Analysis of Biosignals During Immersion in Computer Games

Event-related prefrontal activations during online video game playing are modulated by game mechanics, physiological arousal and the amount of daily playing

There is a trend to study human brain functions in ecological contexts and in relation to human factors. In this study, functional near-infrared spectroscopy (fNIRS) was used to record real-time prefrontal activities in 42 male university student habitual video game players when they played a round of multiplayer online battle arena game, League of Legends. A content-based event coding approach was used to analyze regional activations in relation to event type, physiological arousal indexed by heart rate (HR) change, and individual characteristics of the player. Game events Slay and Slain were found to be associated with similar HR and prefrontal responses before the event onset, but differential responses after the event onset. Ventrolateral prefrontal cortex (VLPFC) activation preceding the Slay onset correlated positively with HR change, whereas activations in dorsolateral prefrontal cortex (DLPFC) and rostral frontal pole area (FPAr) preceding the Slain onset were predicted by self-reported hours of weekly playing (HoWP). Together, these results provide empirical evidence to support the notion that event-related regional prefrontal activations during online video game playing are shaped by game mechanics, in-game dynamics of physiological arousal and individual characteristics the players.

Heartbeats and high scores: esports triggers cardiovascular and autonomic stress response

Introduction

Gaming is often labeled as sedentary behavior. However, competitive gaming, also known as esports, involves significant cognitive demands and may induce stress. This study aims to investigate whether the psychophysical demands during esports elicit a physiological stress response.

Methods

Fourteen FIFA 21 and thirteen League of Legends players (23.3 ± 2.8 years) were recruited for the study. Heart rate (HR), root mean square of successive differences between normal heartbeats (RMSSD), peripheral and central blood pressure (BP), pulse wave velocity (PWV), and energy expenditure (EE) were assessed during supine rest, seated rest, and competitive FIFA or League of Legends matches.

Results

No significant group × condition interactions were observed for any of the outcomes. However, there were significant increases in mean HR (p < 0.001, η p 2  = 0.383), RMSSD (p = 0.019, η p 2  = 0.226), peripheral systolic BP (p < 0.001, η p 2  = 0.588), peripheral diastolic BP (p = 0.005, η p 2  = 0.272), central systolic BP (p = 0.005; η p 2  = 0.369), central diastolic BP (p = 0.016, η p 2  = 0.313), PWV (p = 0.004, η p 2  = 0.333), and EE (p < 0.001, η p 2  = 0.721) during both games compared to the seated rest condition.

Conclusion

Despite the sedentary nature of esports, the psychophysical demands appear to elicit physiological responses. Interestingly, no significant differences were found between the different game genres.

Heart Rate Variability during Online Video Game Playing in Habitual Gamers: Effects of Internet Addiction Scale, Ranking Score and Gaming Performance

Previous studies have demonstrated that individuals with internet gaming disorder (IGD) display abnormal autonomic activities at rest and during gameplay. Here, we examined whether and how in-game autonomic activity is modulated by human characteristics and behavioral performance of the player. We measured heart rate variability (HRV) in 42 male university student habitual gamers (HGs) when they played a round of League of Legends game online. Short-term HRV indices measured in early, middle and late phases of the game were compared between the players at high risk of developing IGD and those at low risk, as assessed by the revised Chen Internet addiction scale (CIAS-R). Multiple linear regression (MLR) was used to identify significant predictors of HRV measured over the whole gameplay period (WG), among CIAS-R, ranking score, hours of weekly playing and selected in-game performance parameters. The high-risk players showed a significantly higher low-frequency power/high-frequency power ratio (LF/HF) relative to the low-risk players, regardless of game phase. MLR analysis revealed that LF/HF measured in WG was predicted by, and only by, CIAS-R. The HRV indicators of sympathetic activity were found to be predicted only by the number of slain in WG (NSlain), and the indicators of parasympathetic activity were predicted by both CIAS-R and NSlain. Collectively, the results demonstrated that risk of developing IGD is associated with dysregulated autonomic balance during gameplay, and in-game autonomic activities are modulated by complex interactions among personal attributes and in-game behavioral performance of the player, as well as situational factors embedded in game mechanics.

Engaging learners with games-Insights from functional near-infrared spectroscopy

The use of game elements in learning tasks is thought to facilitate emotional and behavioral responses as well as learner engagement. So far, however, little is known about the underlying neural mechanisms of game-based learning. In the current study, we added game elements to a number line estimation task assessing fraction understanding and compared brain activation patterns to a non-game-based task version. Forty-one participants performed both task versions in counterbalanced order while frontal brain activation patterns were assessed using near-infrared spectroscopy (within-subject, cross-sectional study design). Additionally, heart rate, subjective user experience, and task performance were recorded. Task performance, mood, flow experience, as well as heart rate did not differ between task versions. However, the game-based task-version was rated as more attractive, stimulating and novel compared to the non-game-based task version. Additionally, completing the game-based task version was associated with stronger activation in frontal brain areas generally involved in emotional and reward processing as well as attentional processes. These results provide new neurofunctional evidence substantiating that game elements in learning tasks seem to facilitate learning through emotional and cognitive engagement.

Health Consequences of Intensive E-Gaming: A Systematic Review

The aim of this review is to examine the links among the different factors that determine harmful or even deadly events in professional and semiprofessional intensive Esports players. Cases of serious injuries or even death in young (<35 years old) male professional Esports players are reported every year. Fatalities and injuries in professional Esports players (PEGS) have only affected male players, and these events have mostly been concentrated in Asia. Studies in the literature have reported several causes and mechanisms of injuries. Links between injuries and previous comorbidities have emerged from the extant literature; obesity and/or metabolic disorders, seizures (associated with overstimulation of the eyes), heart malfunctions, high basal and abrupt increases in systolic blood pressure (SBP), prolonged stress, and poor posture have been associated with injuries. Several clinical signs have been identified and the question emerges whether or not self-regulation by Esports associations or public health authorities is necessary.

Arousal/Stress Effects of "Overwatch" eSports Game Competition in Collegiate Gamers

ABSTRACT

Kraemer, WJ, Caldwell, LK, Post, EM, Beeler, MK, Emerson, A, Volek, JS, Maresh, CM, Fogt, JS, Fogt, N, Häkkinen, K, Newton, RU, Lopez, P, Sanchez, BN, and Onate, JA. Arousal/stress effects of "Overwatch" eSports game competition in collegiate gamers. J Strength Cond Res XX(X): 000-000, 2022-To date, no physical response data are available for one of the most popular eSport games, Overwatch. The purpose of this investigation was to describe the stress signaling associated with competitive Overwatch play and to understand how acute hormonal responses may affect performance. Thirty-two male college-aged gamers (age: 21.3 ± 2.7 years; estimated time played per week: 18 ± 15 hours) completed the study. Subjects were randomly assigned to a 6-player team to compete in a tournament-style match. Salivary measures of cortisol and testosterone were collected immediately before (PRE) and after (POST) the first-round game, with the heart rate recorded continuously during the match. The mean characteristics were calculated for each variable and comparisons made by the skill level. Significance was defined as p ≤ 0.05. There were no differences in measures of salivary cortisol. A differential response pattern was observed by the skill level for testosterone. The low skill group displayed a significant increase in testosterone with game play (mean ± SD, testosterone PRE: 418.3 ± 89.5 pmol·L-1, POST: 527.6 ± 132.4 pmol·L-1, p < 0.001), whereas no change was observed in the high skill group. There were no differences in heart rate characteristics between skill groups. Overall, the average heart rate was 107.2 ± 17.8 bpm with an average max heart rate of 133.3 ± 19.1 bpm. This study provides unique physiological evidence that a sedentary Overwatch match modulates endocrine and cardiovascular responses, with the skill level emerging as a potential modulator.

A review article of the cardiovascular sequalae in esport athletes: a cause for concern?

The esports industry has grown exponentially and is expected to flourish rapidly in the coming years. Awareness about the cardiovascular sequalae in elite esport athletes has gained considerable momentum. Evidence supporting systematic screening in esport athletes is however lacking. In this narrative review, we discuss potential negative health effects on the cardiovascular system in esports enthusiasts. The pathophysiological mechanisms discussed in this narrative review may put esport athletes at an increased risk of cardiovascular events. Although large studies in esport athletes to substantiate these claims are inexistent, case reports or case-controlled studies have been included to support our hypotheses. Sleep deprivation, psychological stress, altered arterial stiffness, hypertension, and heart rate variability are some of these proposed mechanisms. The available data is unfortunately extrapolated from small cohorts. Nevertheless, the risk of sudden cardiac death is an important health concern which should be addressed appropriately. This review will raise awareness about the possible negative impact on the cardiovascular system in esport athletes.

Acute Effects of Esports on the Cardiovascular System and Energy Expenditure in Amateur Esports Players

Introduction

Esports is practiced by millions of people worldwide every day. On a professional level, esports has been proven to have a high stress potential and is sometimes considered equivalent to traditional sporting activities. While traditional sports have health-promoting effects through muscle activity and increased energy expenditure, amateur esports could represent a purely sedentary activity, which would carry potentially harmful effects when practiced regularly. Therefore, this study aims to investigate the acute effects of esports on the cardiovascular system and energy expenditure in amateur esports players to show whether esports can be considered as physical strain or mental stress or whether amateur esports has to be seen as purely sedentary behavior.

Methods

Thirty male subjects participated in a 30-min gaming session, playing the soccer simulation game FIFA 20 or the tactical, first-person multiplayer shooter Counter-Strike: Global Offensive. Respiratory and cardiovascular parameters, as well as energy expenditure, blood glucose, lactate, and cortisol, were determined pre-, during, and post-gaming.

Results

There were no significant changes in oxygen uptake, carbon dioxide output, energy expenditure, stroke volume, or lactate levels. Heart rate, blood glucose and cortisol decreased through the intervention until reaching their minimum levels 10 min post-gaming (Cortisolpre: 3.1 ± 2.9 ng/ml, Cortisolpost: 2.2 ± 2.3 ng/ml, p &lt; 0.01; HRmin0.5: 82 ± 11 bpm, HRpost: 74 ± 13 bpm, p &lt; 0.01).

Conclusion

A 30-min esports intervention does not positively affect energy expenditure or metabolism in amateur esports players. Therefore, it cannot provide the same health-promoting effects as traditional sports participation, but could in the long-term rather cause the same potentially health-damaging effects as purely sedentary behavior. However, it does not trigger a negative stress response in the players. Deliberate physical activity and exercise routines adapted to these demands should therefore be part of the daily life of amateur esports players.

Emotion Recognition Using Electrodermal Activity Signals and Multiscale Deep Convolutional Neural Network

In this work, an attempt has been made to classify emotional states using electrodermal activity (EDA) signals and multiscale convolutional neural networks. For this, EDA signals are considered from a publicly available "A Dataset for Emotion Analysis using Physiological Signals" (DEAP) database. These signals are decomposed into multiple-scales using the coarse-grained method. The multiscale signals are applied to the Multiscale Convolutional Neural Network (MSCNN) to automatically learn robust features directly from the raw signals. Experiments are performed with the MSCNN approach to evaluate the hypothesis (i) improved classification with electrodermal activity signals, and (ii) multiscale learning captures robust complementary features at a different scale. Results show that the proposed approach is able to differentiate various emotional states. The proposed approach yields a classification accuracy of 69.33% and 71.43% for valence and arousal states, respectively. It is observed that the number of layers and the signal length are the determinants for the classifier performance. The performance of the proposed approach outperforms the single-layer convolutional neural network. The MSCNN approach provides end-to-end learning and classification of emotional states without additional signal processing. Thus, it appears that the proposed method could be a useful tool to assess the difference in emotional states for automated decision making.

Research Trend on the Use of IT in Digital Addiction: An Investigation Using a Systematic Literature Review

Despite the negative role of IT in digital addiction development, IT may have a positive role in dealing with digital addiction. The present study undertakes a systematic literature review to explore the state of play and the trend regarding the use of IT in digital addiction research. Using predefined keywords, the Scopus database was searched for relevant literature published from 2017 to 2020. The initial search found 1655 papers. Six stages of study selection were completed using a set of inclusion and exclusion criteria. The study selection and quality assessment process were applied, then 15 papers were selected for further review. The results show that addiction detection using IT is the most researched topic in digital addiction research. The most commonly used IT in the selected studies are AI methods and biosignal recording systems. Various approaches in detection, prevention, and intervention are suggested in the selected studies. The advantages and limitations of each approach are discussed. Based on these results, some future research directions are suggested.

The physiological and biochemical effects of gaming: A review

BACKGROUND

Recreational, seated video gaming (gaming) has become a favorite pastime of children, adolescents, and adults (gamers) in developed countries. Some engage in gaming behavior for more than 6 h daily, which can subsequently lead to less time spent being physically active. Gaming can potentially have a serious impact on the physiology and biochemistry of gamers and can influence both short-term and long-term health. The aim of this review was to provide an overview of what is known about how gaming affects physiological and biochemical parameters in the human body and how studies have previously been designed and to discuss how studies can be designed moving forward.

METHODS

The literature search included material from three scientific databases (PubMed, EMBASE, and Web of Science) using a two-block search strategy. To be included in this review, studies had to investigate a biochemical or physiological aspect of sedentary, video game-related activities. Studies that investigated neurological, psychologic or musculoskeletal outcomes along with physiological or biochemical outcomes in gaming were eligible for inclusion. Studies regarding psychiatric conditions were excluded as this subject was outside the scope of this review. Additionally, non-English language articles were excluded.

RESULTS

A total of 5417 articles were screened, 138 studies from the literature search and 4 studies from reference lists were selected for further evaluation. The studies were evaluated based on their abstracts or full texts, and 51 studies were eventually included in the review. Thirty-seven studies included physiological results, seven studies included biochemical results, and seven studies included both. Several outcomes such as heart rate, blood pressure, blood glucose levels, and cortisol levels, were the subjects of a large number of investigations.

CONCLUSION

This field is heterogenic and does not lend itself to firm conclusions. Tentatively, it seems reasonable to conclude that heart rate variability studies show that gaming increases activity in the sympathetic nervous system. More high-quality studies are required, and the lack of studies using uniform, standardized designs and realistic gaming sessions (i.e., longer than 30 min) limits our current knowledge.

Cruciate ligament healing and injury prevention in the age of regenerative medicine and technostress: homeostasis revisited

PURPOSE

This clinical concepts paper discusses the essential elements of cruciate ligament recuperation, micro-trauma repair, and remodeling.

METHODS

Cruciate ligament mechanobiology and tissue heterogeneity, anatomy and vascularity, and synovial membrane and fluid functions are discussed in relationship to deficiency-induced inflammatory responses, nervous and immune system function, recuperation, repair and remodeling, and modern threats to homeostasis.

RESULTS

Cruciate ligament surgical procedures do not appreciate the vital linked functions of the central, peripheral, and autonomic nervous systems and immune system function on knee ligament injury recuperation, micro-trauma repair, and remodeling. Enhanced knowledge of these systems could provide innovative ways to decrease primary non-contact knee injury rates and improve outcomes following reconstruction or primary repair.

CONCLUSIONS

Restoration of knee joint homeostasis is essential to cruciate ligament recuperation, micro-trauma repair, and remodeling. The nervous and immune systems are intricately involved in this process. Varying combinations of high-intensity training, under-recovery, technostress, and environmental pollutants (including noise) regularly expose many athletically active individuals to factors that abrogate the environment needed for cruciate ligament recuperation, micro-trauma repair, and remodeling. Current sports training practice, lifestyle psychobehaviors, and environmental factors combine to increase both primary non-contact knee injury risk and the nervous and immune system dysregulation that lead to poor sleep, increased anxiety, and poorly regulated hormone and cytokine levels. These factors may create a worst-case scenario leading to poor ligament recuperation, micro-trauma repair, and remodeling. Early recognition and modification of these factors may decrease knee ligament injury rates and improve cruciate ligament repair or reconstruction outcomes.

LEVEL OF EVIDENCE

V.

Functional network integration and attention skills in young children

Children acquire attention skills rapidly during early childhood as their brains undergo vast neural development. Attention is well studied in the adult brain, yet due to the challenges associated with scanning young children, investigations in early childhood are sparse. Here, we examined the relationship between age, attention and functional connectivity (FC) during passive viewing in multiple intrinsic connectivity networks (ICNs) in 60 typically developing girls between 4 and 7 years whose sustained, selective and executive attention skills were assessed. Visual, auditory, sensorimotor, default mode (DMN), dorsal attention (DAN), ventral attention (VAN), salience, and frontoparietal ICNs were identified via Independent Component Analysis and subjected to a dual regression. Individual spatial maps were regressed against age and attention skills, controlling for age. All ICNs except the VAN showed regions of increasing FC with age. Attention skills were associated with FC in distinct networks after controlling for age: selective attention positively related to FC in the DAN; sustained attention positively related to FC in visual and auditory ICNs; and executive attention positively related to FC in the DMN and visual ICN. These findings suggest distributed network integration across this age range and highlight how multiple ICNs contribute to attention skills in early childhood.