Could video games be used to improve mental health?

Jürgen Gallinat (University Medical Center Hamburg-Eppendorf, Germany) presented the current evidence at this ECNP Virtual 2020 session.

Neurogenesis and brain volume

Global gray matter volume shows a linear decrease with age in normal adult brains

The hippocampus is important for acquisition of new memories¹. In adult mouse studies, physical activity increases hippocampal neurogenesis¹. In humans, brain volume is often used as a proxy for neuronal plasticity, with a linear decrease in global gray matter volume with age in normal adult brains⁴.

Video game playing and the brain

In adolescents, left ventral striatum volume (area associated with dopamine release) is higher in frequent video game players (>9 h/week) compared to non-frequent players (<9 h/week)⁵.

In adults, there is a positive association between lifetime amount of video gaming and gray matter volume

In adults, there is a significant positive association (p<0.001) between lifetime amount of video gaming and gray matter volume in parahippocampal, hippocampal and occipital regions, areas associated with spatial navigation and visual attention⁶.

Enhancing neuronal plasticity through cognitive training

Training adults for ≥30 min/day over 2 months with a three-dimensional platformer video game significantly increased gray matter volume in right hippocampal, right dorsolateral prefrontal and bilateral cerebellum regions, associated with changes in navigation strategy and desire for video gaming². Computer game-based inhibition training in older adults increased cortical thickness in the right inferior frontal gyrus triangularis, an area associated with response inhibition³.

Training adults with a video game significantly increased gray matter volume

Possible transfer effects

Can computer game training effects lead to transfer effects on other cognitive skills? A prospective study randomized surgical novices to a game with high visual-spatial demands and visual similarities to endoscopy or a game with mainly cognitive demands (chess)⁷. Both groups demonstrated improved performance in minimally invasive surgical simulators, with increased transfer effect in those trained on the visually similar game.

Therapeutic potential in psychiatry and neurology

Flashbacks, a hallmark symptom of PTSD, are sensory-perceptual, visuospatial mental images. Could visuospatial cognitive tasks selectively compete for resources required to generate mental images? The brain has selective resources with limited capacity, with an estimated 6 h window to disrupt memory consolidation⁸.

Those playing the computer game after viewing a traumatic film had significant reduction in flashback frequency

Participants were randomized to 10 min visuospatial task (Tetris computer game) or no-task, 30 min after viewing a traumatic film (experimental analog for PTSD)⁸. Those playing the computer game had significant reduction in flashback frequency over 1 week. Male patients with combat-related PTSD were randomized to playing Tetris 60 min/day plus therapy or therapy alone for 6 weeks⁹. Following therapy, the Tetris group showed increased hippocampal volume and reduction in symptoms of PTDS, depression and anxiety.

Video game training was used to study traumatic memories after emergency Cesarean section (ECS), randomizing women to 15 min Tetris session, within 6 h following ECS, or usual care¹⁰. The intervention group reported fewer traumatic memories over 1 week.

The video game training group reported fewer traumatic memories after emergency Cesarean section

Further potential applications include reducing schizophrenia symptoms and addressing mild cognitive impairment.