title: Effects of Video Game Training on Behavioral and Electrophysiological Measures of Attention and Memory: Protocol for a Randomized Controlled Trial.
abstract: BACKGROUND
  Neuroplasticity-based approaches seem to offer promising ways of maintaining cognitive health in older adults and postponing the onset of cognitive decline symptoms. Although previous research suggests that training can produce transfer effects, this study was designed to overcome some limitations of previous studies by incorporating an active control group and the assessment of training expectations.
  
  
  OBJECTIVE
  The main objectives of this study are (1) to evaluate the effects of a randomized computer-based intervention consisting of training older adults with nonaction video games on brain and cognitive functions that decline with age, including attention and spatial working memory, using behavioral measures and electrophysiological recordings (event-related potentials [ERPs]) just after training and after a 6-month no-contact period; (2) to explore whether motivation, engagement, or expectations might account for possible training-related improvements; and (3) to examine whether inflammatory mechanisms assessed with noninvasive measurement of C-reactive protein in saliva impair cognitive training-induced effects. A better understanding of these mechanisms could elucidate pathways that could be targeted in the future by either behavioral or neuropsychological interventions.
  
  
  METHODS
  A single-blinded randomized controlled trial with an experimental group and an active control group, pretest, posttest, and 6-month follow-up repeated measures design is used in this study. A total of 75 cognitively healthy older adults were randomly distributed into experimental and active control groups. Participants in the experimental group received 16 1-hour training sessions with cognitive nonaction video games selected from Lumosity, a commercial brain training package. The active control group received the same number of training sessions with The Sims and SimCity, a simulation strategy game.
  
  
  RESULTS
  We have recruited participants, have conducted the training protocol and pretest assessments, and are currently conducting posttest evaluations. The study will conclude in the first semester of 2017. Data analysis will take place during 2017. The primary outcome is transfer of benefit from training to attention and working memory functions and the neural mechanisms underlying possible cognitive improvements.
  
  
  CONCLUSIONS
  We expect that mental stimulation with video games will improve attention and memory both at the behavioral level and in ERP components promoting brain and mental health and extending independence among elderly people by avoiding the negative personal and economic consequences of long-term care.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT02796508; https://clinicaltrials.gov/ct2/show/NCT02796508 (archived by WebCite at http://www.webcitation.org/6nFeKeFNB).
authors.affiliation: Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: Soledad
authors.identifier: http://orcid.org/0000-0002-8391-9615
authors.initials: S
authors.lastname: Ballesteros
authors.affiliation: Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: Julia
authors.identifier: http://orcid.org/0000-0001-5003-4995
authors.initials: J
authors.lastname: Mayas
authors.affiliation: Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: Eloisa
authors.identifier: http://orcid.org/0000-0002-5274-2757
authors.initials: E
authors.lastname: Ruiz-Marquez
authors.affiliation: Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: Antonio
authors.identifier: http://orcid.org/0000-0002-3394-5962
authors.initials: A
authors.lastname: Prieto
authors.affiliation: Studies on Aging and Neurodegenerative Diseases Research Group, Department of Basic Psychology II, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: Pilar
authors.identifier: http://orcid.org/0000-0003-2770-2929
authors.initials: P
authors.lastname: Toril
authors.affiliation: Facultad de Derecho, Department of Social Work, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: Laura
authors.identifier: http://orcid.org/0000-0003-4320-2043
authors.initials: L
authors.lastname: Ponce de Leon
authors.affiliation: Cajal Institute, Neurodegeneration Group, Departament of Translational Neurobiology and Biomedicine Research Center for Neurodegenerative Diseases, Consejo Superior de Investigaciones Científicas, Madrid, Spain.
authors.forename: Maria L
authors.identifier: http://orcid.org/0000-0003-4067-9700
authors.initials: ML
authors.lastname: de Ceballos
authors.affiliation: Facultad de Psicología, Departamento Methodology of the Behavioral Sciences, Universidad Nacional de Educación a Distancia, Madrid, Spain.
authors.forename: José Manuel
authors.identifier: http://orcid.org/0000-0003-3340-8873
authors.initials: JM
authors.lastname: Reales Avilés
keywords: C-reactive protein; attention; cognitive training; electrophysiology; healthy aging; inflammation; video games; working memory