New Study Finds Value in Video Games for Treating Depression

Researchers have found that a digital therapeutic platform using gaming concepts can help adults diagnosed with major depressive disorder (MDD) improve their cognitive function

Researchers from Duke University and Stanford have found that a digital therapeutic video game can help people living with major depressive disorder (MDD).

In a study recently published in the American Journal of Psychiatry, adults diagnosed with MDD and taking antidepressant medication “significantly improved sustained attention” while playing the AKL-T03 game developed by Boston-based Akili Interactive. The mHealth game is designed to address cognitive challenges, including difficulties concentrating, decision making, slowed thinking, and forgetfulness, in people living with MDD.

“Society is facing a growing mental health crisis, with depression rates in the US increasing about 20% during the pandemic,” Richard Keefe, PhD, a professor of psychiatry at Duke University Medical Center and primary investigator of the study, said in a press release. “While mood symptoms are most often associated with MDD, equally concerning are the frequent associated cognitive impairments.”

“More than ever, we need safe and effective ways to support these patients – new tools that can be easily and broadly accessed,” he added. “Based on the results of this study, AKL-T03 has the potential to play a meaningful role in the treatment of MDD patients.”

Digital health companies like Akili have been developing mHealth games for several years to address a variety of health concerns, from behavioral health treatment to chronic care management for conditions ranging from diabetes and asthma to cancer. Many of the products have been tailored for children and young adults, who respond well to games and gaming concepts.

Digital health platforms are especially attractive to care providers because they can be administered at home, in a more comfortable environment for patients, rather than a clinic or doctor’s office, and they can be used when appropriate for the patient.

To address an older population, Akili modified its AKL-T01 digital therapeutic, branded as EndeavorRx and cleared by the US Food and Drug Administration to treat attention symptoms in children ages 8-12 diagnosed with ADHD. The company’s AKL-T03 is an investigational medical device not yet cleared by the FDA and designed on the same technology platform.

The treatment could help the more than 16 million people in the US who are living with MDD, and who suffer from cognitive impairments that aren’t eased through medication.

“Addressing cognitive impairments associated with depression has been an area of interest from healthcare professionals and companies over recent years, yet options remain limited for patients,” Anil S. Jina MD, Chief Medical Officer of Akili, said in the press release. “Akili’s technology is designed to target specific neural networks related to attention function and this study demonstrates the important role it could play in the treatment of patients with cognitive dysfunction in depression.”

In the study, titled the Software Treatment for Actively Reducing the Severity of Cognitive Deficits in Major Depressive Disorder (STARS-MDD), Keefe and Amit Etkin, MD, PhD, of the Department of Psychiatry and Behavioral Sciences and Wu Tsai Neurosciences Institute at Stanford, working with Elena Cañadas, PhD, and Deborah Farlow, PhD, both from Akili, tested the platform on some 80 adults over a six-week time span.

“The results in this randomized controlled trial of an at-home digital intervention for cognitive impairment in patients diagnosed with major depressive disorder indicate that the active intervention, AKL-T03, significantly improved performance on the primary outcome measure of sustained attention compared with the control condition in adults 25–55 years old,” they concluded in the study. “Across a range of secondary and exploratory outcome measures targeting a variety of cognitive domains, including working memory, processing speed, task switching (e.g., letter-number sequencing, symbol coding test), depressive symptoms, and subjective cognitive symptoms (e.g., HAM-D, PHQ, and CPFQ) and quality of life (e.g., WSAS and Q-LES-Q), the benefit of AKL-T03 was not superior to the control intervention.”

“In summary, compared with a control condition, AKL-T03 demonstrated significant improvement on the primary objective measure of cognition in patients with major depression,” they added. “The intervention was well tolerated and presented minimal adverse events. The digital nature of the intervention could help to increase access for patients who otherwise might not find a solution for their depression-related cognitive difficulties.”