Multiple sclerosis patients strengthen brains playing video games

Earlier generations of young people were warned that playing video games would turn their brains to mush. New research suggests just the opposite is possible, as a cognitive-rehabilitation program based on use of Nintendo’s popular “Brain Age” series has been shown to improve scores for sustained attention and executive function in patients with multiple sclerosis.

According to the research report, published online March 8 in Radiology, Laura De Giglio, MD, PhD, Sapienza University, Rome, and colleagues randomly assigned 24 patients with MS and cognitive impairment to either an intervention group or a waitlist group.

The team evaluated these subjects with cognitive tests plus resting-state fMRI at baseline and after an eight-week period.

They also performed baseline resting-state fMRI on 11 healthy subjects.

Patients in the intervention group played the games—which involve puzzles and various mental challenges, also known as “Dr. Kawashima’s Brain Training”—while those on the waitlist served as control subjects.

The idea was to investigate, specifically, changes in thalamic connectivity after use of the game-based program, as thalamic damage and alterations in thalamocortical functional connectivity are known to be important factors in cognitive dysfunction in MS patients, according to the report.

And the results:

The MS patients, who presented with lower functional connectivity compared with healthy subjects at baseline, significantly improved after the program as measured by two tests—the Paced Auditory Serial Addition Test and the Stroop Test (F = 6.616, [P = .018] and F = 5.325 [P = .030], respectively).

As for the imaging component, at follow-up, the intervention group showed significantly increased connectivity in the cingulum, precuneus and bilateral parietal cortex—brain areas in a neural network considered key to cognition.

In their discussion, the authors write that their results “contribute to understanding of the mechanisms of recovery in cognitive rehabilitation of patients with MS and may be helpful for the design of future studies on this topic.”

Fun rehab is followed rehab

In an email, De Giglio told Health Imaging that the team was pleasantly surprised to see patients so willingly performing rehabilitation exercises.

“The combination of exercise and fun could be the key to stimulate participation and adherence to training,” she added. “We think this is a very relevant point for the development of innovative strategies in rehabilitation.”

De Giglio would like to see future research function focus on similar but separate avenues of inquiry into the role of thalamic connectivity in cognitive function.

“I have a lot of questions,” she said. “For example, I’d like to understand if there are drugs able to enhance functional connectivity. Another interesting question is if the plasticity induced in thalamic connectivity from cognitive rehabilitation may determine a positive effect on motor abilities or vice-versa.”

Finally, asked if she believes video gaming shows potential for warding off cognitive decline related to aging in healthy, non-MS patients, De Giglio said the results of her team’s study cannot be directly applied to that hypothesis.

“Cognitive decline in multiple sclerosis has different characteristics compared with that related to aging, and patients suffering from MS are usually young and have a great potential for recovery,” she said. “However, there are studies from other authors suggesting the utility of Dr. Kawashima’s Brain Training in improving cognitive function in the elderly and in young adults, and indicating that video games have the effect of stimulating brain plasticity even in healthy subjects. I think the potential of this tool should be attentively considered and better investigated.”