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December 4, 2015
‘NEURO CROSS-FIT TRAINING’
Can Video Games Elevate Human Minds?

Dr. Adam Gazzaley is crafting video games that can benefit people ill and well.
Dr. Adam Gazzaley is crafting video games that can benefit people ill and well.

Dr. Adam Gazzaley thinks mankind can do a whole lot better than a pill or a small molecule to enhance the brain and its core functions—perception, memory, goalsetting, compassion and wisdom. Modern humans, he concedes, are pretty good at optimizing physical performance—strength, flexibility, speed and agility. But with respect to the brain, “we’re not doing so well there.”

His increasingly popular intervention—as evidenced by the size of his Neuroscape Lab, his many global speaking engagements (more than 450 so far) and the number of large companies jostling to collaborate with him—is video gaming.

“Neuro cross-fit training—that’s what we’re going for,” Gazzaley told a packed balcony C in Natcher Bldg. on Nov. 5. He predicts “a paradigm change, an entirely new class of medicine within the next 4 years”—the prescription of video games, both to enhance wellness and to address cognitive deficits.

A neuroscientist at the University of California, San Francisco, Gazzaley visited NIH at the invitation of the Office of Behavioral and Social Sciences Research to discuss “Video Games and Neuroscience: A Vision of the Future of Medicine and Education.”

Years ago, he wondered whether a custom-designed game could enhance cognitive control in older, normal adults. Hewas frustrated with a range of limitations including poor assessment of deficits that took no advantage of available tools, poor targeting (mostly small molecules rather than entire neural networks), lack of a personalized strategy that acknowledged individual variability, a unimodal approach that treated a single drug as a kind of holy grail and an “open loop” of treatment that struck him as a sloppy, repetitive cycle of “make another appointment in a few weeks if you don’t feel better.”

The same issues exist in education, he noted. “This is just not good enough.”

Gazzaley’s goals were treatments that were targeted, personalized, multi-modal and closed-loop (that is, pitting brain vs. machine, with a measureable index of improvement or lack thereof).

The technological revolution of the past 20 years, including virtual reality, motion-capture and artificial intelligence, provides a diverse array of tools that can be used not to entertain or distract, but to heal, Gazzaley realized.

Interested in enhancing cognitive control, he sought a way to “flexibly and dynamically interact with reality,” in order to buttress attention, working memory and goal management.

“We are ancient brains, living in a modern world,” he said. “But can we flip this all around” and ultimately elevate our minds?

His hunch was that technology could provide a powerful experience capable of enhancing brain plasticity, via video gaming. Nothing off the shelf—Halo, Call of Duty, Grand Theft Auto—would do. Rather, his lab built closed-loop systems designed to effect specific brain changes and circuits.

They built NeuroRacer, which can be used as both a diagnostic and an intervention. Among its lessons: “Decrements in cognitive control with age are most pronounced between one’s 20s and 30s.” And, older participants can be trained to get better, and the improvements persist over time.

Not far off are games that will allow users to “navigate through their own brain, with a joystick. It will be very surreal, very fun,” said Gazzaley.
Not far off are games that will allow users to “navigate through their own brain, with a joystick. It will be very surreal, very fun,” said Gazzaley.

PHOTOS: DANIEL SOÑÉ

He says the new “digital medicines” can compete with “the incumbents” (drugs) already. He and colleagues hope to present their tools to the FDA as a new class of therapeutics, with applications targeting such diagnoses as attention deficit disorder, depression, traumatic brain injury, Alzheimer’s disease and autism.

The Neuroscape Lab creates a variety of interactive media to challenge the brain in a particular way, and is able to capture all data in real time, from the whole body, he said.

An app called ACE (adaptive cognitive evaluation) will be able to perform cognitive assessments remotely, Gazzaley said; a 1 million-person study is anticipated, using the tool.

Six new games, he said, are in production. He is particularly fond of a body-brain trainer that includes both cognitive and physical challenges. An avid beta-tester of his own products, Gazzaley said, “It’s incredibly eye-opening. I plan to do it every year.” The benefits, he said, “are unlike any molecule we have right now.”

In collaboration with Grateful Dead drummer Mickey Hart, Gazzaley has developed Rhythmicity, a game designed to improve a person’s rhythm and therefore, it is hoped, cognition.

Another game uses Oculus VR technology, creating an undersea-scape designed to strengthen attention. Gazzaley said 5 manufacturers are poised to deliver VR platforms in time for the holidays. VR, he predicted, will likely dominate 2016 as a gaming environment.

Another game, Meditrain, focuses on meditation and controlled breathing.

Gazzaley is clearly excited about the potential for carefully built games to deliver health benefits. “The real win will happen when we see how they work with one another, in a multi-modal way,” he said.

Not far off are games that will allow users to “navigate through their own brain, with a joystick. It will be very surreal, very fun.”

Decrying the blunt effect of pills, Gazzaley said the therapeutic games he envisions would still be valuable if they only helped patients get by with less medication. But he’s more optimistic, envisioning games that “are like a gamma knife, aimed at specific processes.

“To me, this is the epitome of personalized medicine—functional personalization,” he concluded. “I feel very strongly about the importance of games and fun. What we’re doing is not trivial, just because it’s a game. Humans engage very deeply through play.”

The entire talk is available at http://videocast.nih.gov/summary.asp?Live=16963&bhcp=1.//1.usa.gov/1GyK1Sn.

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