Video games evaluated as possible treatment for COVID ‘brain fog’, other conditions

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Digital tech company Akili Interactive’s recent collaboration with two academic medical centers to evaluate a video game developed for children with attention-deficit/hyperactivity disorder (ADHD) in patients with COVID-19-related “brain fog”, has become one of the latest investigations of video games in medicine.

Over the past decade, some researchers worldwide have been studying the potential use of video games as a treatment, educational tool, or complementary therapy for a variety of ongoing or perplexing medical challenges, as well as for teaching medical trainees new skills. Journalists can find interesting stories in this area, provided they acknowledge that data and results so far have varied widely.

A glance at the research

In randomized controlled clinical studies, investigators at Vanderbilt University Medical Center and New York-Presbyterian/Weill Cornell Medical Center are testing the potential of Akili’s game EndeavorRx to target and improve cognitive functioning in patients following COVID-19 infection. In the game, approved by the U.S. Food and Drug Administration in June 2020 as a prescription treatment for children with ADHD, players help an alien avatar navigate a digital environment while being presented with on-screen prompts as a form of distraction, according to an article on medicine.com. Users work to earn rewards and unlock new environments.

The game has challenges and demands, said James Jackson, Psy.D., director of long-term outcomes for the ICU Recovery Center at Vanderbilt, in an interview with AHCJ. As people improve, the challenges and demands become harder. If they struggle, the tasks become easier. The hypothesis is that this dynamic nature of the game can help improve function in attention and processing speed, he said — key difficulties experienced by COVID long haulers.

So far, about 30 patients have been enrolled at Vanderbilt, predominantly those who had mild to moderate cases of COVID-19, Jackson said. Now, the study is expanding to include COVID-19 survivors who had been critically ill or hospitalized. Patients are asked to play the game for 30 minutes a day, five days a week, for four to five weeks on iPads sent to their homes. No results have been reported yet.

It wasn’t long ago that there was “tremendous skepticism” in the scientific community about using video games to improve outcomes, particularly as it relates to cognition, Jackson said. But over time, research in support of these game-based brain training approaches has improved, he said. He’ll soon be working on another study in survivors of other critical illnesses using a cognitive game called BrainHQ.

“It’s perfect for the challenging pandemic world that we live in,” he said, because remote encounters people have using the games can protect against virus exposure and be less cumbersome than attending face-to-face appointments with rehabilitation specialists.

Video games have been trialed in other areas of medicine, too:

A search for “video games in medicine” in the National Library of Medicine’s PubMed database retrieved 176 citations during a recent search. This included additional studies looking at cognitive enhancement, as well as investigations into virtual reality and video games in cardiac rehabilitation programs, video games versus conventional rehabilitation in recovering motor function of the upper limbs after stroke, and active video games as a training tool for people with chronic respiratory diseases.

When writing about the application of video games in medicine, there are two key questions that journalists (and investigators) should be asking, Jackson said:

  • What happens when people stop playing the games? Do the benefits continue?
  • What are the benefits of playing these games in real-world performance? Do they just help people get better at playing games, or do they help people improve their performance in daily life tasks?

And, he said, it pays to ask how representative the patients or sample population being studied is to a greater group, and if the participants selected are interested in playing the games.

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