Exposure to first-person shooter videogames is associated with multisensory temporal precision and migraine incidence

Virtual dynamic interaction games reveal impaired multisensory integration in women with migraine

OBJECTIVE

In this cross-sectional observational study, we aimed to investigate sensory profiles and multisensory integration processes in women with migraine using virtual dynamic interaction systems.

BACKGROUND

Compared to studies on unimodal sensory processing, fewer studies show that multisensory integration differs in patients with migraine. Multisensory integration of visual, auditory, verbal, and haptic modalities has not been evaluated in migraine.

METHODS

A 12-min virtual dynamic interaction game consisting of four parts was played by the participants. During the game, the participants were exposed to either visual stimuli only or multisensory stimuli in which auditory, verbal, and haptic stimuli were added to the visual stimuli. A total of 78 women participants (28 with migraine without aura and 50 healthy controls) were enrolled in this prospective exploratory study. Patients with migraine and healthy participants who met the inclusion criteria were randomized separately into visual and multisensory groups: Migraine multisensory (14 adults), migraine visual (14 adults), healthy multisensory (25 adults), and healthy visual (25 adults). The Sensory Profile Questionnaire was utilized to assess the participants' sensory profiles. The game scores and survey results were analyzed.

RESULTS

In visual stimulus, the gaming performance scores of patients with migraine without aura were similar to the healthy controls, at a median (interquartile range [IQR]) of 81.8 (79.5-85.8) and 80.9 (77.1-84.2) (p = 0.149). Error rate of visual stimulus in patients with migraine without aura were comparable to healthy controls, at a median (IQR) of 0.11 (0.08-0.13) and 0.12 (0.10-0.14), respectively (p = 0,166). In multisensory stimulation, average gaming score was lower in patients with migraine without aura compared to healthy individuals (median [IQR] 82.2 [78.8-86.3] vs. 78.6 [74.0-82.4], p = 0.028). In women with migraine, exposure to new sensory modality upon visual stimuli in the fourth, seventh, and tenth rounds (median [IQR] 78.1 [74.1-82.0], 79.7 [77.2-82.5], 76.5 [70.2-82.1]) exhibited lower game scores compared to visual stimuli only (median [IQR] 82.3 [77.9-87.8], 84.2 [79.7-85.6], 80.8 [79.0-85.7], p = 0.044, p = 0.049, p = 0.016). According to the Sensory Profile Questionnaire results, sensory sensitivity, and sensory avoidance scores of patients with migraine (median [IQR] score 45.5 [41.0-54.7] and 47.0 [41.5-51.7]) were significantly higher than healthy participants (median [IQR] score 39.0 [34.0-44.2] and 40.0 [34.0-48.0], p < 0.001, p = 0.001).

CONCLUSION

The virtual dynamic game approach showed for the first time that the gaming performance of patients with migraine without aura was negatively affected by the addition of auditory, verbal, and haptic stimuli onto visual stimuli. Multisensory integration of sensory modalities including haptic stimuli is disturbed even in the interictal period in women with migraine. Virtual games can be employed to assess the impact of sensory problems in the course of the disease. Also, sensory training could be a potential therapy target to improve multisensory processing in migraine.

Rhythmic TMS as a Feasible Tool to Uncover the Oscillatory Signatures of Audiovisual Integration

Multisensory integration is quintessential to adaptive behavior, with clinical populations showing significant impairments in this domain, most notably hallucinatory reports. Interestingly, altered cross-modal interactions have also been reported in healthy individuals when engaged in tasks such as the Sound-Induced Flash-Illusion (SIFI). The temporal dynamics of the SIFI have been recently tied to the speed of occipital alpha rhythms (IAF), with faster oscillations entailing reduced temporal windows within which the illusion is experienced. In this regard, entrainment-based protocols have not yet implemented rhythmic transcranial magnetic stimulation (rhTMS) to causally test for this relationship. It thus remains to be evaluated whether rhTMS-induced acoustic and somatosensory sensations may not specifically interfere with the illusion. Here, we addressed this issue by asking 27 volunteers to perform a SIFI paradigm under different Sham and active rhTMS protocols, delivered over the occipital pole at the IAF. Although TMS has been proven to act upon brain tissues excitability, results show that the SIFI occurred for both Sham and active rhTMS, with the illusory rate not being significantly different between baseline and stimulation conditions. This aligns with the discrete sampling hypothesis, for which alpha amplitude modulation, known to reflect changes in cortical excitability, should not account for changes in the illusory rate. Moreover, these findings highlight the viability of rhTMS-based interventions as a means to probe the neuroelectric signatures of illusory and hallucinatory audiovisual experiences, in healthy and neuropsychiatric populations.

Neurofeedback Modulation of the Sound-induced Flash Illusion Using Parietal Cortex Alpha Oscillations Reveals Dependency on Prior Multisensory Congruency

Spontaneous neural oscillations are key predictors of perceptual decisions to bind multisensory signals into a unified percept. Research links decreased alpha power in the posterior cortices to attention and audiovisual binding in the sound-induced flash illusion (SIFI) paradigm. This suggests that controlling alpha oscillations would be a way of controlling audiovisual binding. In the present feasibility study we used MEG-neurofeedback to train one group of subjects to increase left/right and another to increase right/left alpha power ratios in the parietal cortex. We tested for changes in audiovisual binding in a SIFI paradigm where flashes appeared in both hemifields. Results showed that the neurofeedback induced a significant asymmetry in alpha power for the left/right group, not seen for the right/left group. Corresponding asymmetry changes in audiovisual binding in illusion trials (with 2, 3, and 4 beeps paired with 1 flash) were not apparent. Exploratory analyses showed that neurofeedback training effects were present for illusion trials with the lowest numeric disparity (i.e., 2 beeps and 1 flash trials) only if the previous trial had high congruency (2 beeps and 2 flashes). Our data suggest that the relation between parietal alpha power (an index of attention) and its effect on audiovisual binding is dependent on the learned causal structure in the previous stimulus. The present results suggests that low alpha power biases observers towards audiovisual binding when they have learned that audiovisual signals originate from a common origin, consistent with a Bayesian causal inference account of multisensory perception.

Personalized Adaptive Training Improves Performance at a Professional First-Person Shooter Action Videogame

First-Person Shooter (FPS) game experience can be transferred to untrained cognitive functions such as attention, visual short-term memory, spatial cognition, and decision-making. However, previous studies have been using off-the-shelf FPS games based on predefined gaming settings, therefore it is not known whether such improvement of in game performance and transfer of abilities can be further improved by creating a in-game, adaptive in-game training protocol. To address this question, we compared the impact of a popular FPS-game (Counter-Strike:Global-Offensive–CS:GO) with an ad hoc version of the game based on a personalized, adaptive algorithm modifying the artificial intelligence of opponents as well as the overall game difficulty on the basis of individual gaming performance. Two groups of FPS-naïve healthy young participants were randomly assigned to playing one of the two game versions (11 and 10 participants, respectively) 2 h/day for 3 weeks in a controlled laboratory setting, including daily in-game performance monitoring and extensive cognitive evaluations administered before, immediately after, and 3 months after training. Participants exposed to the adaptive version of the game were found to progress significantly faster in terms of in-game performance, reaching gaming scenarios up to 2.5 times more difficult than the group exposed to standard CS:GO (p < 0.05). A significant increase in cognitive performance was also observed. Personalized FPS gaming can significantly speed-up the learning curve of action videogame-players, with possible future applications for expert-video-gamers and potential relevance for clinical-rehabilitative applications.

Action Video Game Players Do Not Differ in the Perception of Contrast-Based Motion Illusions but Experience More Vection and Less Discomfort in a Virtual Environment Compared to Non-Action Video Game Players

Action video game players (AVGPs) show enhanced visual perceptual functions compared to their non-video game playing peers (NVGPs). Whether AVGPs are more susceptible towards static contrast motion illusions, such as Fraser Wilcox illusions, has not been addressed so far. Based on their improved perceptual skills, AVGPs are expected to be more susceptible to the illusions and perceive more motion in them. The experience of illusory self-motion (vection) is believed to be dependent on top-down attentional processes; AVGPs should therefore experience stronger vection compared to NVGPs based on their improved attentional skills. Lastly, due to their extensive prior experience with virtual environments, AVGPs should experience less discomfort in VR compared to NVGPs. We presented rotating and expanding motion illusions in a virtual environment and asked 22 AVGPs and 21 NVGPs to indicate the strength of illusory motion, as well as the level of discomfort and vection experienced when exposed to these motion illusions. Results indicated that AVGPs and NVGPs perceived the same amount of motion when viewing these illusions. However, AVGPs perceived more vection and less discomfort compared to NVGPs, possibly due to factors such as enhanced top-down attentional control and adaptation. No differences in the perception of expanding and rotating illusions were found. Discomfort experienced by AVGPs was related to illusion strength, suggesting that contrast illusions might evoke the perceived discomfort rather than the virtual environment. Further studies are required to investigate the relationship between contrast sensitivity, migraine and the perception of illusion in AVGPs which should include illusory motion onset and duration measures.

The temporal sensitivity to the tactile-induced double flash illusion mediates the impact of beta oscillations on schizotypal personality traits

The coherent experience of the self and the world depends on the ability to integrate vs. segregate sensory information. Optimal temporal integration between the senses is mediated by oscillatory properties of neural activity. Previous research showed reduced temporal sensitivity to multisensory events in schizotypy, a personality trait linked to schizophrenia. Here we used the tactile-induced Double-Flash-Illusion (tDFI) to investigate the tactile-to-visual temporal sensitivity in schizotypy, as indexed by the temporal window of illusion (TWI) and its neural underpinnings. We measured EEG oscillations within the beta band, recently shown to correlate with the tDFI. We found individuals with higher schizotypal traits to have wider TWI and slower beta waves accounting for the temporal window within which they perceive the illusion. Our results indicate reduced tactile-to-visual temporal sensitivity to mediate the effect of slowed oscillatory beta activity on schizotypal personality traits. We conclude that slowed oscillatory patterns might constitute an early marker for psychosis proneness.