Brain Training Games Enhance Cognitive Function in Healthy Subjects

Abstract

Background

Brain train games ( BTG ) are believed to play a major function in improving cognitive functions. The stream discipline evaluated if BTG showed positive shock on attention and memory functions compared with baseline visit in healthy subjects .

Material/Methods

The learn was carried out from October 2015 until April 2016 in the Department of Physiology, College of Medicine, King Saud University and in King Khalid University Hospital ( KKUH ), Riyadh, Saudi Arabia. We enrolled 51 normal healthy subjects to use a computerize cognitive prepare game ( Lumosity ) for exercises that target a range of cognitive functions, including attention, processing accelerate, ocular memory, and administrator functions for about 15 min per sidereal day, at least 7 days per workweek, for 3 weeks. The control ( n=21 ) group did not perform the prepare. Both groups took the CANTAB test before and 3 weeks after training for assorted cognitive functions ( flexibility, memory, care, focal ratio, and problem clear ). serum samples were used to study the brain-derived increase factor ( BDNF ) and apolipoprotein ( Apo ) E ( APOE ) levels.

Results

A significant improvement in Lumosity operation index was observed in the active agent group compared to the control group by the end of aim ( p-value 0.001 ). After the coach, a statistically significant difference in most of the CANTAB measures, such as attention-switching task ( AST ), mean compensate latency, AST switching cost, AST mean correct rotational latency ( congruous ), AST mean correct latency ( incongruent ), AST mean adjust rotational latency ( blocks 3 and 5 ) [ non-switching blocks ], AST mean correct rotational latency ( block 7 ) [ switching forget ], and MOT mean compensate reaction time ( all P=0.000 ). however, in the manipulate group, meaning improvements were not observed. A positive correlation between traffic pattern recognition memory ( PRM ) and APOE was found and people who had higher ApoE levels had faster response .

Conclusions

An improvement in different cognitive domains was noted, including care and centrifugal speed. however, this study warrants further research to determine the long-run effect on early cognitive functions and in different groups ( for example, aged vs. adults ). MeSH Keywords:

Attention, Cognition, Memory, Long-Term

Background

During the advance of normal senesce, alterations occur in the prefrontal cortex and the medial temporal role lobe system, including the hippocampus and the cerebellum [ 1, 2 ]. These changes are linked to Alzheimer ’ south disease ( AD ) and dementia and are linked with impairment in cognitive processes such as short- and long-run memory, rush, and administrator functions. thus, cognitive functions, including attention, memory, and analytic ability, show a functional decrease with historic period [ 3 – 5 ]. An effective cognitive aging intervention faces 2 challenges : ( 1 ) shifting training improvements to untrained tasks and ( 2 ) designing interventions that boost submission. A major research stress is to find new engineering to understand aging and delay the process of cognitive worsen [ 2 ]. recent studies increasingly use brain train games ( BTG ) to investigate their affect on cognition and possibility of transfer to untrained tasks [ 6, 7 ]. indeed, the term “ brain prepare ” has become used to describe cognitively induce activities designed to improve mental fitness [ 8 ]. many BTG interposition studies have reported increased performance in cognitive tasks such as speed and accuracy, visuo-motor coordination, attention, memory, working memory, and ball-shaped cognitive affair [ 9 – 15 ]. however, other studies showed no positivist effects of BTG on cognitive functions and motion the lotion of such systems as cognitive treatment strategies [ 16, 17 ]. These findings, although not consistent across all studies, suggest that BTG is an effective intervention tool for cognitive improvement. In addition to the above, some studies have reported that apolipoprotein E ( APOE ) and brain-derived neurotropic agent ( BDNF ) could be play a major role in the development of cognitive functions. While APOE has been associated with risk for late-onset AD, its function the damage of goodly cognitive serve is still indecipherable [ 18, 19 ]. The neurotrophin BDNF has the ability to develop and maintain neural function and is crucial for neural malleability. BDNF has been reported to facilitate long-run potentiation of the hippocampus and cortex, which are important processes for memory and learning [ 19, 20 ]. In the deliver report, we assessed whether BTG could improve the cognitive abilities ( for example, AST and MOT ) compared to baseline in a group of healthy subjects using a broad barrage of Cambridge Neuropsychological Test Automated Battery ( CANTAB ) assessments [ 21 ]. In addition, assessments of BDNF and ApoE levels and their correlation with cognitive functions were evaluated. To the best of our cognition, this is the first study combining BTG and its correlation with APOE ɛ4 and BDNF plasma levels, particularly with character to improvement of cognitive functions .

Material and Methods

Participants

This was a randomized, experimental, non-blinded study. All participants were goodly volunteers. After the interview, clinical history-taking and interrogation were performed. We divided the participants randomly to either the active group or the control group. We included all participants who were volition to complete the 3-week prepare menstruation. We excluded any player who could not complete the train or who missed sessions using the BTG in between the trail sessions. All subjects knew which group they were in ( active vs. control condition ). The study was carried out from October 2015 until April 2016 in the Physiology Department, College of Medicine, King Saud University and in King Khalid University Hospital ( KKUH ), Riyadh, Saudi Arabia. The research protocol was approved by the Institutional Review Board, College of Medicine and KKUH. The Mini-Mental State Examination ( MMSE ; Folstein et al., 1975 ) was used on all subjects [ 22 ]. ejection criteria were a cognitive disability ( score of < 26 on the MMSE ) diagnosis of dementia, depression, less than 20/60 vision with or without correction, or current plans to move to another city .

Brain training application (Lumosity)

Lumosity is a brain train lotion which is available in IOS and Google shimmer. We used this app because it ’ s easy to access and use. All participants performed the education for a time period of 21 days for 10–30 min per day. In each educate session, participants played the games Speed Match, Memory Matrix, Rotation Matrix, Face Memory, Money Comb, and Lost In Migration. The control condition group did not receive train. Lumosity measured many aspects of cognitive function such as flexibility, memory, attention, speed, and trouble clear. The median of these values is known as the Lumosity performance index ( LPI ). Baseline and follow-up neuropsychological test were completed by a blind psychometrician, and the cogitation Principal Investigator was besides blinded to group assignments. A dedicated study technician ( outback supervision ) supported participants throughout the 3-week study following a protocol for act hebdomadally contact. Participants were provided with support through call and electronic mail, with the finish of responding to all requests for corroborate within 1 day.

Assessment tasks and procedures

Mini-mental state examination (MMSE)

The MMSE is one of the most widely use tools for quantitative judgment of cognitive function. The quiz consists of 11 questions assessing versatile cognitive functions, including 2 questions on orientation course, 1 on registration, 1 on memory, 5 on linguistic process, 1 on attention and calculation, and 1 on ocular construction [ 23 ]. The MMSE takes only 5–10 min to administer, which makes it a practical creature for research purposes. The test has a utmost score of 30, with scores below 23 being indicative of cognitive stultification [ 24 ]. The standard MMSE form is in English for English-speaking subjects [ 23 ]. For Arabic speakers, a translate version of the MMSE used ; this translation was introduced in 1999 by a group of Saudi researchers [ 25 ] .

Blood assays

venous blood samples were collected from all participants, plasma was separated and stored at −70°C until assayed. Plasma levels of BDNF and APOE were measured by competitive enzyme immunoassay using Human BDNF and APOE ELISA kits following manufacturer ’ second instructions ( Elab Sciences Biotechnology Co., Ltd. China ). The detail description of the procedure is described early [ 26 ] .

Assessment of cognitive functions

cognitive functions were evaluated by CANTAB to assess administrator functions and memory before the participants started using the BTG Lumosity lotion and after they used it for 3 weeks for the active group. For the manipulate group, evaluations were conducted at baseline and a retest was performed again after 3 weeks. We chose 3 tests from CANTAB : model Recognition Memory ( PRM ), Motor Screening Task ( MOT ), and Attention-Switching Task ( AST ). A detail description of the CANTAB routine followed in this discipline is described elsewhere [ 27 ] .

Statistical analysis

Data were analyzed using SPSS ( IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY : IBM Corp. ). We calculated errors, and numbers of trials and stages completed for the PRM task. The AST measured covers focus errors, proportion of successful stops, and MOT measured reaction time and the accuracy of pointing. Data was analyzed using the metric ton test and χ2 tests to determine whether cognitive screen scores changed within intervention or control condition groups. Spearman ’ s rank arrange correlation screen was used to test for any correlation coefficient between enhancement of cognitive function after using BTG with the levels of BDNF and APOE. P values less than 0.05 were considered statistically significant .

Discussion

This report was conducted to understand the function of the BTG application Lumosity in improving cognitive function in a randomly selected megabyte population from Saudi Arabia. In summation, assessments of a probable correlation between blood markers APOE and BDNF with cognitive routine were performed. The study results showed positive effects of the BTG Lumosity on cognitive functions in young adults. These findings are largely coherent with previous evidence showing improvement in cognitive functions after BTG [ 12, 13 ]. BTGs were shown to improve administrator functions and processing speed in aged subjects [ 6 ]. furthermore, studies showed that BTG can improve the performance of several cognitive functions in the trained group but not in the control group in terms of amphetamine accuracy [ 3, 9 ], visuo-motor coordination [ 14 ], attention [ 13, 14 ], memory [ 21 ], working memory [ 11 ], and global cognitive function [ 12 ]. Our study produced 2 main findings. first, the trainees improved their game performance across sessions. The improvements in cognitive processes in executive functions, working memory, processing speed, and attention through BTG were closely related to the prepare cognitive domains ( flexibility, attention, accelerate ). second, the active agent group performed the AST tasks better than the control group. Our study found a negative correlation between MOT and APOE. As the MOT decreased, APOE increased and vice versa. besides, there was a positive correlation between PRM and APOE. however, there was no significant deviation for BDNF and cognitive markers in both groups, although a few animal studies showed brain malleability to be linked with BDNF [ 28 – 30 ]. Owing to the possible character of APOE and BDNF in modulating cognitive responses, far studies in larger populations may provide more clarity on the demand correlation coefficient between cognitive markers and these blood markers. Although the present study provided interest results with esteem to cognitive improvement after execution of BTG coach, in addition to highlighting a possible association of BDNF and APOE with cognitive markers, it besides has a few limitations. Regardless of the nature of remote control testing benefits of BTG, there is besides uncertainty around reproducible presidency. The education period of 3 weeks is not enough time to obtain the transfer effect, as BTGs do not change the trouble of tasks depending on the participant ’ s performance. second, an adaptive education method, which is more effective than a non-adaptive training for the enhancement of cognitive functions [ 13, 14 ], was not used for BTG. In addition, far inquiry is needed to explore the use of the lapp cognitive measures for long-run consumption of BTG, specially since a few studies have indicated that cognitive trail confers long-run profit in cognitive functions [ 12, 31 ]. The sample distribution size of our sketch was small and longer follow-up would be more useful in terms of knowing the long-run effects of BTG. To get a preliminary understand of the effect of BTG on cognitive function, we initially performed the study in young populations ( the average old age of our population was 25 years ) and not in older senesce groups ( 60 years and above ) or diseased patients ( Alzheimer and degenerative disorders patients ). In accession, the current study analyzed results within the active and passive control group and not between the 2 groups. This survey design helped us to identify specific cognitive improvements after the trail, whereas the dominance group showed no substantial improvements after the completion of 3-week trail. While a few studies used both an active and a passive restraint group [ 12, 13, 32 ], some studies used a passive see group [ 12, 31 ] to compare with the train group. Although the potency of BTG will be more clinically relevant in the aged and diseased patient populations, the aged may not play the game every sidereal day due to aging and technology adaptation, which may affect the study results. however, because the study indicated that BTG influenced cognitive outcomes and longer follow-up, studies in the aged population with data comparing between active and control groups are needed to confirm the association.

Conclusions

An improvement in versatile cognitive domains including attention and centrifugal rush was observed after BTG in young adults. A correlation between rake markers such as APOE and BDNF with cognitive function was besides established. The study results indicate that playing BTG may besides improve cognitive functions and avail reduce effects of aging in adults. however, further research is warranted to determine the long-run beneficial effect of BTG on cognitive functions in aged affected role populations. In malice of the deficiencies outlined, this is the first study to evaluate BTG in subjects from Saudi Arabia and provides significant results that pave the way for far clinical studies .

Footnotes

Source of support: Deanship of Scientific Research, King Saud University for the Undergraduate Student ’ s Research Support Program, project No. USRSP-17–13