by Brain training games are extremely popular, but whether they prevent cognitive decline remains to be seen. Studies in recent years have gone back and forth on this topic, with no definitive conclusion.
Many people have started playing Wordle or doing crossword puzzles, but those brain teasers don’t seem to improve overall cognition, CNN chief medical correspondent Dr. Sanjay Gupta recently told viewers on CNN.
“What crossword puzzles and word games are probably really good at is making you better at crossword puzzles and word games,” says Gupta. “People often use brain training exercises in the hope of reducing their risk (of dementia). The truth is, there isn’t a lot of data on this to suggest that it actually reduces your risk of dementia.”
But there’s a new twist to that scientific conundrum: According to a new clinical trial, brain training’s success in slowing cognitive decline may depend on the type of game and how it affects certain neurotransmitters in the brain.
Brain games that focus on increasing attention and improving processing speed – such as Double Decision and Freeze Frame from BrainHQ – appear to preserve acetylcholine, an important neurotransmitter, according to the new research.
Acetylcholine is an “excitatory” neurotransmitter and neuromodulator, which “functions like a switch to make the brain more awake, focused and attentive,” says senior study author Etienne de Villers-Sidani, associate professor in the Department of Neurology and Neurosurgery at McGill University in Montreal.
When acetylcholine is activated, it changes the activity of the entire brain, says Dr. Michael Merzenich, professor emeritus at the University of California, San Francisco and co-founder and chief scientist of Posit Science, which makes BrainHQ a for-profit brain training company.
Screenshot of Brain HQ’s double decision. – Set science
Merzenich, an elder statesman in the field of neuroplasticity, and two other scientists received the prestigious Kavli Award in Neuroscience in 2016 for their groundbreaking discoveries that the adult brain can change, adapt and create new neural connections throughout life. Prior to their discoveries, it was thought that the brain could no longer change or regenerate after a certain point in early adulthood.
“This is the first human study to document an increase in acetylcholine, which is absolutely critical for maintaining brain plasticity with aging,” Merzenich said.
Upregulation causes a cell to add more receptors for a neurotransmitter, increasing its responsiveness.
“This is an important study because the training had a brain-wide impact – it is not limited to the very limited set of processes on which people are trained,” Merzenich said. “We’re talking about a fundamental physicochemical change that we know really matters as a contributor to brain health.”
The discovery adds to existing knowledge about how to prevent cognitive decline, says preventive neurologist Dr. Richard Isaacson, director of research at the Institute for Neurodegenerative Diseases in Boca Raton, Florida.
Eating a well-balanced diet, improving sleep and getting regular exercise are all proven ways to improve brain power and overall vitality. Research has also shown that engaging the brain in new ways builds cognitive reserve, which is how the brain can continue to function in the face of aging, damage, or early stages of disease.
Brain training can be one of many ways to build cognitive reserve, Isaacson said.
“There is no one magic pill to prevent dementia, but a combination of interventions can help people take control in the fight against Alzheimer’s disease,” he said. “Because of the science, I suggested these exact BrainHQ tests as part of a cognitive engagement plan, along with learning a new language, playing a new instrument, or taking up a new hobby, like dancing or photography.”
The games they played
The study, published Tuesday in the peer-reviewed gaming journal JMIR Serious Games, randomized 92 relatively healthy older adults from Quebec into two groups. Each group was asked to do 30 minutes of brain training every day for 10 weeks.
The control group played the card game Solitaire and Bricks Breaking Hex – which requires the user to break bricks into groups of the same color – at their own pace. The intervention group played BrainHQ’s Double Decision and Freeze Frame modules, which became increasingly difficult as players improved.
Freeze Frame shows a target image and then a series of other images, asking the user to click “No” for each wrong image. Double Decision briefly shows the user one of two cars in a desert, along with a Route 66 sign that can appear anywhere on the screen. To perform the training correctly, the player must quickly click on the correct car and the location of the board.
An earlier version of Double Decision was used in the 2001 ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) study, which showed that the cognitive benefits of the training were still present after five years.
Cognitive and other tests were done before and after training and during a three-month follow-up period. Acetylcholine was measured with PET scans.
According to the scans, the intervention group had a 2.3% increase in acetylcholine upregulation after the 10-week high-speed training. The improvement occurred in key brain areas responsible for memory and decision-making, said functional imaging specialist Dr. Raj Attariwala, founder and medical director of AIM Medical Imaging in Vancouver, who was not involved in the study.
This improvement nearly offset the average 2.5% decline in acetylcholine that occurs naturally in each decade of life. However, the control group had no significant benefit.
While the study advances science in this area, it’s too early to draw conclusions because “the work is in its early stages (and) effect sizes are small,” says brain game researcher Aaron Seitz, a joint professor of psychology, game design and physical therapy, exercise and rehabilitation services at Northeastern University Bouvé College of Health Sciences in Boston. He was not involved in the investigation.
“It will be important for others to replicate these findings before we can reliably conclude that acetylcholine production is upregulated by this type of computerized exercise,” Seitz said.
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