Not all games are created equal

The employment of video games in the research of cognitive training can be divided in two categories: off-the-shelf games and gamification of existing cog- nitive tasks [98]. Some researchers have proven that certain commercial action video games can improve specific cognitive skills like visual attention [110, 43]. Cohen, Green and Bevalier [43] have studied the effects of different video games in visual attention. Participants (18 to 29 years old) with little to no gam- ing experience were trained on one of several video games (Unreal Tournament

2004, America’s Army, Harry Potter or Tetris) for 12 hours and tested on two

paradigms: attentional blink and multiple object tracking. Individuals who played the action video game (Unreal Tournament) showed improvements on these two measures of visual attention while participants trained on other games showed less or no improvement. They concluded that fast paced games and re- quirements to track various objects at once, produce changes in visual selective attention. Although participants trained in other games showed significant im-

provements on the visual attention tests, they could not conclude that it was produced by the training itself as they could not compare it with a control group that was not trained on any of the games. Oei and Patterson [110] also tested the benefits of four different commercial action games on attention and WM played on iPhone/iPod. Their study demonstrated that not all games have the same cognitive demands, and transfer to a cognitive skill is more likely if the underlying skill is highly practiced in the game [8, 110, 77].

On the other hand, the gamification approach simply introduces game ele- ments like storyline, goals or rewards in boring cognitive tasks, making slightly more engaging exercises [98]. This is a very successful method in certain pop- ulations like children [160]. Anguera and Gazzaley [8] argue that maybe the low-engaging nature of cognitive tasks has driven the usual negative results in the field of game-based cognitive training. They explain that one of the most important factors differentiating these two types of games is the motivational factor. Most commercial video games create a high engagement and immersion through carefully designed stories and reward structures that challenge and mo- tivate the individuals to reach greater outcomes. Due to their targeted approach, these cognitive exercises are more focused on challenging specific cognitive skills than including engaging game elements to motivate the player [8]. The intro- duction of game elements to increase engagement and intrinsic motivation can benefit the players’ attention performance, creating a more effective cognitive training [82]. These elements should be carefully incorporated as they can also bring distractions, even though some research suggests that off-task behaviours are a way for players to regulate their emotions [140].

This gamification method was very popular a few years ago when private companies such as CogMed or Lumosity, developed specific training programs based on the gamified versions of existing verbal and visuo-spatial cognitive tasks [147]. Although these programs have been tested in different studies with positive results [92, 64, 78], many researchers have constantly questioned the sci- entific validity of these experiments [147] demonstrating that these brain train- ing programs do not improve our cognitive skills [115]. A consensus signed by many well-known researchers on the so called Brain Training industry pub- lished in October 2014 [4], express a general agreement on the fact "there is no

compelling scientific evidence to date" that brain games reduce or reverse the

cognitive decline in older age population and patients with Alzheimer’s disease. In January 2016, the company Lumosity has been fined by the American Federal Trade Commission to pay 2 million dollars for deceptive advertising. Lumosity

Figure 2.5: NeuroRacer experimental conditions (A) and training design (B) [7].

two events are focused on the use of brain games to cure Alzheimer’s disease and cognitive decline in older people. Further research needs to be done to clarify whether video game playing can improve our cognitive skills.

Gazzaley and his research group have created a game called NeuroRacer [7] that claims to enhance multitasking in older healthy adults. In this game the players have to drive a car while occasionally responding to the coloured shapes presented (Figure 2.5). Playing an adaptive version of NeuroRacer in multitasking mode for one month, adults between 60 and 85 years old reduced the cognitive costs when task-switching in multitasking mode and improved the sustained and divided attention as well as their WM. These effects persisted 6 months later. Even more revealing is the recent work by Shute, Ventura and Ke [148], which claims that playing the puzzle video game Portal 2 for 8 hours, led to more positive effects in spatial and other non-cognitive skills than training the same time on multiple mini-games on the Lumosity platform. This mean that it may be dependent on the game’s design and focus, whether it is possible to improve cognitive skills like attention or WM. Anguera and Gazzaley [8] argue that the higher cognitive impact of video games compared to gamified cognitive exercises might be due to their fun and motivational factor.

Even though further research is required to demonstrate that game-based

training can improve with cognitive skills [147], it is vital to highlight some im- portant facts. Firstly, the impact of these cognitive games in different groups of people like novice and expert video game players must be clarified. Some re- searchers have argued that skilled players have better visual attention skills [59] and their extent of improvement in video game training is smaller compared to novices [141]. Hence, greater effects from video game cognitive training would be observed in novice players than experienced ones [59, 141]. Even more impor- tant is the age of the subjects. Toril et al [159] completed a meta-analytic study to investigate the effects of video game training in older healthy adults compared to younger adults. They concluded that video game cognitive training has pos- itive effects in older adults, with age and number of sessions being significant in modifying the effect size of the training program. Finally, as aforementioned, certain personal factors like motivation to play or level of fun experienced are modifiable variables that can explain the inconsistency of results [159, 8].

In summary, it is not clear whether game-based brain training programs can improve cognitive abilities in all populations. Recent studies have rejected this hypothesis [115, 4], especially when using programs like Lumosity, which claim that playing 15 minutes 3 days a week we can improve our attention or WM. However, it seems more evident that certain entertainment video games (especially action games) can improve certain aspects of our cognition like visuo- spatial attention [110, 43]. Results like the ones achieved by the game Neuro-

Racer [7] or by Cohen, Green and Bavelier [43] encourage the idea that it de-

pends on the game itself whether it can improve specific cognitive skills. On top of this, other studies point out the effect that subjective factors like motivation can modulate the effects of these games on our cognition [159, 8].