Multi-tasking, Chronic Fatigue Syndrome and Fibromyalgia

You might call multitasking the cognitive bane of the chronic fatigue syndrome patient’s world. With their reduced information processing slowing them down, and their lowered working memories not allowing them to retain as much, the last cognitive challenge any person with ME/CFS/FM would enjoy engaging in is multitasking; i.e., trying to effectively manage several tasks at once.

elderly person with video game

Video games seem like just the wrong idea for seniors (and people with ME/CFS/FM) but this study suggests they could provide a boon…

Gudrun Lange, a neuropsychologist who focuses on ME/CFS/FM, simply says don’t multitask – just focus on doing single-tasking better. Johannes Starke’s series of blogs on Health Rising emphasize ways to clear out the mental clutter – leaving room for more organized and calming thought processes. Marco’s blogs about sensory gating and cognitive processes suggest the signal to noise ratio in ME/CFS/FM patients’ minds may just be too low to engage in effective multi-tasking.

People with chronic fatigue syndrome and fibromyalgia, however, are not alone. Seniors, it turns out, display similar types of cognitive issues, and that means that our aging population may end up providing some answers in our search to improve cognition.

One of those answers include, believe it or not, playing video games.

Picture a group of seniors sitting before their computers concentrating on a 3D driving game developed specifically for them by neuroscientists.

What happened next blew more than a few researchers minds and landed this stjudy on the cover of Nature. By the end of the study the worst multitaskers in the world, the seniors, blew the best multitaskers in the world, a bunch of twenty year olds, away. It was no contest.

The Study

First, participants of all ages were given extensive cognitive tests. The researchers found that the ability to multitask declines in a linear fashion as we age (as do, unfortunately, other ‘fluid cognitive’ skills such as reasoning (reasoning!) and working memory.

Then they were asked to play NeuroRacer, a 3D video driving game, that had them speed up, slow down, turn right and left according to signs that appeared. The game, which was years in the making, was specifically designed by neuroscientists to impact the kinds of cognitive deficits they had.

memory loss

The ‘working memory’ loss seen before the seniors did the video game disappeared after – as they out-gamed a bunch of 20 year olds

A month and 12 hours of gaming later, the seniors returned to the lab. They repeated the game while hooked up to an EEG. Not only were the seniors better at the multitasking skills they’d practiced with the NeuroRacer game, but their working memory capacity (the ability to retain information for a short period of time), and their sustained attention (the ability to focus on one task over a period of time) improved significantly, as well. This kind of carryover where improvement in one cognitive skill carried over to another had not been seen before.

“What’s most novel here is other abilities that were not directly trained, such as sustained attention, which is vigilance, and working memory, their ability to hold on to something for a short period of time, also improved,” Adam Gazzaley – lead researcher

Remarkably, after six months of no gaming the seniors still retained many of their cognitive gains. Then when the seniors and 20 years were tested on the same game, the seniors blew the 20 year olds away; not only were they faster but they were more accurate. The seniors had the advantage of playing the game before, but their ability to beat 20 year olds well acquainted with gaming was astonishing.

The researchers pointed out that these gains were not because the seniors were simply processing information more rapidly (another problem in ME/CFS), but in fact reflected gains in distinct areas of cognition.

The How of It

The question then became what was happening to float these seniors’ cognitive boats, so to speak, all at one time.

The introduction of signs that popped during the driving process requiring the seniors to multitask turned out to be a key to the multidimensional progress made. In effect, it was only by forcing (in a fun way) the seniors to engage in a more complex cognitive challenge that they saw really significant benefits. (The authors noted how different their 3D ‘immersive’ (and fun) video game was from the sparse environments used in the dual task (as opposed to multitask) training studies done before this.

Revving Up Brain Skills – an Introduction to NeuroRacer

An EEG suggested that deactivation of medial prefrontal cortex activity played a critical role in reducing ‘internal distractibility’ and allowing for better task performance.

Medicine for the Mind?

”I think … the careful validation that it actually works in the way you hope it does are essential ingredients in really thinking of this type of interactive media as medicine, which I hope is what we will see happen over this next decade.”


Neural plasticity turned out to the be the key as immersion in an ‘interference-rich’ video game allowed seniors to get back up to speed

One of the strategies seniors adopt to adapt to their declining cognitive powers is slowing down when they need to evaluate information – something that seems to doom them with a video game that requires quick responses. One can imagine seniors (and ME/CFS/FM patients) taking one look at fast moving video game and turning away.

It turned out, though, that the right type of ‘interference-rich’ video was exactly what was needed. They simply had to be exposed to a cognitive challenge that seemed on the face of it a bad idea. Seniors’ brains (and perhaps ME/CFS/FM patients’ brains) still retained enough plasticity to learn how to respond very quickly once again. (By the time the study was over several seniors were upset they had to stop playing the game.)

The Future

“Our motto is better science, better games”

Is NeuroRacer coming to your local doctor’s office or video store soon? The game is not commercially available – yet. The lead researcher, Adam Gazzaley, co-founded a company, Akili Interactive Labs, including neuroscientists and professional gamers, to produce a game called Project Evo for iOS phones and tablets. Currently in clinical trials for cognitive disorders ranging from ADHD to autism spectrum disorder to depression, Gazzaley is hoping Project Evo becomes the first FDA approved video game in a couple of years.

seniors playing video games

Will seniors (and people with ME/CFS/FM) be playing video games to improve their cognition in the near future?

Despite other commercial labs assertions that their video games improve cognition, NeuroRacer is the first to be tested in a clinical setting, and it’s not clear how effective the other games are. With the NeuroRacer study and its startling findings making the cover of Nature, and then being featured in numerous media outlets, expect more groups to step into the ‘video game as medical device’ arena.

“The sustained multitasking cost reduction over time … provide(s) optimism for the use of an adaptive, interference-rich, video game approach as a therapeutic tool for the diverse populations that suffer from cognitive control deficits (for example, attention deficit hyperactivity disorder (ADHD), depression, dementia).”

The company envisions developing a series of games specifically targeting these disorders.


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