Any game developer sooner or later has the experience of mentioning what they do to an acquaintance or relative, and is treated to a diatribe about video games as the cause of everything from teen violence to increased isolation and mental aberration. There are studies of dubious validity that they may cite, if they even bother to go beyond the “everyone knows that” premise. But what is the reality, and is there a way to both counter these claims, and perhaps harness the power of brain imaging to make games that are more effective in their intended aim, be that health, learning, or simply fun?
Happily, the truth is that there are many games that are having strong positive effects on people’s mental health, documented by neuroscientists with a lot more credibility than your average radio or TV commentator. The initial overlap between these scientists and game developers is in the Games for Health field, but that’s an artifact of the relative novelty of the collaboration. Just look at the trickle of scientific research starting to be published that goes beyond conjecture into actual brain scans of individuals playing games and you will see all sorts of applications to game play. It’s clear that an alliance between neuroscientists and game developers is increasingly helping both parties, and the eventual result will be games that rely on what will become a flood of data about what happens in the brain of a gamer during play. In the hope of inspiring other designers to experiment with this emerging field and find inspiration, and to provide some concrete examples of games clearly benefiting players, I offer this brief survey based on my own direct experience.
Mihaly Csikszentmihalyi
It’s no surprise that many game designers are avidly curious about how the brain works. It’s hard to be a serious designer and not wonder what is going on in those hundred billion neurons when immersed in a game. Many of my fellow designers are up on the latest brain research, reading books by evolutionary biologists like Steven Pinker’s “How the Mind Works”, psychologists like Mihaly Csikszentmihalyi’s “Flow” or Neuropsychiatrists like Richard Restak’s “The Brain”. Scott Kim, a well known game designer, has even co-written a book with Restak. I have to content myself with merely trying to master the correct pronunciation of Csikszentmihalyi! Increasingly there are many opportunities to work with neuroscientists, and the fields of game design and neuroscience are starting to sprout connections faster than neurons in the brain of an Angry Birds player. 
East3 Trainer Prototype
My own first direct experience with true neuroscientists was in 1999 with Dr. Alan Pope, a psychophysiology researcher at NASA who learned that biofeedback could be used to train people to be more attentive - an area of study that has had ongoing developments. He was working on the problem of pilots and astronauts on long missions becoming inattentive, and then suddenly having to deal with a crisis (think Apollo 13). It turned out that people in an attentive state of mind had a particular ratio of theta to beta waves in their brains. Neurofeedback techniques have long been available to let people learn how to train their brains to moderate brain waves. So Dr. Pope tried training children with ADD (Attention Deficit Disorder) to emulate the ratio of brain waves, and found that it was not only possible, but was correlated with an increase in the ability to pay attention that worked even better than the drug Ritalin, with no apparent side effects. The only catch was that it was expensive to put kids through the procedure, which required a good brain wave monitor then found only in labs, and dozens of hours of training. A short-lived game company of the time called East3 was working on a consumer-priced brain wave monitor and games to make the training process fun and exciting. Unfortunately, a crooked CFO and the subsequent collapse in the dot-com market all but eliminated that venture. But it confirmed that there are clear emotional, medical and financial benefits of actually being able to help people deal with challenging brain conditions through gameplay.
Dr. Cynthia Phelps
In the last decade, the growth of interactive titles with medical ties has found a home in the Games for Health movement, with an organization http://www.gamesforhealth.org and annual conferences in both the US and Europe. At the first Games for Health conference I met Cynthia Phelps, PhD, who is currently CEO of HEALHeDesigns LLC. Cynthia got into games through her post-doctoral work in electrophysiology, on a project studying memory by listening in on nerve cells communicating with each other. She began designing web-based adventure games in 1997 to teach kids the science behind drugs. Says Cynthia, “It was intuitive to me that games are a powerful way to learn. When I began to explore learning theory and research, I realized that games held many of the same mechanics of excellent instructional design, such as motivation, focus of attention, practice and repetition, pattern recognition, exploration, and more.” The concept of Games for Health has struck a chord with many individuals and companies, and recently things have been heating up even more. A few years ago saw the rise of companies like Neurosky http://neurosky.com and Emotiv http://emotiv.com creating brain wave monitors cheap enough for consumers to afford. Simultaneously, the rise of interest in serious games in general, and games for health in particular started bringing more attention (there’s that concept again) to how games themselves could affect the brain in positive ways. In the last few years the presence of consumer priced brain wave monitors has been just one of several factors simultaneously (dare I say?) coming to a head. In addition we’ve seen much more attention paid to games as contributors to health, with the serious games movement and dozens of conferences focusing on the use of games to treat psychological disorders, train physicians and other caregivers, serve as fun exercise solutions, and educate and inform the public in many ways. We’ve also seen increasing use of professional brain imaging in hospitals and research institutions used to study what goes on in the brain when someone plays a game. 
Dr. Adam Gazzaley
A recent example of that is the work of Dr. Adam Gazzaley, Director of the Neuroscience Imaging Center at UCSF. He has been working with a group of game developers, initially to create a simple racing game designed to be played by someone during brain imaging through EEG, fMRI, or eventually both at once. This is a great mutual win for both scientists and game developers. The neuroscientists get a much more engaging test than the usual “keep this crosshair centered” task common to research, which means the subjects are much more likely to stay on task for the hours it may take to complete it. And game developers get an exciting glimpse into what is really going on in someone’s brain as they play. The process of designing this game was fascinating - many tricks of the trade from a traditional game design point of view had to be avoided in order to minimize interference with the brain imaging, which was intended to see how the subject’s brain reacts to distraction from a critical task. For example, flashing lights are effective at catching a player’s attention, and for that very reason they needed to be dropped lest they spike the brain activity and make it difficult to read what was going on with the primary focus of the test. Similarly, all music and sound effects were excluded as they would light up other regions of the brain and likewise interfere with the main focus. Many other aspects of the game had to be controlled carefully to make sure that the data from the tests were consistent over all users. Following the successful experiment with this research game, Dr. Gazzaley has been involved as a co-founding advisor to a new company, Akili Interactive Labs (ww.akiliinteractive.com), aiming to translate neuroscience research into the hands of real users – by including all of the elements necessary to make truly immersive therapeutic games that would be used by patients outside the lab. “I have always been passionate about doing impactful translational research outside the walls of my lab, and this new venture presents a great opportunity to get closer to reaching patients in the most effective way,” said Dr. Gazzaley. Akili was founded by PureTech Ventures, a Boston life-science group, in collaboration with cognitive scientists and technology thought-leaders (including myself as an Advisor). 
Shenly Glenn
Another neuroscience researcher with game projects in the works and UCSF connections is Shenly Glenn, co-founder of Neurovue. She worked at UCSF’s Memory and Aging Center, living with people “whose morality, personalities and sexual practices changed so radically in mid-life (due to various neurological conditions) that they fundamentally became different people.” Shenly is currently developing some games based on published scientific research. She has some intriguing observations about the social brain. “Scientists typically study brains in isolation, but human brains function in networks,” says Shenly. “It is rare--and is often a sign of distress--when a brain is isolated. Technologies of the last decade have leveraged our sociability and have provided a convenient avenue for investigation. A recent study shows a strong correlation between the grey matter volume in the orbital prefrontal cortex and the number of close friendships a person sustains on Facebook. I see the social brain benefiting and feeding the love affair between games and neuroscience for a long time to come. As I type, multiple gaming initiatives are already underfoot to help iron-out the social deficits found in autism spectrum disorders” The confluence of autism, video games, and brain research is a fertile area of discussion these days. It has long been noted that there seem to be a lot of computer programmers who have some degree of Aspergers Syndrome, on the milder end of the Autistic Spectrum Disorder. Some characteristics of Aspergers could easily be ascribed to the population of software engineers, such as predominately male, obsessively focused on details, and being more comfortable with computers than with people. Bill Gates himself is regularly noted to have traits that are often associated with Aspergers. Several of the programmers I’ve worked with in my career - often some of the most effective ones - have been diagnosed with Aspergers Syndrome.
Dr. Maureen Noel Dunne
Dr. Maureen Dunne has done research and worked with many people with Autism. Like numerous others I’ve met in this field she is very down-to-earth and unpretentious, despite a stunning collection of degrees (she is a Rhodes Scholar with an education from University of Chicago, London School of Economics, Harvard, and Oxford). At Oxford she researched visual and verbal thinking, and developed mental rotation, selective attention and working memory games. She is currently leading several initiatives blending games and neuroscience, including one to help train people with Asperger syndrome in on-the-job skills they can use to find work. That project involves a game that includes practice in recognizing the emotional significance of facial expressions that can be challenging for people with Aspergers. Dr. Dunne’s work with games goes beyond that though, she is CEO and founder of UQ Life, a new San Francisco based startup that hopes to transform education by building the next generation educational platform with proprietary patent-pending personalization technology. Says Dunne, “In some respect, all game designers are applied psychologists whether they have had formal training or not. Game developers are ‘staging experiences’ for their users and are in an enormously powerful position to make a positive impact if they want to.” Looking ForwardTen years ago it seemed we were looking at a games industry that was increasingly focused on huge AAA console titles in a narrow range of genres. Unless one’s sole aim is to be one of a 200-person team working on the 4th FPS in a series, it’s great to see how games have experienced a blossoming into so many new areas, including ties with neuroscience. It can be tremendously encouraging to meet people such as these, and to see that we are at the early stages of a very deep and rich exploration of just what goes on in the brains of game players. And as Maureen says, this also means we can have a positive impact on the lives of others. Not bad for a field that has been often blamed by the media (and even our current President) for having the opposite effect! 
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