 Can video games be good for your brain? A team of scientists has been developing video games that are supposed to improve your cognitive function to the point that they could potentially support treatment for diseases like ADHD, depression, or Alzheimer's. In fact, they think these games could be prescribed in the very near future and create an entirely new category of digital medicine. Is this the next level of video games? This is Neuroscape. It's a lab at the University of California, San Francisco, and it's where I spent the better part of a day playing games that could someday be prescription video games. Led by neuroscientist Adam Guzzali, the team at Neuroscape is entirely focused on developing and testing games that are designed, in some way, to impact brain function. Neuroscape's main focus is on all things related to attention, either selective attention or our ability to sustain it or to switch our attention between multiple tasks. And these abilities decline as we get older. Many different clinical populations like ADHD and depression have challenges with them, and we don't really have any strong drugs that actually work well without side effects. And so the idea was if we can build a new type of treatment that doesn't rely on molecules but rather creates an experience, a very powerful, targeted, personal experience that challenges your brain and optimizes how it functions. Guzzali has also co-founded a Boston-based company called Akili, and it's Akili that is trying to push these games through the FDA approval process, and in doing so, could create an entirely new category of digital medicine. But let's talk about the games themselves. What was that thing that just ran up on the screen? Good. That was a... Some type of gourd thing. Good. There you go. The first game I tried was called Body Brain Trainer, or BBT. The idea is to use your body to physically select the digital objects that the game is pointing you towards. So if the game shows you a pepper, you're supposed to move your hands to a corresponding pepper on the screen. The hypothesis of BBT is that if we challenge you cognitively and physically at the same time, your cognitive benefits will be greater than if you played BBT on an iPad, let's say. Veggie. No, no. So you got the interference there, you went for the collar. Exactly. What is it? So the interference means what? It's called a stupor fact. It means that you're trying to use one piece of information, but you're using the other. Just happened there again. Exactly. And how does that improve over time? The goal is that you learn how to process that interference more rapidly as you train. The other game I tried at Neuroscape was this labyrinth game, which is still in development. It's a virtual city game, and you see stuff in it like a Starbucks or a Chase Bank. But at each level, the city changes slightly, testing your ability to navigate a new environment. The goal with this game, according to Peter Ways, is to put demands on the part of your brain's memory system that is destroyed in Alzheimer-type dementias. In your mind, you're laying down a grid of what the town is, and it's that process that is creating connections in the brain that we want to stimulate to keep those cells healthy. I'll be honest, I tried to skip a level in this game and felt pretty disoriented and not a little bit nauseous. But it is still in beta. Neuroscape also has developed a rhythm game for iPad, one that's being used in the study of older adults to see if becoming rhythmically superior helps you in other areas of brain function, as well as a VR application that lets you watch neurons fire inside a person's brain. In this case, Ghazali's own brain. One of Neuroscape's most well-known games is called NeuroRacer, and it's this core technology that's been licensed to Akili, that company I mentioned earlier. Akili has turned this into a game called Project EVO, which the company hopes will be part of a prescribed treatment for children with ADHD. The game is currently in phase 3 clinical trials. The work that Neuroscape is doing is obviously cutting edge and extremely creative in the scientific world and very innovative. What Akili does is we find that fantastic research and we vet it, we partner with the neuroscientists in a very close way to license and build further what they've created and bring those products through great clinical validation to market as prescribed FDA-acquired products that from a parent to a patient to a doctor are undeniably medicine. So you might be thinking at this point, I've heard of these brain games before, and you're probably thinking of games like Lumosity or Brain HQ or CogniFit, which have all claimed to do some variation of the same thing, boost your cognitive abilities. These kinds of brain training games have actually been pretty controversial. Some scientists have argued that there is no compelling scientific evidence to date that training your brain on one type of task can help it with other tasks. In fact, a group of more than 70 scientists and cognitive psychologists argued this in an open letter signed back in 2014. Other scientists say there's a substantial and growing body of evidence that shows certain cognitive training regimens can significantly improve cognitive function. The U.S. Federal Trade Commission has even gotten involved. In 2015, the FTC barred a company called Focus Education from making unsubstantiated claims around its games for kids. And in 2016, the creators of Lumosity ended up having to pay a $2 million fine for deceptive advertising. But those games differ from what Akili is trying to do. They're not FDA approved for one. Akili, on the other hand, is taking the research from Neuroscape and other scientists and attempting to validate their games. Ghazali says Neuroscape games are also increasingly designed to include both cognitive challenges and physical movement, which is different from sitting and staring at a screen. This idea of brain training has been somewhat controversial when it comes to the efficacy of teaching a person one cognitive task and expecting it to improve cognitive activities in another area. Do you consider your work to be brain training? We don't really call it that so much anymore. The term brain training has become complicated because it's been used by a lot of companies that have what I think of as like gamified exercises that are often not validated. A lot of what we do we think of as digital medicine. The challenges with the field really arise because of two problems, in my view. One is that a lot of the games that are used are not games as we tend to think of them in the entertainment world. I believe that deep engagement, immersion continuously in these activities and these experiences is what's required to really have that impact. It would be like if you went to the gym and superficially worked out for 15 minutes a day, it wouldn't really lead to a change in your physical health. The other challenge is the scientific validation. It's either often not done or not done in a well-controlled way. The goal is to have double-blinded randomized placebo-control trials just like we do with medical devices or drugs and really reach the highest level of empirical evidence so that regulatory agencies are satisfied and practitioners also believe that what they are using is going to have an impact. Akili executives agree that it's at least partly a matter of needing to gather more evidence in order to show exactly how the brain is being impacted. The evidence hasn't been clearly shown yet and that's a huge part of what we're trying to do here. We all believe very strongly that that is fully true and it's just a matter of having the data out there to show it definitively. Hence us going through very long, very expensive, rigorous clinical trials to do this right. It's very hard to do to really prove things crystal clear, but that's our mission. That's what we want to do. Akili says that Project EVO could be submitted for FDA approval as soon as next year, but there could still be a long way to go before it becomes software is medicine. Another question is how the game will be categorized once it's prescription. It's not exactly a medical mobile app as the category exists right now, but it's not your standard drug or medical device either. But regardless of whether that happens, games like this one and the ones developed in the Neuroscape lab could be used as biomarkers for future clinical trials. All of which can help us better understand the human brain, if not unlock its mysteries entirely. Do you see a brain? Yep. Oh no, I don't see, I see a health and safety warning. Okay, I think that's on just a couple seconds. I don't know what that says about your brain, but I do see a health and safety warning. I think that's just an oculist fault. Now I'm in your brain. Yeah, I'm flying you in now. So it's pretty, pretty nice in there, right?