Brain Games: The Intervention

Authored by: Noah Goodman

Art by: Laura Lee

Introduction

Can “brain games” serve as an effective intervention for battling normative and pathological cognitive decline? According to Anderson and Grossberg (2014), the answer may be yes [1]. But, what are brain games? And what evidence supports their clinical effectiveness?

Throughout this article, I will refer to “brain games” as reading, comprehension, writing, mathematics, and even memory exercises that are aimed at improving cognitive functioning. I consider these exercises to be “games,” since many of them are fun and interactive, rather than structured as typically organized lesson plans. Furthermore, many of these exercises are available  in the form of active video games or iPhone applications [1, 2]. 

Depending on the research article being discussed and the clinical population being targeted, interventional exercises may range from very simple (i.e. “what color is my pencil?”) to quite complex (i.e. “please describe some of the most profound moments of your life”). Of course, matching the difficulty level of the exercises to the clinical population being served is of key importance to their success [1]. 

Benefits of Brain Games

According to Anderson and Grossberg (2014), brain games improve cognitive outcomes for individuals with Alzheimer's by providing patients with much-needed mental stimulation, which thereby helps them stave off declines from the disease [1]. Supporting this model, Kawashima et al. (2005) concluded that arithmetic and reading exercises improve neural functioning in dementia patients [3]. Furthermore, Belleville (2008) suggested that cognitive exercises may even delay or decrease normative cognitive decline as well [4]. Thus, brain games demonstrate effectiveness in both clinical and nonclinical settings. But what is their mechanism of action?

Mechanism of Action

One hypothesis stems from considering learning as a form of long-term potentiation (LTP). Long Term Potentiation describes a process in which neurons that are consistently and continuously fired subsequently (or essentially concurrently on a macroscopic scale), undergo a strengthening of underlying connections [5]. In other words, neurons that “fire together, wire together.” This means that the more consistently a neural pathway is stimulated, the stronger the pathway becomes. Pathways that are not used efficiently or consistently are, in-turn, pruned-out and no longer functional. In other words, we “use them or lose them.”

LTP hypotheses stipulate that learning and memory may be considered to be macroscopic manifestations of many molecular long-term potentiation events [5]. Through this lens, we can start to understand why the mental stimulations provided by brain games may help to prevent cognitive decline. Essentially, by stimulating pathways that are not typically used during the day (i.e. when recalling something from years before, performing simple mathematical operations, or reading a story), brain games may preserve these pathways and prevent neural pruning. Reinforcing many such pathways (i.e. through various different brain games) may then yield measurable, macroscopic changes in brain functioning as a whole, explaining the incredible benefits that brain games have been observed to provide. 

Applications

Brain games can be implemented to support both clinical and nonclinical populations. For health care volunteers, playing brain games with patients can serve as a fun method of improving their cognitive outcomes, while also fostering a social environment that is conducive to the formation of strong, personal relationships. Meanwhile, for those looking to stave off normative cognitive decline, playing brain games can serve as a practical at-home interventional practice. 

It is worth noting that the presented research also suggests that it may be beneficial to vary the brain game that is used from time to time, in order to potentiate a range of different neural pathways. Furthermore, the research suggests that consistency is key, as regularly-intervalled stimulations, occurring consistently over a long period of time, is a necessity of optimal neural potentiation. 

Conclusions

Overall, this article used an LTP model to explain the benefits observed from the application of brain games in clinical and nonclinical settings. It seems that the progression of both pathological and normative cognitive decline can be mitigated by engaging in a mosaic of different brain games on a consistent basis over a long stretch of time. 

References:

1. Anderson, K., & Grossberg, G. T. (2014). Brain games to slow cognitive decline in Alzheimer's disease. Journal of the American Medical Directors Association, 15(8), 536-537.

2. Stanmore, E., Stubbs, B., Vancampfort, D., de Bruin, E. D., & Firth, J. (2017). The effect of active video games on cognitive functioning in clinical and non-clinical populations: A meta-analysis of randomized controlled trials. Neuroscience & Biobehavioral Reviews, 78, 34-43.

3. Kawashima, R., Okita, K., Yamazaki, R., Tajima, N., Yoshida, H., Taira, M., ... & Sugimoto, K. (2005). Reading aloud and arithmetic calculation improve frontal function of people with dementia. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 60(3), 380-384.

4. Belleville, S. (2008). Cognitive training for persons with mild cognitive impairment. International Psychogeriatrics, 20(1), 57-66.

5. Teyler, T. J., & DiScenna, P. (1987). Long-term potentiation. Brain slices: Fundamentals, Applications and Implications, 168-176.