Playing your Meds: Video Games as Neuroplasticity-based Mental Illness Treatment
Imagine a world where, instead of needing to take your medication as pills, you play thirty minutes of prescribed video games. Wait. Stop imagining, because this world already exists.
Certainly, a video game would not come to your mind when you think of medicine, but for one UCSF professor, Dr. Gazzaley, it did. Adam Gazzaley MD, PhD is a neuroscientist and physician leading Neuroscape Lab, one of the West Coast’s largest neuroscience research centres. He’s also a personal hero of mine, and while I’d genuinely love nothing more than to write a biography on his life, it is his research that fascinates the most.
Through combining the power of game systems with our brain’s incredible malleability, Dr. Gazzaley has created the world’s first FDA-approved prescription medication for ADHD. This “playable medicine” is just the very beginning of what may transform our current conventional approach to mental health disorders.
Defining the Neuroplastic Brain
When a blind man regains sight, when a woman born with half a brain learns to function perfectly normally, when children with cerebral palsy begin skipping gracefully, who you gonna call? Not Ghostbusters. Neuroplasticity.
Once thought to have been utterly unchangeable since birth, the brain is actually a highly malleable network of interconnected neurons that can be strengthened, wired, or rewired in almost every imaginable way. These changes in neural connection give the meaning of neuroplasticity.
A fascinating example of neuroplasticity at work in the real world involves taxi cab drivers in London. To become a taxi driver, one must take “The Knowledge,” a formidable exam that involves memorizing London’s 25,000+ streets, landmarks and business locations.
A McGill University study in 2000 demonstrated that the hippocampi of taxi drivers, a brain structure involved in visual-spatial processing and memory, were “significantly larger relative to those who did not drive taxis.” These findings, which were since replicated numerous times, provided significant evidence supporting neuroplasticity.
However, this concept remained primarily confined within the scientific community until the publication of Norman Doidge’s insanely popular book, The Brain that Changes Itself. The book, which significantly helped popularize the concept of neuroplasticity, details fascinating case studies of “miraculous recoveries” made possible through the power of the neuroplastic brain. Some include a man who single-handedly cured his blindness through meditation, or a patient who managed to reverse all his symptoms of Parkinson’s using neuroplasticity techniques.
Scientists largely viewed such recoveries as impossible in the past, but neuroplasticity definitively establishes that the brain is not an unchangeable, immovable block you’re cursed to live with since birth. Rather, changing habits and experiences have the potential to change your brain. Remember:
“Neurons that fire together, wire together” — Dr. Donald Hebb, in The Organization of Behavior
Application in ADHD Medicine
ADHD meds have side effects. Antidepressants have side effects. All medications have side effects, but have you ever wondered why?
Drug-based medicine targets chemicals in the brain, known as neurotransmitters. These chemicals work together in incredibly complex ways to keep our body functioning and are involved in practically every body function. Whether its memory, arousal, muscle movement, mood, or the “runner’s high,” neurotransmitters play a part in it all. And this is where the problem arises.
Certain neurotransmitters are so complex because they’re not involved in just one process, but many. For example, serotonin deficiency is associated with depression. However, serotonin doesn’t only regulate mood but also affects appetite, sleep, memory, learning, and sexual arousal.
Therefore, when you take antidepressants designed to raise serotonin levels in the brain, these other functions are impacted as well, leading to weight gain, problems sleeping, confusion, and low sex drive. Current drug-based medication is not “selective” enough to pick and choose which functions to affect and leave alone.
When you pick up one end of the stick, you pick up the other.
Well, that’s frustrating. Medication for mental illness is essential, so do we have to live with the side effects forever?
Not quite. This is where neuroplasticity can offer a solution. Rather than messing with neurotransmitter levels so that the pros outweigh the cons, neuroplasticity-based medicine will nudge neurons to form new synaptic connections that can take over functions unable to be performed due to an imbalance in neurotransmitter levels. Put simply, it encourages the brain to fix itself.
And we know neuroplasticity will come through for us, because it’s already been done.
Video Games as ADHD Treatment
Enter EndeavorRx: It’s fun, it’s challenging, it’s… an FDA-approved prescription treatment? That’s right! Just three months ago, on June 15, Dr. Gazzaley and his company Akili Interactive announced that their video game had become the world’s first ever FDA-approved digital treatment.
The game has gone through a rigorous testing process involving five clinical studies of over 600 children with ADHD. Akili Interactive’s results demonstrated that “After four weeks of EndeavorRx treatment, one-third of children no longer had a measurable attention deficit on at least one measure of objective attention. Further, about half of parents saw a clinically meaningful change in their child’s day-to-day impairments after one month of treatment with EndeavorRx; this increased to 68% after the second month of treatment. Improvements in ADHD impairments following a month of treatment with EndeavorRx were maintained for up to a month.”
Currently, there have been no severe side effects reported with the use of EndeavorRx. Non-serious side effects included frustration and dizziness, which were experienced by 9.3% of study participants. Although the video game has been proven to yield substantial improvements in children diagnosed with ADHD, it is important to emphasize that at its current state, EndeavorRx is not meant to replace drug-based medications but rather supplement them.
Though this video game treatment is the first of its kind, the beauty of EndeavorRx is that it is non-invasive yet backed by clear evidence and proven to be effective. Not only does it combat ADHD symptoms, but EndeavorRx also paves a vital road to the development of more digital therapies that can help all people living with cognitive conditions.
“The clearance of EndeavorRx marks the culmination of nearly a decade of research and development and was fueled by the commitment of our team and collaborators to challenge the status quo of medicine.” — Scott Kellogg, Senior VP of Medical Devices at Akili Interactive.
The Future of Mental Illness Treatment
ADHD isn’t the only mental condition that we can target with digital therapy. As we’ve mentioned earlier, drug-based treatment for major depressive disorder comes with a host of side effects, demonstrating a real, pressing need for new neuroplasticity-based treatment. This applies to not just depression, but schizophrenia, bipolar disorder, OCD, anxiety, and so much more.
As researchers enthusiastically conduct studies to discover more and more about our neuroplastic brains, it becomes exceedingly clear that our status quo of suffering through side effects doesn’t have to remain this way. In the future, it is more than likely that emerging technology and medicine will converge to transform healthcare as we know it. New frontiers in medicine and neuroscience will result in unconventional yet compelling treatments, allowing those affected by mental illness to lead secure, healthy lives.
After all, it’s already happening.
Learn More:
