title: Monitoring the early signs of cognitive decline in elderly by computer games: an MRI study.
abstract: BACKGROUND
  It is anticipated that current and future preventive therapies will likely be more effective in the early stages of dementia, when everyday functioning is not affected. Accordingly the early identification of people at risk is particularly important. In most cases, when subjects visit an expert and are examined using neuropsychological tests, the disease has already been developed. Contrary to this cognitive games are played by healthy, well functioning elderly people, subjects who should be monitored for early signs. Further advantages of cognitive games are their accessibility and their cost-effectiveness.
  
  
  OBJECTIVE
  The aim of the investigation was to show that computer games can help to identify those who are at risk. In order to validate games analysis was completed which measured the correlations between results of the 'Find the Pairs' memory game and the volumes of the temporal brain regions previously found to be good predictors of later cognitive decline.
  
  
  METHODS
  34 healthy elderly subjects were enrolled in the study. The volume of the cerebral structures was measured by MRI. Cortical reconstruction and volumetric segmentation were performed by Freesurfer.
  
  
  RESULTS
  There was a correlation between the number of attempts and the time required to complete the memory game and the volume of the entorhinal cortex, the temporal pole, and the hippocampus. There was also a correlation between the results of the Paired Associates Learning (PAL) test and the memory game.
  
  
  CONCLUSIONS
  The results gathered support the initial hypothesis that healthy elderly subjects achieving lower scores in the memory game have increased level of atrophy in the temporal brain structures and showed a decreased performance in the PAL test. Based on these results it can be concluded that memory games may be useful in early screening for cognitive decline.
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Enikő
authors.initials: E
authors.lastname: Sirály
authors.affiliation: Semmelweis University, Magnetic Resonance Imaging Research Center, Budapest, Hungary.
authors.forename: Ádám
authors.initials: Á
authors.lastname: Szabó
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Bernadett
authors.initials: B
authors.lastname: Szita
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Vivienne
authors.initials: V
authors.lastname: Kovács
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Fodor
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Csilla
authors.initials: C
authors.lastname: Marosi
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Pál
authors.initials: P
authors.lastname: Salacz
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Hidasi
authors.affiliation: Healthcare Technologies Knowledge Center, Budapest University of Technology and Economics, Budapest, Hungary.
authors.forename: Viktor
authors.initials: V
authors.lastname: Maros
authors.affiliation: Healthcare Technologies Knowledge Center, Budapest University of Technology and Economics, Budapest, Hungary.
authors.forename: Péter
authors.initials: P
authors.lastname: Hanák
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Éva
authors.initials: É
authors.lastname: Csibri
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Gábor
authors.initials: G
authors.lastname: Csukly
mesh_terms: D000368:Aged; D001284:Atrophy / Q000473:pathology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000188:drug therapy*; D018728:Entorhinal Cortex / Q000473:pathology*; D005260:Female; D006624:Hippocampus / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008568:Memory / Q000502:physiology; D009483:Neuropsychological Tests; D013702:Temporal Lobe / Q000473:pathology*; D018910:Video Games