking of this type of interactive media as medicine, which I hope is what we will see happen over this next decade."