Daily dose of game-like online exercises reverse 10 years of brain aging

A brain exercise a day might keep you current—it might even revive your brain chemistry. In a landmark clinical trial led by McGill University, researchers discovered that ten weeks of brain training rehabilitation tuned a critical brain network involved in attention, memory, and decision-making to the capacities of a subject ten years younger.

As people age, the brain's cholinergic system—a system that is dependent on the neurotransmitter acetylcholine—slows down with age. This deterioration is a principal reason why older individuals have trouble concentrating and working memory. It also plays a major role in neurodegenerative disease such as Alzheimer's.

Medications that are intended to increase levels of acetylcholine do exist, but they can only augment the availability of the chemical, not the original connections that deliver and accept it. The new research approached the challenge entirely differently: retracing the brain to redo its own wiring through computer-based mental exercises.

The experiment, titled INHANCE (Improving Neurological Health in Aging through Neuroplasticity-based Computerized Exercise), enrolled 92 healthy adults aged 65 to 83. Participants were equally divided into two groups. One group exercised daily with BrainHQ, an internet-based treatment that has been developed by Posit Science, while the control group played regular computer games for entertainment.

Volunteers contributed 30 minutes per day, every day of the week, to their assigned task for ten weeks. Before and after the program, scientists at The Neuro—Montreal Neurological Institute-Hospital—ran advanced brain scans using positron emission tomography (PET) with a specific tracer, [18F]FEOBV, that captures cholinergic activity.

The primary region of interest was the anterior cingulate cortex, an area of the brain that is linked with attention, concentration, and control over the mind. Participants also received standardized testing of cognition to evaluate thinking, memory, and reaction time.

After training, improvements were observed in cholinergic activity within the BrainHQ group alone, as indicated by the scans demonstrating a rekindling of brain chemistry roughly equivalent to ten years of restored aging.

"This is the first time any intervention—drug or non-drug—has been demonstrated to do that in humans," said senior author Dr. Etienne de Villers-Sidani, associate professor of neurology and neurosurgery at McGill and a neurologist at The Neuro.

The findings show the first biological mechanism by which some forms of brain training reduce the risk of dementia and enhance thinking. In contrast, the control participants did not enhance any of their cholinergic function and, as a result, casual computer use or popular gaming doesn't seem to do the same thing.

BrainHQ training isn't the usual crossword or word game. It provides adaptive, speed-based exercises that test your attention and processing capacity to the maximum. As abilities get better, the software automatically ups the level of difficulty in order to keep the brain working harder.

"Many people think that crossword puzzles or reading is sufficient to keep the brain sharp," de Villers-Sidani said. "But not all activities really enhance neuroplasticity.

With time, such consistent challenge may enhance new pathways in cholinergic circuits to rewire the brain. The scientists believe such targeted stimulation encourages neurons to reconstruct communication pathways, reinstating chemical signaling rather than merely retarding decline.

The Neuro is also among a handful of centers worldwide that can produce and utilize the specialized tracer needed for cholinergic imaging. Using the technology, researchers could directly observe alterations in the subjects' brain chemistry rather than relying solely on behavioral tests.

The researchers also concluded that performance on a quick computer test called "Double Decision" was associated with PET scan result, suggesting a simple thinking test could someday be employed as a simple means of assessing brain chemical health.

Though the research was conducted with healthy older people, researchers are already planning follow-up tests in people with early-stage dementia or mild cognitive impairment. They want to know whether such recovery in the brain is possible even in those who already have memory loss.

Subsequent studies will look at how long-lasting the effects are, whether exercise or diet can be added to training for extra benefit, and what other areas of the brain besides the anterior cingulate would be most benefited.

The study was conducted independently by the researchers at McGill in collaboration with Posit Science, who provided them with access to the BrainHQ platform. It was funded by the National Institute on Aging at the U.S. National Institutes of Health.

For older adults seeking ways to keep sharp minds, this study has some positive news. To it, specific, instructed brain training—specifically, not casual puzzles or video games—can potentially undo cognitive aging's biological markers.

If the results hold up in larger, longer-duration trials, this kind of training could become a powerful tool to slow, or even prevent, dementia. Unlike drugs that have a temporary impact on neurotransmitters, training might lead to the brain rebuilding the systems themselves.

As BrainHQ is already available and can be employed at home, it could offer doctors a new, low-risk option to suggest to patients who wish to maintain brain function.

The ultimate hope is that by constructing the chemical pillars of the brain with neuroplasticity, people can extend the age of their mental energy well into old age.

Research findings are available online in the journal JMIR Serious Games.

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