Could video games be used to improve mental health?

Newly formed neurons play a role in brain function, and age-related decline in neurogenesis contributes to impairment in learning and memory1. Recreational video game playing is the phenomenon of our time and there is evidence it can enhance neuronal plasticity2,3.  Could this cognitive training have therapeutic potential in conditions such as post-traumatic stress disorder (PTSD)?

Jürgen Gallinat (University Medical Center Hamburg-Eppendorf, Germany) presented the current evidence at this ECNP Virtual 2020 session.

 

Neurogenesis and brain volume

Global gray matter volume shows a linear decrease with age in normal adult brains

The hippocampus is important for acquisition of new memories1. In adult mouse studies, physical activity increases hippocampal neurogenesis1. In humans, brain volume is often used as a proxy for neuronal plasticity, with a linear decrease in global gray matter volume with age in normal adult brains4.

 

Video game playing and the brain

In adolescents, left ventral striatum volume (area associated with dopamine release) is higher in frequent video game players (>9 h/week) compared to non-frequent players (<9 h/week)5.

In adults, there is a positive association between lifetime amount of video gaming and gray matter volume

In adults, there is a significant positive association (p<0.001) between lifetime amount of video gaming and gray matter volume in parahippocampal, hippocampal and occipital regions, areas associated with spatial navigation and visual attention6.

 

Enhancing neuronal plasticity through cognitive training

Training adults for ≥30 min/day over 2 months with a three-dimensional platformer video game significantly increased gray matter volume in right hippocampal, right dorsolateral prefrontal and bilateral cerebellum regions, associated with changes in navigation strategy and desire for video gaming2. Computer game-based inhibition training in older adults increased cortical thickness in the right inferior frontal gyrus triangularis, an area associated with response inhibition3.

Training adults with a video game significantly increased gray matter volume

 

Possible transfer effects

Can computer game training effects lead to transfer effects on other cognitive skills? A prospective study randomized surgical novices to a game with high visual-spatial demands and visual similarities to endoscopy or a game with mainly cognitive demands (chess)7. Both groups demonstrated improved performance in minimally invasive surgical simulators, with increased transfer effect in those trained on the visually similar game.

 

Therapeutic potential in psychiatry and neurology

Flashbacks, a hallmark symptom of PTSD, are sensory-perceptual, visuospatial mental images. Could visuospatial cognitive tasks selectively compete for resources required to generate mental images? The brain has selective resources with limited capacity, with an estimated 6 h window to disrupt memory consolidation8.

Those playing the computer game after viewing a traumatic film had significant reduction in flashback frequency

Participants were randomized to 10 min visuospatial task (Tetris computer game) or no-task, 30 min after viewing a traumatic film (experimental analog for PTSD)8. Those playing the computer game had significant reduction in flashback frequency over 1 week. Male patients with combat-related PTSD were randomized to playing Tetris 60 min/day plus therapy or therapy alone for 6 weeks9. Following therapy, the Tetris group showed increased hippocampal volume and reduction in symptoms of PTDS, depression and anxiety.

Video game training was used to study traumatic memories after emergency Cesarean section (ECS), randomizing women to 15 min Tetris session, within 6 h following ECS, or usual care10. The intervention group reported fewer traumatic memories over 1 week.

The video game training group reported fewer traumatic memories after emergency Cesarean section

Further potential applications include reducing schizophrenia symptoms and addressing mild cognitive impairment.

 

PTSD : Post Traumatic Stress Disorder 
ECNP : European College of Neuropsychopharmacology 
min : minutes
h : hour
ECS : emergency Cesarean section

BE-NOTPR-0174 approval date 10/2022

Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

References
  1. Lazarov O, et al. Trends Neurosci 2010;33:569-79.
  2. Kühn S, et al. Mol Psychiatry 2014;19:265-71.
  3. Kühn S, et al. Neuroimage 2017;156:199-206.
  4. Good CD, et al. Neuroimage 2001;14:21-36.
  5. Kühn S, et al. Transl Psychiatry 2011;1:e53.
  6. Kühn S, Gallinat J. Mol Psychiatry 2014;19:842-7.                 
  7. Schlickum MK, et al. World J Surg 2009;33:2360-7.
  8. Holmes EA, et al. PLoS One 2009;4:e4153.
  9. Butler O, et al. J Psychiatry Neurosci 2020;45:279-87.
  10. Horsch A, et al. Behav Res Ther 2017;94:36-47.
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