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Vital Signs with Dr. Sanjay Gupta
Possible Health Benefits of Video Game Playing Examined. Aired 2:30-3p ET
Aired April 15, 2017 - 14:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
[14:31:00] DR. SANJAY GUPTA, CNN CHIEF MEDICAL CORRESPONDENT: Video games provide us with an escape from the real world, an alternative reality where we can have some fun, work our aggressions, and learn something new.
Welcome to VITAL SIGNS. I'm Dr. Sanjay Gupta.
Video games look very different from the day Pong came on the scene in 1972. The 80s brought us Tetris, a game where blocks of different shapes fall from the sky faster and faster and faster. Then came perhaps the best known face in video gaming, Super Mario.
But nowadays it's not all fun and games. Researchers are coming to realize there's a largely unlocked potential for video games to train our brains to be stronger, faster, better. Kathy Lasky is in great shape for 71, 71-and-a-half, she likes to say. Kathy eats right, exercises, and gets plenty of sleep.
And you're still working?
KATHY LASKY, DOUBLE DECISION PLAYER: Yes, 37 years the same job, pharmacy technician. I tried to retire four years ago, and after a few months I just wasn't for me.
GUPTA: What happened?
LASKY: Daytime TV gets very old.
GUPTA: Physically Kathy was feeling great, but mentally she was starting to get a bit foggy.
LASKY: So I got the catalogue from the school district, continuing ed. I read about brain fitness, and it said to sharpen your skills, your cognitive skills, improve your memory, and everything that an adult needs in their later years, and no computer skills required. I thought, I'm in. That's perfect for me.
LASKY: Sold, yes.
GUPTA: For the last 12 semesters, Kathy has been coming here to San Diego Community College almost religiously to play video games. Participants in the recent active study, that's Advanced Cognitive Training for Independent and Vital Elderly, took part in ten one-hour speed training sessions over the course of five weeks. They played games like Double Decision. A decade later, they were found to have a 33 percent lower risk of developing dementia, and patients who received additional booster sessions saw that risk drop by 48 percent.
I think what this Double Decision game has taught us more than anything else is that the speed of processing may be as important if not more important than memory or reasoning itself. If you want to reduce your rates of developing dementia later on, focus on speed.
There's a lot of research going on in terms of preventing or decreasing the risk of dementia, various medications people can take. How do you sort of balance this idea that I can may take a pill that's a cognitive enhancer or may decrease my risk of dementia versus up to nine hours a week of sort of brain training?
LASKY: I am a pharmacy technician and well aware of what's available, and I have seen results good, but this is so much better. All medication, as you know, has side effects, and I don't want something preventative. I want to be proactive about it all.
GUPTA: The concept at play here is known as neuroplasticity. It's this idea that your brain can form new neural connections to prevent future problems or even to make up for ones that are lost due to a brain injury like a concussion or a disease like Alzheimer's.
You're going to keep doing this?
GUPTA: Until when?
LASKY: I'll never stop as long. As I can get to class, pencil it right in with everything else.
GUPTA: This is a whole new way of thinking about video games, which is no surprise considering how much they changed over the last few years.
[14:35:07] But what will the future of scientific gaming look like? At the Cognitive Neuroscience Research Lab at the University of California, San Francisco, Dr. Adam Gazzaley is working to figure that out.
This is a nice activity. What sort of things in the brain or behaviors could you potentially address using games like this?
DR. ADAM GAZZALEY, UNIVERSITY OF CALIFORNIA, SAN FRANCISCO: I think it's incredibly broad the different type of brain systems that you'll be able to improve. Our center over here really focuses on attention processes, how we direct our limited resources where and when we want them. And we know that when these abilities decline, you see all sorts of conditions arise from ADHD to depression, autism, even things like Alzheimer's.
GUPTA: Adam and his team are building video games from scratch with some pretty lofty goals. The trick is figuring out what the video games should look like and how they should work in order to challenge the brain in just the right way. To do that Adam and his team needed to improve on standard EEG and MRI imaging techniques. They wanted to paint a better picture of what was happening inside someone's brain not just right after they played a video game but even as they were playing the video game.
GAZZALEY: What makes the Glass Brain so exciting is that it's not just MRI. We could overlay on top of it these type of signals. So what you're looking at here now represented by different colors are frequencies, electrical activity in the brain captured in real-time, in our case, while I was playing a video game.
GUPTA: Ahead on "Vital Signs," we're going to go live inside A.J. Delgado's brain as he breaks a sweat, challenging his body but also his brain to level up. You're looking at what could very well be the future of medicine, but keep in mind, it's also a sport.
UNIDENTIFIED MALE: You're live here for the main event.
UNIDENTIFIED MALE: Who will get a shot at the $1 million?
[14:40:23] GUPTA: You think video gaming isn't a sport? Well, this may change and boggle your mind. Take a look at these prize pools. For the Tour de France, about $2.5 million. The super bowl, just north of $7.5 million. The Masters golf tournament and the cricket world cup, $10 million. And for Dota 2 international championship, $20,770,460. It might be the biggest game you've never heard of.
UNIDENTIFIED MALE: He's going to go. It's probably going to be a double.
GUPTA: You've probably never seen a match-up like this before. The game is Dota 2, and this is the international tournament. At stake, a whole lot of cash and bragging world if your team is the best int eh world.
These are The Evil Geniuses. Last year, they took home first place and more than $6.5 million. EG's most seasoned player is Clinton Loomis, known better by his gamer name, Fear.
How did you get into gaming in the first place?
CLINTON "FEAR" LOOMIS, EVIL GENIUSES: I started playing online and just got really hooked to this game, and then eventually out of nowhere some team was like, do you want to win some gear by playing in this tournament? I'm like, yes, sure, that sounds fun, and just slowly progressed into getting paid a little bit.
GUPTA: Just going back to that early time though, what was it about the gaming that attracted you, do you think?
LOOMIS: It was just like, very mentally stimulating, I guess. It could keep my attention for hours, and then you make little mistakes and just want to play a new one to fix those mistakes. So just every game just made you want to play better. So it was very addicting I guess.
GUPTA: That addiction explains why Dota adds more 13 million new players a month. Spending too much time in video gaming's alternative world can lead to some serious real world injuries.
Dr. Levi Harrison is the self-proclaimed and now trademarked e-sports doctor. Dr. Levi is an orthopedic surgeon specializing in hand, wrist, and upper extremity conditions. Gamers seek him out from just down the street in California and from as far from the Middle East.
Who is your most typical patient?
DR. LEVIN HARRISON, "THE GAMERS AND ESPORTS DOCTOR": My most typical patient is a guy between ages of 18 and 24 years old, 24 is really getting up there.
GUPTA: Are there certain types of injuries that are the most common?
HARRISON: Yes. I see a lot of repetitive stress injuries, specifically tendinitis. I also see carpal tunnel.
GUPTA: If somebody came, and I don't take care of these injuries, but if someone came to me and said, look, I'm having a lot of pain from playing these, I would say?
HARRISON: You would say don't play these games as much. I would say, not necessarily. One, after I do the evaluation, I have the gamer, for example, come in with all of their equipment, so we sit here and we go through the full evaluation on what they're doing improperly and what can be corrected. So as I correct those things, then I give them specific exercises for them.
GUPTA: But the problem with extreme gamers, they don't know when enough is enough. China was the first country in the world to declare Internet addiction a clinical disorder in 2008. These teenagers in Beijing can't pull themselves away from the computer. Not to eat, not to sleep, not even to go to school. The documentary "Web Junkie" follows them as parents have them admitted to Internet addiction treatment center in an attempt to break them of their bad habits.
We decided to go see director Tao Ran ourselves. He's a psychologist who established this facility to teach children how to use the Internet responsibly. Tao says he's rescued thousands of addicted teens through a mixture of medicine and psychology. He claims 80 percent of teenagers can recover if their family is engaged in the process, but only half of that if they're going it alone.
[14:45:05] TAO RAN, PSYCHOLOGIST (via translator): The reasons for Internet addiction are the feelings of inferiority, introversion, and poor interpersonal relations. The feeling of inferiority mainly comes from the family, and a child with that feeling has a disgruntled and depressed mood and cannot release it. That's why they turn toward the Internet, to express their mood. Children are likely to stay away from the Internet when the relationships between them and parents are strengthened. GUPTA: Only now looking back can these teens fully appreciate the
depths of their addiction. And 18-year-old Wang used to play from five hours a day to an entire night.
WANG ZHAOYANG, INTERNET ADDICT (via translator): I haven't been to school for two years and gained almost 30 kilograms. I'm always having headaches and getting dizzy.
GUPTA: And 14-year-old Shen also gained a lot weight, started having trouble with eyesight, and tells us he didn't have a lot of energy.
SHEN RUICHENG, INTERNET ADDICT (via translator): I get up and have breakfast. Then I play video games until lunch. After lunch, I take a two hour nap and then I play until 10:00 p.m. After eating some more, I continue to play until 3:00 a.m., then I go to bed.
GUPTA: So here the boys are learning basic life skills like washing clothes and making their beds as well as games to challenge their minds and bodies. They tell us Tao's program has helped their relationships with their families and that when they leave, they're going to spend more time in the real world.
Up next on "Vital Signs," video games like you've never seen them before.
There's no medication to it. This is a game.
UNIDENTIFIED MALE: It's a digital medicine.
[14:50:07] GUPTA: People who play video games actually see more than the rest of us. They make better and faster use of visual input according to a recent Duke University study. What if we could all benefit from this? The goal is for doctors to one day prescribe video games like they would a medicine. Think controllers instead of pills, and this might not be too far off.
Meet A.J. He's a research associate at Adam Ghazali's lab at UCSF. You can see he's healthy as a horse, but Adam's plan is to push A.J.'s brain beyond its limits to give him cognitive abilities that are almost super human.
A.J. SIMON, RESEARCH ASSOCIATE, UCSF COGNITIVE NEUROSCIENCE RESEARCH LAB: Basically, I'm just going to be doing what we call a visual search. I'm just going to be looking for a target object among distractors and I'm going to be using physical movements to respond to the correct target.
GUPTA: So this is A.J. playing this game as you can see behind me. He's also all wired up. That's EEG monitoring. Take a look at the game on this screen. But I think more importantly is this over here. This is actually A.J.'s brain as he's playing the game. You see the brain but you also see what's happening inside the brain as a result of that EEG monitoring. What makes the Glass Brain so revolutionary is not just the real-time
3d visualization with a lag time of just 0.2 seconds, but also something known as a feedback loop. That's the ability of the game to use the data streaming out of A.J. to optimize the game engine itself. Too easy, the game gets harder. Too difficult, it lets up a bit.
GAZZALEY: So back here, for example, is an area of the brain that is typically responsible for vision.
GUPTA: So if someone is not seeing as much frequency or activity back there, the game may change in response to that?
GAZZALEY: Exactly. And the rewards are changing the response. And when they do bring that activity to a high level, they get rewarded.
GUPTA: Changing the brain takes time and patience. In 2011, Adam cofounded Akili Interactive to expand his research from a purely academic setting into a clinical one. Eddie Martucci is Akili's CEO.
EDDIE MARTUCCI, CEO, AKILI INTERACTIVE: As a company we formed about four years ago, four-and-a-half years ago now with a vision of creating a new type of medicine, a new type of medical product that could be just as effective and safe as drugs, as traditional medical devices, but operate in an entirely new way so the patient had a very different experience. They almost had fun with the products. So what we did is we combined some really strong neuroscience algorithms and then we build those into action video game interfaces.
GUPTA: The result is Project Evo.
ASHLEY MATEUS, AKILI INTERACTIVE: This is our treatment software we'll have you demo.
GUPTA: Should I be nervous?
MATEUS: I don't think so. It customizes to everyone. So it will adjust to your abilities as you go along.
GUPTA: Much like a pharmaceutical guards the R&D of its medications, we can't even show you the screen of this iPad while I play. The game for now is proprietary, but here are a few screenshots of what I'm seeing.
Another reason secrecy is so important, Akili is running what's known as a randomized, double blind, placebo controlled trial. That means neither the researchers nor the participants know who's getting the placebo and who's getting the real treatment. That's the gold standard when it comes to testing if and how well a medication or therapy works.
So what can we tell here?
MARTUCCI: Sure. So this is just a quick snapshot of a play data. It's collecting at 30 games a second. So every second that you were playing, we were getting 30 snapshots of your data. So we use those for a number of things. We build cognitive profiles out of them, but, importantly, we adapt. So one of the analogies we make is that when we have this richer data, imagine a self-adapting tread mill. So imagine you're on a tread mill and it's not just set at 10 or just at one. Based on your performance and how well your physiology is doing, this is constantly changing over time, so we use the rich data to make sure we're doing that in a very precise way.
GUPTA: So you can't make a diagnosis, but what can you tell me? What sort of insight can I take away from what I just did?
MARTUCCI: The most important in what you just did is we can see your trajectory over time and we can watch how you're able to manage multiple streams of information, and that's actually critical to treatment. It meant that you were able to essentially multitask with lots of incoming information at a relatively high level.
GUPTA: How unique is what you're doing here?
[14:55:00] MARTUCCI: Pretty unique, pretty unique, that neuroscience can stand alone as a new type of medicine and gaming can stand alone for its entertainment quality alone. Combining those two into a new medical product, we think that's pretty novel.
GUPTA: In fact, it's never been done before. Once clinical trials are complete, Akili plans to petition the U.S. Food and Drug Administration to approve its video game as a medical device, at first to treat ADHD but then other illnesses such as Autism, Alzheimer's, Parkinson's disease, anything with a cognitive control center of the brain, the prefrontal cortex, is affected.
In terms of getting approval for this sort of stuff from the FDA, this is a bit of a paradigm shift. How does that work from your perspective when you're trying something new like this? Where do you even begin?
MARTUCCI: That's right. It's a great question. We are a medical device company at the core. We make medical device software and algorithms. But that said, the FDA has never seen or approved a medical device quite like this that on the front end looks like a video game.
GUPTA: Not to sound glib, but do you imagine doctors actually writing a prescription for that sort of thing?
MARTUCCI: That's our hope. What we want is we want for every aspect of the treatment that a patient receives to be just like it is in the drug industry with the exception of what a patient goes home with is actually a phone or tablet.
GUPTA: It's safe to say the makers of Space Invaders, Centipede, Pac- Man, never saw this coming, a future where video games could be used to treat what ails us. And that future is now. We put so much emphasis on exercise and the importance of keeping our bodies healthy as we age. But what good is a healthy body without a sharp mind to go with it? Happy, safe gaming.
For VITAL SIGNS, I'm Dr. Sanjay Gupta. Thanks for watching. (COMMERCIAL BREAK)