Therapeutic Games and Applications Lab, University of Utah
The neurologist said Pam Stevens’ cognitive impairment could not be treated. After suffering a stroke in 2014, the 85-year-old was unresponsive to medication. She and her husband, Pete Stevens, were told to give up hope.
“Twice over a two-year period the neurologist said there was nothing we could do,” Pete Stevens said. “He said ‘Take her home and prepare for her to die.'”
But he refused to accept this grim prognosis. He was willing to try anything – including experimental video game therapy – to restore Pam’s brain.
Fight cognitive decline
After a referral from her psychiatrist, the Stevens eventually came to Sarah Shizuko Morimoto and her lab at the University of Utah. Morimoto’s work focuses on cognitive disorders, particularly those related to brain aging such as geriatric depression and mental decline.
“My interest has always been the intersection between mood and cognition, so how you think affects how you feel,” Morimoto said. “I started thinking ‘could we make the brain circuitry work better through our eyes rather than our ears?'”
Enter Neurogrow: Morimoto’s gardening video game is designed to target and improve the functioning of neural circuits. Their hope is that an aging brain, when exposed to the program, will eventually respond better to medications like antidepressants.
Video games entertain, amuse and inspire. But Morimoto’s research begs the question: can they heal?
More like an exercise than a game
Therapeutic Games and Applications Lab, University of Utah
Neurogrowth is not a hit video game like Call of Duty or Animal Crossing. It has a rudimentary design that eschews cutting-edge graphics and elaborate storytelling for tasks that challenge memory or the reaction time of an aging brain. Someone playing Neurogrow may be presented with a specific color flower and challenged to water it with the correct watering can before time runs out. For a brain unaffected by cognitive impairment, this task would most likely prove easy, but memorization and timing can be demanding for patients like Pam Stevens.
“When you want a certain part of the brain to be activated,” Morimoto explains, “you use something similar to problems in a game. When someone solves a problem, a certain part of the brain turns on. so we started there and gamified those tasks.”
According to Morimoto, his team’s games aren’t supposed to hook you. In fact, Neurogrow isn’t very fun at all.
“My games are designed to do something completely different for your brain,” she said. “They’re not designed so you want to keep playing or spend more money on them. The things we ask patients to do are pretty hard and pretty boring, which is exactly what’s so hard for them.”
It’s more of an exercise regimen than a game. When Pete Stevens would drive Pam home after her Neurogrow sessions, he would notice how exhausted it was.
“There were times when we wouldn’t even be a mile from Morimoto’s office, and she was sleeping in the car,” he said. “Other times she would come home but then sleep for four hours. It was emotional and physical exhaustion.”
But Pam’s hard work paid off. After four months of multiple sessions, Pete and his doctors noticed positive changes in Pam’s behavior; She was more social, more conversational, and Pete even mentioned that Pam was reading a book on dialectical behavior therapy before our phone interview.
Other scholars thought Morimoto was crazy. Video games as a treatment for depression? Unheard of, especially in the elderly, whose brains have undergone normal deterioration as part of aging.
“Very few people thought it would work,” Morimoto said. “They said there was no way I could make a game and encourage older patients to play it.”
But the federal government thought otherwise. Morimoto and his team received a $7.5 million grant from the National Mental Health Institute to conduct clinical trials of Neurogrow.
FDA approval for a video game
Neurogrowth isn’t the only game that claims to address brain health. EndeavorRx is a video game designed to treat ADHD in children. It looks like a cross between the popular Subway Surfers app and Mario Kart. Developed by Akili Interactive, it became the very first video game to receive FDA approval for the treatment of ADHD in 2020.
While FDA approval seems like the ultimate stamp of approval for a medical product, some researchers are skeptical. Talk to The Washington PostRussell Barkley, a clinical psychologist and researcher, called the game a “marketing ploy”.
“The effects [of the game] just don’t generalize,” Barkley said. “You get better at playing the game and anything that resembles playing the game.”
Rather than improving, say, a student’s test scores or reading comprehension, these reviewers say a child using EndeavorRx would only get better at playing similar games like the aforementioned Subway Surfers or Temple Run.
But Eddie Martucci, CEO of Akili Interactive, says he can point to tangible results.
“I think the reason there’s skepticism, and there’s a good reason for it, is that people have been burned by marketing gimmicks, especially in the area of digital health and neuroscience. “said Martucci.
“Over time, skepticism has diminished significantly as we continue to seek and show data.”
It’s not easy to decipher whether games like Neurogrow or EndeavorRx work or have long-term benefits. Researchers aren’t always keen on disclosing their findings, especially if it would reveal game mechanics that could be copied. But without outside verification, it’s hard to say whether the so-called medical video games have any merit.
“We don’t see the research around it,” said Anthony Bean, a clinical psychologist and video game researcher. “Sometimes the data looks muddled when we can see it, but we’re also really in the dark with a hands-on sample they created to check their game.”
But Neurogrow patients like Pam Stevens aren’t waiting for independent researchers to give a thumbs up. Neither did investors – Akili Interactive went public and merged with Social Capital Suvretta Holdings Corp., injecting developer EndeavorRx around $412 million in gross proceeds.
Keller Gordon is a columnist for Join the game. Find him on Twitter: @kelbot_