Mind games

Academic researchers are turning their work into a game. They’re using video games and cognitive tests to win the ultimate prize: a greater understanding of neurodegenerative diseases.

The convenience of connected devices and the power of play are helping researchers unlock new levels by adapting some tried-and-true tactics of leisure entertainment for serious work.

They’re gamifying dementia research to advance knowledge, treatments and, in the process, awareness for neurocognitive diseases.

“More and more people are using the Internet for all kinds of things—to shop, travel, buy music. Our research needs to take advantage of the new technology,” says Michael Weiner, MD, professor of radiology and biomedical engineering, medicine, psychiatry and neurology at the University of California, San Francisco.

Think of it as gaming for good. They’re using casual games to recruit, retain and engage the masses who can contribute to dementia research while in line at Starbucks, on their lunch break or before bedtime.

A new approach

Michael Hornberger, PhD, loved playing console games as a child. He never connected an entertaining pastime with the work he does today as professor of applied dementia research and head of the department of medicine at the Norwich Medical School and as the Director of Aging Research in the Norfolk & Suffolk Mental Health Trust at the University of East Anglia in Norwich, England.

Over the years, he watched cognitively-impaired patients wander off and saw the stress it put on caregivers and government resources. In his rural community, three people with dementia died of exposure last year.

Hornberger wanted to know if navigation difficulties began before memory problems set in, which could lead to an earlier dementia diagnosis. The problem was, there was no wayfinding test, so no one had studied how healthy people navigated, either. Then, in July 2015, Hornberger attended a workshop about how gaming can help science.

“I had this lightbulb moment that navigation is so integral to lots of video games,” he tells I Advance Senior Care. “I thought, ‘What if we use a game to measure navigation?’”

Hornberger and Hugo Spiers of University College London partnered with Glitchers, a British-based boutique video game developer, to create a mobile game to study wayfinding and establish global benchmarks. Their idea was brought to life in Sea Hero Quest, an immersive journey of an adult son helping his aging father, a fisherman, recover lost memories.

Similarly, Pietro Michelucci, PhD, executive director at the Human Computation Institute to solve problems that can’t be automated and found one in the work of Chris B. Schaffer, associate professor of biomedical engineering at Cornell University. Schaffer and colleagues are exploring the relationship between dementia and reduced blood flow in the brain. They found people with dementia have transient, repeated stalled capillaries in the brain, which is compacted by a buildup of blood cells.

They developed specialized imaging methods to watch black and white video of clogged blood vessels. Their experiments have the potential to offer a new model for Alzheimer’s disease, but data analysis is a painstaking, manual process. It takes trained researchers about a week to collect data from each experiment but an entire year to analyze it.

“In terms of normal research progress, that’s glacial,” Michelucci says. “It’s hard to maintain a research program when you have to wait a year to get every single result because you’re doing research that’s often predicated on the results from your last experiment. So basically, he projected that it would take three to six decades to complete the research leading to a treatment target based on their existing work. Anyone with Alzheimer’s today or anyone who knows someone with Alzheimer’s today doesn’t want to wait 30 to 60 years for a treatment. That’s not viable.”

So Michelucci and the Human Computation Institute developed Stall Catchers, which turns the analytic task of annotating blood vessels into a game. By crowdsourcing analysis to citizen scientists, it is expected to speed up Schaffer’s research by a factor of 30 to just a few years. That means people with early stage Alzheimer’s could see a treatment in their lifetime.

Mass appeal

Gaming taps into the rewards system of the brain. It motivates people to keep playing by embarking on epic quests, battling enemies, earning points and revealing new challenges. It’s also inherently fun. 

Sea Hero Quest resembles a casual game with its high-resolution graphics and immersive storytelling. The look and feel is an intentional way to appeal to players of all backgrounds and abilities. “We didn’t just want the people who wanted to do this because of helping dementia research,” Hornberger says. “We wanted to have people involved in general.”

Traditionally, clinical research has meant filling out surveys or making trips to a physical facility. It’s expensive and time consuming for both researchers and participants. The games allow players to contributed to massive longitudinal studies, become citizen scientists and speed up clinical findings.

“The greatest obstacle to getting effective treatment is simply getting people enrolled in studies,” Weiner says. “We have lots of things to try out, but we need to do the studies.”

Weiner created the online Brain Health Registry more than three years ago to make clinical trials more accessible and convenient. People go online, sign a consent form and answer questions about themselves or a loved one regarding their health, family history, medications, cognition and complete assessments adapted through partnerships with Cogstate, Lumos Labs and MemTrax. More than 50,000 people have opted to enroll, and tens of thousands have returned.

Those people are a pool for other researchers, too. Weiner and his team can refer eligible participants to nearby clinical trials. That reduces the screening and vetting time for external researchers and reduces recruiting efforts. 

“Everybody agrees we need better treatments,” says Weiner, who is the principal investigator of the Brain Health Registry project. “The only way we’re going to get better treatments is to do more research studies to figure out which treatments work and which treatments don’t work.”

The multiplier effect

These games are generating data—lots of data. Researchers are using the unprecedented sample size to delve into the complexities and mysteries of dementia today to create a rich and reliable data set for the future. In the process, these researchers are helping to build an open and collaborative community that will reward everyone with new findings.

Gaming removes much of the data collection and analysis burden for researchers, and it reduces barriers for participants. As a bonus reward, turning research into a game also makes players part of the action. And that might unlock new levels for dementia research. Crowdsourced and citizen science initiatives tap into altruism, a key motivator. Participants feel a sense of purpose in taking up arms and are actively battling the evil monster.

It’s possible citizen scientists can produce lab-quality data even if they only play for five minutes a day so long as enough people partake. The trick, then, is to get people engaged without making it feel like a burden. If anything, it needs to feel fun—uncharted territory for researchers. Early numbers indicate it is possible. Since its launch in late 2016, Sea Hero Quest has been played by more than 2.7 million people, which equates to more than 73 years of game play research, making it the largest dementia study in history. Hornberger says the game is another tool in the clinician’s arsenal. The dataset is helping to set global benchmarks that allow clinicians to data to develop an individualized treatment plan. 

For now, these games are putting the future of dementia research into peoples’ hands.

“It gives caregivers something they can do to actually make a difference,” Michelucci says. “It’s like this game represents hope. It represents an opportunity do something. This is hopefully going to get us somewhere—finally—with this.”


Topics: Alzheimer's/Dementia , Articles , Technology & IT