Videogame training increases clinical well-being, attention and hippocampal-prefrontal functional connectivity in patients with schizophrenia

Recent research shows that videogame training enhances neuronal plasticity and cognitive improvements in healthy individuals. As patients with schizophrenia exhibit reduced neuronal plasticity linked to cognitive deficits and symptoms, we investigated whether videogame-related cognitive improvements and plasticity changes extend to this population. In a training study, patients with schizophrenia and healthy controls were randomly assigned to 3D or 2D platformer videogame training or E-book reading (active control) for 8 weeks, 30 min daily. After training, both videogame conditions showed significant increases in sustained attention compared to the control condition, correlated with increased functional connectivity in a hippocampal-prefrontal network. Notably, patients trained with videogames mostly improved in negative symptoms, general psychopathology, and perceived mental health recovery. Videogames, incorporating initiative, goal setting and gratification, offer a training approach closer to real life than current psychiatric treatments. Our results provide initial evidence that they may represent a possible adjunct therapeutic intervention for complex mental disorders.

Investigating the Role of Individual Differences in Adherence to Cognitive Training

Consistent with research across several domains, intervention adherence is associated with desired outcomes. Our study investigates adherence, defined by participants' commitment to, persistence with, and compliance with an intervention's regimen, as a key mechanism underlying cognitive training effectiveness. We examine this relationship in a large and diverse sample comprising 4,775 adults between the ages of 18 and 93. We test the predictive validity of individual difference factors, such as age, gender, cognitive capability (i.e., fluid reasoning and working memory), grit, ambition, personality, self-perceived cognitive failures, socioeconomic status, exercise, and education on commitment to and persistence with a 20-session cognitive training regimen, as measured by the number of sessions completed. Additionally, we test the relationship between compliance measures: (i) spacing between training sessions, as measured by the average time between training sessions, and (ii) consistency in the training schedule, as measured by the variance in time between training sessions, with performance trajectories on the training task. Our data suggest that none of these factors reliably predict commitment to, persistence with, or compliance with cognitive training. Nevertheless, the lack of evidence from the large and representative sample extends the knowledge from previous research exploring limited, heterogenous samples, characterized by older adult populations. The absence of reliable predictors for commitment, persistence, and compliance in cognitive training suggests that nomothetic factors may affect program adherence. Future research will be well served to examine diverse approaches to increasing motivation in cognitive training to improve program evaluation and reconcile the inconsistency in findings across the field.

Central Auditory Processing Dysfunction in Service Members and Veterans: Treatment Considerations and Strategies

PURPOSE

Military risk factors such as blast exposure, noise exposure, head trauma, and neurotoxin exposure place Service members and Veterans at risk for deficits associated with auditory processing dysfunction. However, there is no clinical guidance specific to the treatment of auditory processing deficits in this unique population. We provide an overview of available treatments and their limited supporting evidence for use in adults, emphasizing the need for multidisciplinary case management and interdisciplinary research to support evidence-based solutions.

METHOD

We explored relevant literature to inform the treatment of auditory processing dysfunction in adults, with emphasis on findings involving active or former military personnel. We were able to identify a limited number of studies, pertaining primarily to the treatment of auditory processing deficits through the use of assistive technologies and training strategies. We assessed the current state of the science for knowledge gaps that warrant additional study.

CONCLUSIONS

Auditory processing deficits often co-occur with other military injuries and may pose significant risk in military operational and occupational settings. Research is needed to advance clinical diagnostic and rehabilitative capabilities, guide treatment planning, support effective multidisciplinary management, and inform fitness-for-duty standards. We emphasize the need for an inclusive approach to the assessment and treatment of auditory processing concerns in Service members and Veterans and for evidence-based solutions to address complex military risk factors and injuries.

Effects of Gamification on Assessment of Spatial Release From Masking

PURPOSE

Difficulty understanding speech in noise is a common communication problem. Clinical tests of speech in noise differ considerably from real-world listening and offer patients limited intrinsic motivation to perform well. In order to design a test that captures motivational aspects of real-world communication, this study investigated effects of gamification, or the inclusion of game elements, on a laboratory spatial release from masking test.

METHOD

Fifty-four younger adults with normal hearing completed a traditional laboratory and a gamified test of spatial release from masking in counterbalanced order. Masker level adapted based on performance, with the traditional test ending after 10 reversals and the gamified test ending when participants solved a visual puzzle. Target-to-masker ratio thresholds (TMRs) with colocated maskers, separated maskers, and estimates of spatial release were calculated after the 10th reversal for both tests and from the last six reversals of the adaptive track from the gamified test.

RESULTS

Thresholds calculated from the 10th reversal indicated no significant differences between the traditional and gamified tests. A learning effect was observed with spatially separated maskers, such that TMRs were better for the second test than the first, regardless of test order. Thresholds calculated from the last six reversals of the gamified test indicated better TMRs in the separated condition compared to the traditional test.

CONCLUSIONS

Adding gamified elements to a traditional test of spatial release from masking did not negatively affect test validity or estimates of spatial release. Participants were willing to continue playing the gamified test for an average of 30.2 reversals of the adaptive track. For some listeners, performance in the separated condition continued to improve after the 10th reversal, leading to better TMRs and greater spatial release from masking at the end of the gamified test compared to the traditional test.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22028789.

Near transfer to an unrelated N-back task mediates the effect of N-back working memory training on matrix reasoning

The extent to which working memory training improves performance on untrained tasks is highly controversial. Here we address this controversy by testing the hypothesis that far transfer may depend on near transfer using mediation models in three separate randomized controlled trials (RCTs). In all three RCTs, totalling 460 individuals, performance on untrained N-back tasks (near transfer) mediated transfer to Matrix Reasoning (representing far transfer) despite the lack of an intervention effect in RCTs 2 and 3. Untrained N-back performance also mediated transfer to a working memory composite, which showed a significant intervention effect (RCT 3). These findings support a model of N-back training in which transfer to untrained N-back tasks gates further transfer (at least in the case of working memory at the construct level) and Matrix Reasoning. This model can help adjudicate between the many studies and meta-analyses of working memory training that have provided mixed results but have not examined the relationship between near and far transfer on an individual-differences level.

Computer-Delivered Cognitive Training and Transcranial Direct Current Stimulation in Patients With HIV-Associated Neurocognitive Disorder: A Randomized Trial

Objective: HIV infection is associated with impaired cognition, and as individuals grow older, they may also experience age-related changes in mental abilities. Previous studies have shown that computer-based cognitive training (CCT) and transcranial direct current stimulation (tDCS) may be useful in improving cognition in older persons. This study evaluated the acceptability of CCT and tDCS to older adults with HIV-associated neurocognitive disorder, and assessed their impact on reaction time, attention, and psychomotor speed. Methods: In a single-blind randomized study, 46 individuals with HIV-associated mild neurocognitive disorder completed neuropsychological assessments and six 20-min training sessions to which they had been randomly assigned to one of the following conditions: (1) CCT with active tDCS; (2) CCT with sham tDCS, or (3) watching educational videos with sham tDCS. Immediately after training and again 1 month later, participants completed follow-up assessments. Outcomes were evaluated via repeated measures mixed effects models. Results: Participant ratings of the intervention were positive. Effects on reaction time were not significant, but measures of attention and psychomotor speed suggested positive effects of the intervention. Conclusion: Both CCT and tDCS were highly acceptable to older persons with HIV infection. CCT and tDCS may improve cognitive in affected individuals. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03440840].

Exergame training-induced neuroplasticity and cognitive improvement in institutionalized older adults: A preliminary investigation

BACKGROUND

Prior research has reported cognitive improvements in elderly individuals when mental and physical exercise are practiced simultaneously, as in exergaming. However, the molecular mechanisms driving this beneficial response remain unclear. Moreover, there is robust evidence that regular exercise increases neurotrophic factors and promotes neuroplasticity, contributing to cognitive improvement. This research aimed to assess the impact of a 6-week Xbox 360 Kinect exergame protocol on cognitive function and brain-derived neurotrophic factor (BDNF) levels in institutionalized older individuals.

METHODS

Participants living in a long-term care facility were included. The intervention (Xbox 360 Kinect exergame protocol) was conducted individually and consisted of two sessions per week (40 min each) over 6 weeks. Participants' cognitive function (Montreal Cognitive Assessment, MoCA) was evaluated before and after the intervention. Blood samples (15 ml) were collected at the same time to measure BDNF levels.

RESULTS

Although there were no changes in total MoCA scores, exergame training improved the "language" domain and demonstrated a tendency toward an improvement in the "abstraction" and "memory/delayed recall" domains. Furthermore, BDNF levels were significantly increased after the intervention.

CONCLUSION

BDNF enhancement might mediate, at least in part, the cognitive changes induced by a 6-week Xbox 360 Kinect exergame protocol in institutionalized older adults.

Short-Term Audiovisual Spatial Training Enhances Electrophysiological Correlates of Auditory Selective Spatial Attention

Audiovisual cross-modal training has been proposed as a tool to improve human spatial hearing. Here, we investigated training-induced modulations of event-related potential (ERP) components that have been associated with processes of auditory selective spatial attention when a speaker of interest has to be localized in a multiple speaker ("cocktail-party") scenario. Forty-five healthy participants were tested, including younger (19-29 years; n = 21) and older (66-76 years; n = 24) age groups. Three conditions of short-term training (duration 15 min) were compared, requiring localization of non-speech targets under "cocktail-party" conditions with either (1) synchronous presentation of co-localized auditory-target and visual stimuli (audiovisual-congruency training) or (2) immediate visual feedback on correct or incorrect localization responses (visual-feedback training), or (3) presentation of spatially incongruent auditory-target and visual stimuli presented at random positions with synchronous onset (control condition). Prior to and after training, participants were tested in an auditory spatial attention task (15 min), requiring localization of a predefined spoken word out of three distractor words, which were presented with synchronous stimulus onset from different positions. Peaks of ERP components were analyzed with a specific focus on the N2, which is known to be a correlate of auditory selective spatial attention. N2 amplitudes were significantly larger after audiovisual-congruency training compared with the remaining training conditions for younger, but not older, participants. Also, at the time of the N2, distributed source analysis revealed an enhancement of neural activity induced by audiovisual-congruency training in dorsolateral prefrontal cortex (Brodmann area 9) for the younger group. These findings suggest that cross-modal processes induced by audiovisual-congruency training under "cocktail-party" conditions at a short time scale resulted in an enhancement of correlates of auditory selective spatial attention.

A Gamification Framework for Cognitive Assessment and Cognitive Training: Qualitative Study

Background

Cognitive tasks designed to measure or train cognition are often repetitive and presented in a monotonous manner, features that lead to participant boredom and disengagement. In this situation, participants do not put forth their best effort to do these tasks well. As a result, neuropsychologists cannot draw accurate conclusions about the data collected, and intervention effects are reduced. It is assumed that greater engagement and motivation will manifest as improved data quality. Gamification, the use of game elements in nongame settings, has been heralded as a potential mechanism for increasing participant engagement in cognitive tasks. Some studies have reported a positive effect of gamification on participant performance, although most studies have shown mixed results. One reason for these contrasting findings is that most studies have applied poor and heterogeneous design techniques to gamify cognitive tasks. Therefore, an appropriate gamification design framework is needed in these tasks.

Objective

This study aimed to propose a framework to guide the design of gamification in cognitive tasks.

Methods

We employed a design science research (DSR) approach to provide a framework for gamifying cognitive assessments and training by synthesizing current gamification design frameworks and gamification works in cognitive assessment and training, as well as incorporating field experiences. The prototypes of the framework were iteratively evaluated with 17 relevant experts.

Results

We proposed a framework consisting of 7 phases: (1) preparation; (2) knowing users; (3) exploring existing tools for assessing or training a targeted cognitive context and determining the suitability of game-up and mapping techniques; (4) ideation; (5) prototyping using the Objects, Mechanics, Dynamics, Emotions (OMDE) design guideline; (6) development; and (7) disseminating and monitoring.

Conclusions

We found that (1) an intermediate design framework is needed to gamify cognitive tasks, which means that game elements should be selected by considering current cognitive assessment or training context characteristics since game elements may impose an irrelevant cognitive load that, in turn, can jeopardize data quality; (2) in addition to developing a new gamified cognitive task from scratch, 2 gamification techniques are widely used (first, adding game elements to an existing cognitive task and second, mapping an existing game to a cognitive function or impairment to assess or train it); and (3) further research is required to investigate the interplay of cognitive processes and game mechanics.

The impact of video gaming on cognitive functioning of people with schizophrenia (GAME-S): study protocol of a randomised controlled trial

BACKGROUND

Video gaming is a promising intervention for cognitive and social impairment in patients with schizophrenia. A number of gaming interventions have been evaluated in small-scale studies with various patient groups, but studies on patients with schizophrenia remain scarce and rarely include the evaluation of both clinical and neurocognitive outcomes. In this study, we will test the effectiveness of two interventions with gaming elements to improve cognitive and clinical outcomes among persons with schizophrenia.

METHODS

The participants will be recruited from different outpatient units (e.g., outpatient psychiatric units, day hospitals, residential care homes). The controlled clinical trial will follow a three-arm parallel-group design: 1) cognitive training (experimental group, CogniFit), 2) entertainment gaming (active control group, SIMS 4), and 3) treatment as usual. The primary outcomes are working memory function at 3-month and 6-month follow-ups. The secondary outcomes are patients' other cognitive and social functioning, the ability to experience pleasure, self-efficacy, and negative symptoms at 3-month and 6-month follow-ups. We will also test the effectiveness of gaming interventions on neurocognitive outcomes (EEG and 3 T MRI plus rs-fMRI) at a 3-month follow-up as an additional secondary outcome. Data will be collected in outpatient psychiatric services in Hong Kong. Participants will have a formal diagnosis of schizophrenia and be between 18 and 60 years old. We aim to have a total of 234 participants, randomly allocated to the three arms. A sub-sample of patients (N = 150) will be recruited to undergo an EEG. For neuroimaging assessment, patients will be randomly allocated to a subset of patients (N=126). We will estimate the efficacy of the interventions on the primary and secondary outcomes based on the intention-to-treat principle. Behavioural and EEG data will be analysed separately.

DISCUSSION

The study will characterise benefits of gaming on patients' health and well-being, and contribute towards the development of new treatment approaches for patients with schizophrenia.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03133143 . Registered on April 28, 2017.

Papesh M, Gallun FJ. A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties

Purpose A questionnaire survey was conducted to collect information from clinical audiologists about rehabilitation options for adult patients who report significant auditory difficulties despite having normal or near-normal hearing sensitivity. This work aimed to provide more information about what audiologists are currently doing in the clinic to manage auditory difficulties in this patient population and their views on the efficacy of recommended rehabilitation methods. Method A questionnaire survey containing multiple-choice and open-ended questions was developed and disseminated online. Invitations to participate were delivered via e-mail listservs and through business cards provided at annual audiology conferences. All responses were anonymous at the time of data collection. Results Responses were collected from 209 participants. The majority of participants reported seeing at least one normal-hearing patient per month who reported significant communication difficulties. However, few respondents indicated that their location had specific protocols for the treatment of these patients. Counseling was reported as the most frequent rehabilitation method, but results revealed that audiologists across various work settings are also successfully starting to fit patients with mild-gain hearing aids. Responses indicated that patient compliance with computer-based auditory training methods was regarded as low, with patients generally preferring device-based rehabilitation options. Conclusions Results from this questionnaire survey strongly suggest that audiologists frequently see normal-hearing patients who report auditory difficulties, but that few clinicians are equipped with established protocols for diagnosis and management. While many feel that mild-gain hearing aids provide considerable benefit for these patients, very little research has been conducted to date to support the use of hearing aids or other rehabilitation options for this unique patient population. This study reveals the critical need for additional research to establish evidence-based practice guidelines that will empower clinicians to provide a high level of clinical care and effective rehabilitation strategies to these patients.

Action Real-Time Strategy Gaming Experience Related to Increased Attentional Resources: An Attentional Blink Study

Action real-time strategy gaming (ARSG) is a cognitively demanding task which requires attention, sensorimotor skills, team cooperation, and strategy-making abilities. A recent study found that ARSG experts had superior visual selective attention (VSA) for detecting the location of a moving object that could appear in one of 24 different peripheral locations (Qiu et al., 2018), suggesting that ARSG experience is related to improvements in the spatial component of VSA. However, the influence of ARSG experience on the temporal component of VSA-the detection of an item among a sequence of items presented consecutively and quickly at a single location-still remains understudied. Using behavioral and electrophysiological measures, this study examined whether ARSG experts had superior temporal VSA performance compared to non-experts in an attentional blink (AB) task, which is typically used to examine temporal VSA. The results showed that the experts outperformed the non-experts in their detection rates of targets. Furthermore, compared to the non-experts, the experts had faster information processing as indicated by earlier P3 peak latencies in an AB period, more attentional resources distributed to targets as indicated by stronger P3 amplitudes, and a more flexible deployment of attentional resources. These findings suggest that experts were less prone to the AB effect. Thus, long-term ARSG experience is related to improvements in temporal VSA. The current findings support the benefit of video gaming experience on the development of VSA.

Effects of Nonaction Videogames on Attention and Memory in Young Adults

Objective: In this intervention study, we investigated the benefits of nonaction videogames on measures of selective attention and visuospatial working memory (WM) in young adults. Materials and Methods: Forty-eight young adults were randomly assigned to the experimental group or to the active control group. The experimental group played 10 nonaction adaptive videogames selected from Lumosity, whereas the active control group played two nonadaptive simulation-strategy games (SimCity and The Sims). Participants in both groups completed 15 training sessions of 30 minutes each. The training was conducted in small groups. All the participants were tested individually before and after training to assess possible transfer effects to selective attention, using a Cross-modal Oddball task, inhibition with the Stroop task, and visuospatial WM enhancements with the Corsi blocks task. Results: Participants improved videogame performance across the training sessions. The results of the transfer tasks show that the two groups benefited similarly from game training. They were less distracted and improved visuospatial WM. Conclusion: Overall, there was no significant interaction between group (group trained with adaptive nonaction videogames and the active control group that played simulation games) and session (pre- and post-assessment). As we did not have a passive nonintervention control group, we cannot conclude that adaptive nonaction videogames had a positive effect, because some external factors might account for the pre- and post-test improvements observed in both groups.

Video gaming and working memory: a large-scale cross-sectional correlative study

Studies have indicated that video gaming is positively associated with cognitive performance in select cognitive domains, but the magnitudes of these associations have been called into question, as they have frequently been based on extreme groups analyses that have compared video gamers with non-gamers. When including the whole range of participants, and not just extreme cases, these effects were observed to reduce markedly (Unsworth et al., 2015). To further study this issue, we compared the associations between video gaming and aspects of working memory (WM) performance in an extreme groups design to those of a design that includes the full range of participants in a large adult sample (n = 503). WM was measured with three composite scores (verbal WM, visuospatial WM, n-back). The extreme groups analyses showed that video gamers performed better than non-gamers on all three WM measures, while the whole sample analyses indicated weak positive associations between the time spent playing video games and visuospatial WM and n-back performance. Thus, study design modulated the effects, but two of the three associations between WM and video gaming were consistent across both analysis techniques. A separate study confirmed that our questionnaire-based estimate of gaming hours was reliable when compared with one-week diaries of videogame playing. While the present cross-sectional results preclude causal inferences, possible mechanisms of WM - videogame playing associations and future research directions are discussed. Overall, our results indicate that cognition - videogame playing relationships, albeit weak, are not solely due to recently discussed methodological artefacts concerning the particular analytical approach and survey reliability.

Recursos informáticos y discapacidad intelectual: Aplicaciones en el contexto escolar

La discapacidad intelectual, como se ha denominado recientemente, amerita una nueva mirada que no puede quedarse solo en el cambio del término, sino que exige el desarrollo de una aproximación más “real”, en la que prevalezca la atención integral por parte de un equipo interdisciplinario y el empleo de instrumentos que contribuyan a la optimización y mejoramiento de las habilidades cognitivas en los estudiantes. Uno de los escenarios en los que se puede contribuir en este aspecto es en el ámbito escolar donde, por medio del acercamiento a las nuevas tecnologías y a la implementación de aplicaciones informáticas, se puede favorecer el desarrollo integral de la población estudiantil, principalmente en el ciclo de la básica primaria. En este artículo, derivado del proyecto de investigación “Programa de evaluación e intervención neuropsicológica para niños entre 8 y 12 años con discapacidad intelectual”, se propone una reflexión basada en la revisión de herramientas y recursos informáticos que pueden contribuir al mejoramiento de los procesos de intervención infantil dirigidos a la población con discapacidad intelectual. Partiendo de las controversias que sobre el concepto de discapacidad intelectual se han generado en las últimas décadas, se hace referencia a cómo las diferentes plataformas informáticas y entornos virtuales pueden generar altos niveles motivacionales para su uso y, de esta forma, potencializar y favorecer los procesos cognitivos y de aprendizaje

Acute Effect of Intermittent Exercise and Action-Based Video Game Breaks on Math Performance in Preadolescent Children

PURPOSE

The purpose of this study was to compare the acute effects of video game breaks and intermittent exercise breaks, performed at varying intensities, on math performance in preadolescent children.

METHODS

A total of 39 children (18 males and 21 females; aged 7-11 y) completed 4 experimental conditions in random order: 8 hours of sitting interrupted with 20 two-minute low-, moderate-, or high-intensity exercise breaks or 20 two-minute sedentary computer game breaks. The intensity of exercise breaks for the low-, moderate-, and high-intensity conditions corresponded with 25%, 50%, and 75% of heart rate reserve, respectively. Math performance was assessed 3 times throughout each condition day using a 90-second math test consisting of 40 single-digit addition and subtraction questions.

RESULTS

There were no significant differences in percent change in math scores (correct answers out of attempted) by condition [low: -1.3 (0.8), moderate: 0.1 (1.3), high: -1.8 (0.7), and computer: -2.5 (0.8); P > .05]. There were significant differences in percent change in math scores over the course of the condition days with lower math scores reported at end-of-day test compared with midday test [-2.4 (0.5) vs -0.4 (0.3); P = .01]. There were no significant condition × time, time × age, condition × age, or condition × time × age interactions (all Ps > .05).

CONCLUSION

Action-based video game and exercise breaks elicit the same level of math performance in children; however, time of day may impact this relationship. These findings may have important implications for instructional time in elementary classrooms.

Game-based training of flexibility and attention improves task-switch performance: near and far transfer of cognitive training in an EEG study

There is a demand for ways to enhance cognitive flexibility, as it can be a limiting factor for performance in daily life. Video game training has been linked to advantages in cognitive functioning, raising the question if training with video games can promote cognitive flexibility. In the current study, we investigated if game-based computerized cognitive training (GCCT) could enhance cognitive flexibility in a healthy young adult sample (N = 72), as measured by task-switch performance. Three GCCT schedules were contrasted, which targeted: (1) cognitive flexibility and task switching, (2) attention and working memory, or (3) an active control involving basic math games, in twenty 45-min sessions across 4-6 weeks. Performance on an alternating-runs task-switch paradigm during pretest and posttest sessions indicated greater overall reaction time improvements after both flexibility and attention training as compared to control, although not related to local switch cost. Flexibility training enhanced performance in the presence of distractor-related interference. In contrast, attention training was beneficial when low task difficulty undermined sustained selective attention. Furthermore, flexibility training improved response selection as indicated by a larger N2 amplitude after training as compared to control, and more efficient conflict monitoring as indicated by reduced Nc/CRN and larger Pe amplitude after training. These results provide tentative support for the efficacy of GCCT and suggest that an ideal training might include both task switching and attention components, with maximal task diversity both within and between training games.

The Benefits and Challenges of Implementing Motivational Features to Boost Cognitive Training Outcome

In the current literature, there are a number of cognitive training studies that use N-back tasks as their training vehicle; however, the interventions are often bland, and many studies suffer from considerable attrition rates. An increasingly common approach to increase participant engagement has been the implementation of motivational features in training tasks; yet, the effects of such "gamification" on learning have been inconsistent. To shed more light on those issues, here, we report the results of a training study conducted at two Universities in Southern California. A total of 115 participants completed 4 weeks (20 sessions) of N-back training in the laboratory. We varied the amount of "gamification" and the motivational features that might make the training more engaging and, potentially, more effective. Thus, 47 participants trained on a basic color/identity N-back version with no motivational features, whereas 68 participants trained on a gamified version that translated the basic mechanics of the N-back task into an engaging 3D space-themed "collection" game (Deveau et al. Frontiers in Systems Neuroscience, 8, 243, 2015). Both versions used similar adaptive algorithms to increase the difficulty level as participants became more proficient. Participants' self-reports indicated that the group who trained on the gamified version enjoyed the intervention more than the group who trained on the non-gamified version. Furthermore, the participants who trained on the gamified version exerted more effort and also improved more during training. However, despite the differential training effects, there were no significant group differences in any of the outcome measures at post-test, suggesting that the inclusion of motivational features neither substantially benefited nor hurt broader learning. Overall, our findings provide guidelines for task implementation to optimally target participants' interest and engagement to promote learning, which may lead to broader adoption and adherence of cognitive training.

Neural Basis of Video Gaming: A Systematic Review

Background: Video gaming is an increasingly popular activity in contemporary society, especially among young people, and video games are increasing in popularity not only as a research tool but also as a field of study. Many studies have focused on the neural and behavioral effects of video games, providing a great deal of video game derived brain correlates in recent decades. There is a great amount of information, obtained through a myriad of methods, providing neural correlates of video games.

Objectives: We aim to understand the relationship between the use of video games and their neural correlates, taking into account the whole variety of cognitive factors that they encompass.

Methods: A systematic review was conducted using standardized search operators that included the presence of video games and neuro-imaging techniques or references to structural or functional brain changes. Separate categories were made for studies featuring Internet Gaming Disorder and studies focused on the violent content of video games.

Results: A total of 116 articles were considered for the final selection. One hundred provided functional data and 22 measured structural brain changes. One-third of the studies covered video game addiction, and 14% focused on video game related violence.

Conclusions: Despite the innate heterogeneity of the field of study, it has been possible to establish a series of links between the neural and cognitive aspects, particularly regarding attention, cognitive control, visuospatial skills, cognitive workload, and reward processing. However, many aspects could be improved. The lack of standardization in the different aspects of video game related research, such as the participants' characteristics, the features of each video game genre and the diverse study goals could contribute to discrepancies in many related studies.

No Overt Effects of a 6-Week Exergame Training on Sensorimotor and Cognitive Function in Older Adults. A Preliminary Investigation

Several studies investigating the relationship between physical activity and cognition showed that exercise interventions might have beneficial effects on working memory, executive functions as well as motor fitness in old adults. Recently, movement based video games (exergames) have been introduced to have the capability to improve cognitive function in older adults. Healthy aging is associated with a loss of cognitive, as well as sensorimotor functions. During exergaming, participants are required to perform physical activities while being simultaneously surrounded by a cognitively challenging environment. However, only little is known about the impact of exergame training interventions on a broad range of motor, sensory, and cognitive skills. Therefore, the present study aims at investigating the effects of an exergame training over 6 weeks on cognitive, motor, and sensory functions in healthy old participants. For this purpose, 30 neurologically healthy older adults were randomly assigned to either an experimental (ETG, n = 15, 1 h training, twice a week) or a control group (NTG, n = 15, no training). Several cognitive tests were performed before and after exergaming in order to capture potential training-induced effects on processing speed as well as on executive functions. To measure the impact of exergaming on sensorimotor performance, a test battery consisting of pinch and grip force of the hand, tactile acuity, eye-hand coordination, flexibility, reaction time, coordination, and static balance were additionally performed. While we observed significant improvements in the trained exergame (mainly in tasks that required a high load of coordinative abilities), these gains did not result in differential performance improvements when comparing ETG and NTG. The only exergaming-induced difference was a superior behavioral gain in fine motor skills of the left hand in ETG compared to NTG. In an exploratory analysis, within-group comparison revealed improvements in sensorimotor and cognitive tasks (ETG) while NTG only showed an improvement in a static balance test. Taken together, the present study indicates that even though exergames might improve gaming performance, our behavioral assessment was probably not sensitive enough to capture exergaming-induced improvements. Hence, we suggest to use more tailored outcome measures in future studies to assess potential exergaming-induced changes.

The influence of action video game playing on eye movement behaviour during visual search in abstract, in-game and natural scenes

Action game playing has been associated with several improvements in visual attention tasks. However, it is not clear how such changes might influence the way we overtly select information from our visual world (i.e. eye movements). We examined whether action-video-game training changed eye movement behaviour in a series of visual search tasks including conjunctive search (relatively abstracted from natural behaviour), game-related search, and more naturalistic scene search. Forty nongamers were trained in either an action first-person shooter game or a card game (control) for 10 hours. As a further control, we recorded eye movements of 20 experienced action gamers on the same tasks. The results did not show any change in duration of fixations or saccade amplitude either from before to after the training or between all nongamers (pretraining) and experienced action gamers. However, we observed a change in search strategy, reflected by a reduction in the vertical distribution of fixations for the game-related search task in the action-game-trained group. This might suggest learning the likely distribution of targets. In other words, game training only skilled participants to search game images for targets important to the game, with no indication of transfer to the more natural scene search. Taken together, these results suggest no modification in overt allocation of attention. Either the skills that can be trained with action gaming are not powerful enough to influence information selection through eye movements, or action-game-learned skills are not used when deciding where to move the eyes.

Action Video Game Training for Healthy Adults: A Meta-Analytic Study

Action video game (AVG) has attracted increasing attention from both the public and from researchers. More and more studies found video game training improved a variety of cognitive functions. However, it remains controversial whether healthy adults can benefit from AVG training, and whether young and older adults benefit similarly from AVG training. In the present study, we aimed to quantitatively assess the AVG training effect on the cognitive ability of adults and to compare the training effects on young and older adults by conducting a meta-analysis on previous findings. We systematically searched video game training studies published between January 1986 and July 2015. Twenty studies were included in the present meta-analysis, for a total of 313 participants included in the training group and 323 participants in the control group. The results demonstrate that healthy adults achieve moderate benefit from AVG training in overall cognitive ability and moderate to small benefit in specific cognitive domains. In contrast, young adults gain more benefits from AVG training than older adults in both overall cognition and specific cognitive domains. Age, education, and some methodological factors, such as the session duration, session number, total training duration, and control group type, modulated the training effects. These meta-analytic findings provide evidence that AVG training may serve as an efficient way to improve the cognitive performance of healthy adults. We also discussed several directions for future AVG training studies.