Over the recent years, there has been more cases of Alzheimer’s disease (AD) being diagnosed (Teixeira, Pallas-Bazarra, Bolós, Terreros-Roncal, Ávila, & Llorens-Martín, 2018). The characteristics that make up AD are advanced cell death that can result in degeneration of particular brain regions (Teixeira et al., 2018). This can result in deficits that include memory loss and loss in cognitive control (Teixeira et al., 2018). These characterizations that make up AD can highly decrease the quality of life (QOL) of the individual. Not only does this neurogenerative disease affect the QOL of the individual, it also affects the family. With AD, the individual may even forget their family members, or certain memories with them. Thus, highlighting how important finding ways to manage or treat AD can be. With the amount of people who are affected by this disease, it only warrants researchers like us to want to study ways to do so. One of these proposed ways is through the use of playing video games. With the rise of the video game industry, it has also resulted in a large negative aspect around them. Despite there being negative connotations surrounding video games, playing and using video games can results in an increase in our cognitive control functions.
Background Information
Video games have become a staple in many households, with countless hours and money spent towards this advancing industry. As this industry gains more traction with competitions, awards shows for the best of the best and the rise of esports being considered a possible sport, it opens up the possibilities of potential benefits. Recent studies have shown that playing video games improves aspects of cognition, such as attention and cognitive control (Mayas, Parmentier, Andres, & Ballesteros, 2014). An increase in alertness and reduction in distractibility was seen in the older adults who were in the test group (Mayas et al., 2014). One of the interesting aspects of their study was the affects that were resulted from their video game task, also transformed over to their performance in the oddball task (Mayas et al., 2014). Thus, suggesting some form of neuroplasticity had occurred in these individuals (Mayas et al., 2014). Although Mayas et al., (2014) had established correlation between video games and an increase in cognitive function, they were not the only ones to do so. Remarkable research conducted by Green, & Bavelier, (2006), examined the effects of action video games on visuospatial attention. There was on overall increase in visuospatial attention seen throughout all three experiments. Playing the action video games resulted in an overall increase in the amount of available attentional resources (Green, & Bavelier, 2006).
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Other studies have examined how neuroplasticity can occur in certain individuals. The concept of neuroplasticity has been used in various clinical applications. Studies using methods of neuroplasticity have discovered ways to regain spinal cord function and brain function following injuries (Wolpaw, 2012).With these ideas in mind, it’s easy to think about how neuroplasticity can be used to regenerate brain functions that have been lost due to cognitive decline/disorders. This was the very idea that Fisher, Holland, Subramaniam, & Vinogradov, (2010), had. Fisher et al., (2010) conducted noteworthy research on the cognitive neuroplasticity that occurred in patients with schizophrenia. Participants had endured through cognitive training that increased the neuroplasticity in various regions of the brain such as memory and cognitive control (Fisher et al., 2010). The effects that resulted from this study were seen in the patients six months after the initial training had occurred (Fisher et al., 2010).
Another research study that found evidence of neuroplasticity in individuals with a disorder was Han, Chapman, & Krawczyk, (2018). This study focused on individual who had suffered through a traumatic brain injury (TBI). Through the use of cognitive training, the results of this study indicated changes in the neuronal networks on connectivity in the induvial with TBI (Han et al., 2018). Other results from this study provided evidence of neuroplasticity occurring in these patients with chronic TBI (Han et al., 2018). On the contrary, a study conducted by Kumar et al., (2017) discovered impaired neuroplasticity occurring in the prefrontal cortex of individuals with AD. They believed these results could show the relationship between impaired prefrontal cortex neuroplasticity and its affect in working memory for those with AD.
While these previous studies have shown extensive research on the effects of video games and neuroplasticity, Gong et al., (2017) research is another notable study. Gong et al., (2017) examined working memory networks in correlation with action video games. Action video games experience was found to increase working memory networks in the prefrontal cortex (Gong et al., 2017). Since there was an increase in the prefrontal cortex, Gong et al., (2017) established a correlation between working memory neuroplasticity and video games. This suggested that playing action video games could have a clinical basis.
From these previous research studies, it is clear that the effects of videos can cause an increase in cognitive control. As well they have demonstrated the effects of neuroplasticity in certain populations of individuals. Some of the studies have found a link between neuroplasticity cognitive control and video games, however none of the studies focused on individuals with AD. The current research focuses on comparing how the impact of playing video games can cause an increase in cognitive function through neuroplasticity. This study seeks out to prove the possibility of neuroplasticity occurring in individuals with neurodegenerative diseases. The literature that was described consisted of many different studies that touched on various individuals of different populations, such as older adults or individuals with schizophrenia. This study will combine the effect of playing video games with participants with AD. This current study will utilize a conditioned video game training group alongside a control group and with the analysis of functional magnetic resonance imaging (fMRI) scans and cognitive data to do so. We hypothesis that the conditioned video game training group (test group) will show an increase in their neuronal activity in the prefrontal cortex in the fMRI scans from their first scan to their second scan. As well the conditioned video game training group will still show an increase in neuronal activity from baseline in their final scan three months later. Lastly, we hypothesize that the video game training group will perform better in the cognitive control video game test.
Method
The variables to be manipulated in the study will be the training the two different groups go through. The control group will not be going through a conditioned video game training program, rather they will be exposed to various video games that are readily available. The test group will be going through a conditioned video game training that will follow a strict regimen. Both groups will be tested at the end on a specific video game that is to test their cognitive control.
The variables to be measured from these tests are the levels of brain activation obtained by brain imaging scans (fMRI), at three different times. In addition to this, the level of success that will occur during the final video game will also be monitored. This will measure the level of their functional cognitive control through the various sections of the game that will occur, such as decision making and working memory. As well, the video game will serve as the cognitive task
Participants
Older adults that are diagnosed with AD and are above the age of 60 will be included in this study. The ~50 participants will be recruited through a mental health treatment center in the community and all participation will be voluntary. Participants will have to give a written consent whether through them or their guardian to be able to participate in the study. Participants of a variety of different cultural backgrounds and different genders will be accepted into the study. Approximately Twenty-five of the participants will belong to the control and the other approximate twenty-five will belong to the manipulation group. The group that will be assigned to the participants will drawn by random assignment to eliminate interviewer bias.
Procedure
As soon as the participants are initiated into the study, they will undergo a fMRI scan to obtain a baseline activity levels of their brains. For the study, participants will be using software that has been developed previously by a company (Fisher et al., 2010). This software contains various video games that have been developed to engage certain aspects of cognitive control (Fisher et al., 2010). Participants will be randomly assigned to either the control or test group. This will assign them a log in for the computer, depending on which group they are in, the tests will appear for that. For the control group, the various commonly used video games will be accessible and for the test group the controlled video game training will be available. Participants will attend a weekly one-hour session for ten weeks. During this time the control condition will continue to use the computer to play whichever games they have access to. The test group will progress through the training course one week at a time. After ten weeks of training have occurred, each participant will be coming back the following week to participate in the final video game test. The test will be calibrated so that is hits certain features of cognitive control such as working memory, and decision making, through the various quests that will need to be performed. This test will be graded out of a score of five. After the test the participants will undergo another fMRI test. From the date that they had their video game test, participants will be brought back three months to undergo a third fMRI scan.
The study will be conducted after being approved by the ethics board of the university. The participants will be informed what they would be taking part in a study that would examine their cognitive control. The true reason for the study will be hidden from them through the manipulation of the hypothesis. The experiment will be taking place in one of the labs in the university. After each participant has gone through the whole study, the participants or their guardians will be debriefed about the study and will be told what the hypothesis really is. At this moment if any participants feel they are being misled, they will be able to withdraw their data from the study.
Predicted Findings
Going off of the interpretation that our hypothesis was correct, the results of the study should be as following. The pattern of data to be expected in the fMRI scan analysis is that in the control group there should be no difference in the amount of neural activation throughout the three scans. As well the data that will be collected from the cognitive control video game test, which will be analysed through the use of ANOVA, should remain at baseline levels. Predicting that the mean for the control group would remain under fifty percent. For the test group, the fMRI scan data analysis should increase from each scan that is conducted. In the second scan there should be an increase in neuronal activity in the prefrontal cortex. In the third scan the neuronal activity will resemble the same as the second scan. As for the cognitive control video game test, the results for the test group will indicated an increase in working memory and cognitive control. Predicting that the results for the test group will be above fifty percent.
Interpretations
The implications that can be drawn out from the results that are targeted towards neuroplasticity is that neuroplasticity still has the ability to occur in brains that have degenerated due to various reasons. Thus, this provides a gateway to treatments that can help those with neurodegenerative disorders. This can increase the QOL of these individuals as neurodegenerative disorders can be life deliberating. For further implications in the field of neuroscience, these results indicate further results of the effects of neuroplasticity. As well, the results provide further information on understanding how the brain adapts to abnormities towards it. In the interest of humans, these results prompt hope that there can be improvements or possible cures for those with neurodegenerative diseases. As of right now, the QOL can degrade very quickly with those with neurogenerative disease. This does not only affect the individuals diagnosed but the family as well. With advances such as this study, the QOL of these individuals and their families can be improved. Further research that can be done to follow up on the findings of these study can be replications of the study. With replications of the same study, with the other study producing similar results, the results of this study will be more concrete. Further research can be done in this field with other neurodegenerative diseases. As well, further research with neuroplasticity can examine what affects would occur through earlier interventions. The greater the research that is conducted in this field, the one step closer we will be for finding possible cures.
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