Focusing senior minds

lifestyle August 02, 2016 01:00

By PARINYAPORN PAJEE
THE NATION

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An award-winning neurofeedback cognitive training game developed by Chulalongkorn Hospital is helping the elderly stay away from dementia



With Asia's elderly population projected to reach 922.7 million by the middle of this century, |scientists and medical personnel in every field are turning their attention to what can be done to make life easier for them and their carers. 
Mobility is of course one of the problems but perhaps a more pressing one in Thailand is the cognitive decline that comes with ageing, with current statistics suggesting that more than eight per cent of the over-60s suffer from dementia. 
In an attempt to forestall further decline in cognitive impairment, Chulalongkorn University’s Department of Psychiatry has developed an attention training system that it hopes will help |the elderly stay away from or |at least slows down the symptoms of dementia and Alzheimer’s |disease.
The efficiency of the system was recently evaluated through a clinical trial for healthy elderly and Mild Cognitive Impairment (MCI) patients through a neurofeedback cognitive training game developed by the department in cooperation with the engineering faculty’s Department of Computer Engineering and the National Electronics and Computer Technology Centre (Nectec).
Sasaphin Louharanu, 66, is one of the group taking part in the evaluation. Wearing a mind control headset similar to those used in scientific experiments with 10 or so electrodes attached to her head, she stares at the screen which shows a cute animated bear. The bear stands still when the bar on the bottom left on the screen shines red and starts walking when the bar turns green. She has no joystick or mouse but controls the bear’s movements purely with her mind. 
“If I try to think “walk faster, hurry!” it doesn’t work at all,” she says. “All that happens is that the bear stops moving. You have to clear your mind, pay attention to the character and then the bear 
 will start walking. If you don’t allow yourself to be distracted by anything, then it will work,” says Sasaphin, whose brain sends a signal to the screen via the headset, which is equipped with electroencephalography (EEG) capture, a brain-computer interface (BCI) that allows humans to control external devices by modulating their brain waves.
The control group has been playing the game for 15 minutes, two or three times per week and their attention ability has improved.
Dr Solaphat Hemrungrojn, of Chulalongkorn Hospital’s Cognitive Fitness Centre and the assistant dean for educational innovation and information at the medical faculty, explains that the NFT system comprises six game sets, which have been specially designed for the elderly. They estimate attention levels by investigating the power spectrum of Beta/Alpha wave bands – the brain waves related to attention – through the interaction with the game characters. Once the user focuses on the character, causing a rise in the Beta/Alpha wave, the good wave length will adjust the target object (the bear) and move 
 it according to the attention level.
The result shows on the screen, and this teaches the user how to create a good Beta wave. When this is repeatedly achieved, the user will improve their attention ability and eventually adapt the method for use in daily life.
Sasaphin is pleased with the progress she’s made at the Cognitive Fitness Centre. Unlike others in the group, she only started playing the game around two months ago, and says her memory has improved. 
“All the activities I’ve done at the centre including playing the game have changed my life and made me a happier and more relaxed person. I kept forgetting and misplacing things but the 
 training has helped me to sort things out systematically,” says Sasaphin.
Even though neurofeedback cognitive training has been widely used for years, the game-based NFT is new. Chulalongkorn Hospital is the country’s first centre to apply the training to patients in the mild cognitive impairment and the results have been so significantly successful that the game was awarded the Gold Medal at the International Exhibition of Inventions of Geneva in April.
The principle behind the game is to find the good brain wave related to attention efficiency. Attention is the ability to focus on specific information and maintain that focus for the required amount of time. In order for cognitive thought processes to perform, an individual must be able to pay attention to a particular detail of information and fully absorb the material being learned.
Moreover, the ability of sustained attention potentially leads to enhanced cognitive performance. Attention training provides a promising alternative method to help the elderly suffering from memory loss.
“Unlike medication, which is only effective for a while, this training an directly cure the symptoms. There are no side effects either,” says Dr Solaphat.
She does however caution that so-called attention enhancing games on the market will not have the same benefits as game-based NFT. Indeed, some might even have a detrimental effect on the mind. 
“A game shouldn’t have too many tasks or require speed to accomplish them. A good game for the elderly mustn’t rush them. It should be user friendly game so that it can attract the elderly to keep playing. It will be useless if they are not interested from the word go,” she says. 
Research into the NFT system has proliferated over the years. Most of the studies have focused on improving the subject’s cognitive state of attention, especially in Attention Deficit Hyperactivity Disorder (ADHD) patients. In this regard, the centre has also developed neurofeedback for ADHD.
“And we are very pleased with its success,” Dr Solaphat says.
There are only four game stations at the Cognitive Fitness Centre, which is located on the seventh floor of the hospital’s Sor Thor Building. Dr Solaphat is planning to give another 10 stations to network hospitals in different provinces this month.
Another two game stations for ADHD kids are available at the Child Psychiatry Department on the Por Por Ror Building’s 12th floor. Both places are open to those interested in playing. The fee is about Bt200 for 30 minutes.
Dr Solaphat and her team are working on adding more games and improving the existing ones. One constraint, of course, is cost, as the EEG capture headset costs more than Bt10,000. Her aim, she says, is to reduce it to just a few thousand baht so that the game can be used at home.