#SfN14: The Neuroscience of Gaming
I was in total nerd heaven this afternoon. This year's Social Issues Roundtable combined two of my favourite topics – gaming and neuroscience – into a two hour long discussion led by a dream panel. The session was stimulating, informative and admirably level-headed, especially compared to the fear-mongering type of reporting that I often see in mass media ("violent first-person shooters make your kids violent!"). After ruminating over the session, I've synthesized some of the stuff that surprised me, resonated with me or fascinated me into this post. The entire session was videotaped, so keep an eye out for the footage – it's worth watching in it's entirety.
"How many of you think that the benefits of gaming outweigh the faults?" A flurry of hands shot up in the packed lecture room. With this question, Dan Greenberg, CEO of MediaRez began his talk on designing games for good.
When I went into the lecture, I had absolutely no idea about the state of research regarding the neuroscience of gaming. I wasn't even sure what type of gaming the panel was going to talk about. Sure, I've heard of Lumosity and their "cognitive training games", as well as the NeuroRacer game that is designed to delay cognitive aging. But that was the gamut of my knowledge: in my head I divided "games" into commercial snake-oil and boring therapeutics with little real-world application. Boy I was wrong.
As it turns out, the panel barely touched on the topic of commercial "brain training" games, only briefly mentioning that they have little proven effects in term of cognitive enhancement. Instead, the experts focused more on two specific types of games: commercial hits like Portal and first-person shooters, as well as custom-designed games targeted towards a specific cognitive deficit. As Dr. Martha Farah continually stressed, when evaluating the benefits of gaming it's critical to focus on the nature of the game, the targeted user population, and the ability that the game is actively trying to improve. The term "gaming" is simply too broad without context.
But why use gaming as a learning tool to begin with? Aren't they ridiculously addictive? Greenberg addressed these questions head-on in the first part of his talk. Gaming has enormous unexplored potential as educational and therapeutic tools, said Greenberg. At it's core gaming is a type of scientific method: you observe the unknown, form a hypothesis based on those observations and test it out. There's usually no explanation involved – gamers are thrown into the deep end to fend for themselves. And that's why it's so engaging, said Greenberg, because you learn through discovery. Unfortunately, the media tends to focus on the negative aspects of gaming – like any other compelling medium such as music and dance, gaming has somehow become the scapegoat for societal issues.
But the potential for gaming are endless, gushed Greenberg. For example, they can promote medical adherence, or supplement cognitive-behaviroual training for various psychiatric diseases. They are also incredibly effective for pain management: games (such as SnowWorld) have been successfully used to lower the dosage of opioids used for burn victims. Other games seem to help smokers kick the habit or facilitate diabetes management. Gaming is also at the forefront of citizen science. FoldIt, a game that challenges its players to fold long peptide chains into protein structures based on actual biophysical principles, has been wildly successful at unraveling the structure of several proteins.
The key to gamification is to construct an environment that causes a state of "eustress", said Greenberg. You see the challenge, experience the rush, and then master the task and get rewarded. Gaming induces a positive emotional response.
In addition as a tool for therapeutics, gaming may also enhance cognition, especially in the aged population. Dr. Adam Gazzaley next took the stage, introducing his interest in using gaming as a tool for cognitive enhancement. "I'm interested in the healthy and the impaired," said Gazzaley, "in the healthy population it's really about education."
Gazzaley is interested in developing games that fundamentally improve how we process information. Rather than focus on a single cognitive domain, Gazzeley is interested in enhancing the whole suite of cognitive tools that we have at our disposal: reasoning, inhibition, working memory, just to name a few. "I got excited about gaming as a therapeutic tool partly because of the paucity of interventions that we currently have for age-related cognitive decline," explained Gazzeley. The current treatment for "senile moments" is often drugs, prescribed without stringent characterization of the deficient cognitive domain. It's non-personal, unimodel and hardly adjustable; in stark contrast, video games are ubiquitous, customizable and highly interactive.
The bottom line is we are trying to harvest the brain's inherent plasticity, said Greenberg. However, just because the brain is malleable doesn't mean it'll change in response to any stimuli to the same degree. Thus, Gazzeley stressed the importance of designing games targeted towards improving a particular cognitive deficit, rather than releasing a slew of "cognitive training" games willy-nilly. "What we try to do is distill elements that work from commercial games and put those engrossing factors into our therapeutic ones." explained Gazzeley.
And he's been successful. In an attention-grabbing Nature paper published last year, Gazzeley introduced the scientific community to NeuroRacer, a game that trains multi-tasking skills. It's a simple game: the player drives a virtual car, and occasionally needs to respond the signs on the road. Nevertheless, the elderly experience a 63% drop in accuracy when they're forced to multitask; after a month of training however, their performance dramatically improved, in that they performed even better at the game than people in their 20s. What's more, the cognitive improvement was transferable: the elderly also improved their working memory for faces and attention, and this effect lasted up to half a year after the initial gaming. "And it's not just a change in mental strategy", stressed Gazzeley. When they monitored the elderly gamers' brains using EEG, the researchers found a clear shift in how fast the prefrontal cortex comes online to deal with multi-tasking. "We're seeing a fundamental, long-lasting change in brain activation", said Gazzeley. Encouraged by these data, the neurologist started AKILI, a company dedicated towards developing games for various mental disorders, such as ADHD, autism and depression.
Despite his success, Gazzeley pointed out the need for rigorous testing. "We know that art, music and story drives user engagement – violence is not a necessary component. We also know that real-time feedback, adaptivity and interference are key elements that promote cognitive enhancement.", he explained. However, the benefits of gaming needs to be reproduced in a larger population before physicians can begin to prescribe gaming as a main therapy. After all, we don't know how they compare to other interventions, such as social interaction, exercise or pharmaceuticals. We also don't completely understand the side effects.
In fact, gaming can go too far, said Dr. Mark Griffiths, an expert in internet gaming addiction. The word "addiction" gets thrown around a lot, and it's crucial to define what we mean by that, said Griffiths at the beginning of his talk. To Griffiths, behavioural addiction shows six main characteristics: salience, in that you become totally pre-occupied; mood modification; tolerance, in that you spend more time or money to get that "high"; withdrawal, both psychological and physical; conflict, in that the addiction compromises life; and relapse, in which it's easy to pick up the habit again. According to this definition, people can become addiction to anything, "even gardening. Not that I've ever met anyone like that."
Many factors contribute to internet gaming addiction, continued Griffiths. It's easily accessible, highly affordable and anonymous. It's also easier to hide and therefore more socially acceptable. However, excessive gaming doesn't necessarily represent addiction, said Griffiths, "many kids these days spend their time gaming rather than watching TV. Nothing wrong with that." So does online gaming addiction actually exist? "According to my definition, absolutely", said Griffiths. In fact, internet gaming disorder is now listed in DSM-V. "One thing that you notice studying so-called 'internet addiction' is that they tend to be highly specific rather than generalized; you don't really get addicted to the internet, it's more what you do on it."
Despite potential side-effects, Griffiths feels cautiously optimistic about the future of gaming for good. We just need to keep in mind that it may trigger adverse affects in the susceptible, he said. In the end, it's all about the cost-benefit balance, and most of the time the benefits seem to outweigh the cost.
Although the data is still preliminary, gaming does seem to have immense potential as a therapeutic and educational tool. "I'm not saying my game 'NeuroRacer' is a game-changer," explained Gazzely, "however, the underlying protocol – that is, to cautiously design a game targeted towards a specific deficit and rigorously test it out – may be." His research company is now exploring the use of meditation principles and rhythm in designing novel games. Sure, researchers may have vested interests, he acknowledged along with Farah, but as long as they stick to scientific principles when evaluating the benefits of gaming, we can still push the field forward.