Gaming The Brain

I was diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) when I was in 5th grade. I have all the symptoms – inability to concentrate, restlessness, hyperactivity. I’ve followed and researched different types of treatments ranging from behavioral therapy to medication. One of the more promising therapies is neurofeedback, which involves continually monitoring patients’ brainwaves. Subjects attempt to change their brainwaves to a set pattern and receive an auditory signal that tells them whether they were successful. With enough repetition, neurofeedback can rewire a person’s brain. A study published in 2005 examines how patients diagnosed with ADHD can learn to better maintain their concentration through neurofeedback. Depending on how individuals respond to this type of treatment, it can even be used as a replacement for medication.


One manufacturer of neurofeedback devices stands out: SmartBrain Technologies uses videogames. Called the SMART system, it works as a modified PlayStation 2 or Xbox controller. A visor on the patient’s head reads his or her brainwaves and sends the information to a processing unit. The unit decides how well the patient’s brainwaves match up to a specified profile and adjusts the sensitivity of the controller accordingly – the more closely the patient can match the profile, the more responsive the game becomes to the patient’s input. The controller sensitivity is not handled like an on/off switch; it’s more like dimmer, able to provide a wide range of feedback.

The SMART system works with any game released for the PlayStation 2 or Xbox, but it’s most effective with games that provide constant movement. The best genres are platforming and racing, as it’s easy to feel when the controller is losing its responsiveness. After patients complete the training, they can still use ADHD medication but it will likely not be necessary.

The advantages of this approach are obvious: Unlike other software solutions, there is a library of games readily available for patients to use with the SMART system, and playing a game is inherently more engaging than listening for a sound. Many have found success using it. A 2001 study that used videogames with neurofeedback found that patients were more motivated and more likely to complete their treatment than with conventional neurofeedback.

Most neurofeedback systems are only available to clinics due to their cost and the experience they require to use them effectively. But the SMART system is inexpensive enough to be used at home. SmartBrain Technologies even offers a DVD version of SMART that adjusts the screen’s brightness according to the patient’s brainwaves. It was a move to open the technology to an older audience who may not be comfortable with videogames.

The idea of neurofeedback dates back to the 1960s. Promoted to the public as a kind of magic wand, it fell out of vogue when it couldn’t deliver the impossible. As computers became faster and cheaper, better neurofeedback devices became available, triggering a resurgence of the technology.

The birth of the SMART system began at NASA in the 1990s. Dr. Allen Pope, an engineering psychologist, was trying to increase the awareness and attention of astronauts training to fly the space shuttle. When using neurofeedback in a flight simulation, he found improvements in the pilots’ attention and engagement. He created a spin-off technology that used videogames, and NASA patented the idea. In 2001 SmartBrain Technologies was awarded the patents and went about adapting a system that was as big as a room and made for trained personnel. After years of work, the system was easy to use and small enough to carry around.

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The SMART system isn’t the first game peripheral to try to make use of brainwaves. The Atari Mindlink attempted a more primitive version of brainwave reading by monitoring the muscles in your head. The result was that it trained players how to have a migraine rather than how to control a game. The peripheral was never released. It lives as a reminder of the importance of good, responsible research when the brain is involved.

The problem with scientific exploration in this area is the difficulty of a double blind study. You can give someone a sugar pill as a placebo when testing pharmaceuticals, but it is only recently that researchers have taken a similar approach for neurofeedback. In 2008, the National Institute of Mental Health (NIMH) decided to start funding neurofeedback studies. With NIMH’s backing, neurofeedback has established itself in the scientific realm.

A study conducted in 2005 showed that ADHD kids using the SMART system and videogames demonstrated “significantly less hyperactivity at home and school” and “demonstrated significant improvement on behavioral and neuropsychological tests of attention.” Another study done by NASA concluded that a neurofeedback system could “be used largely without clinician involvement,” meaning the system could work as well at home as in a professional setting.


Not all researchers are convinced. Dr. Russell Barkley, an expert in ADHD, has been critical of neurofeedback. He pointed me to a study he co-wrote in 2005 that suggested previous studies involving ADHD and neurofeedback suffered from methodological flaws. Still, the study also states that there are “some promising results that require further study.” It also doesn’t discount the effects of videogames: They can provide the motivation to complete a task. Anyone who has lost a night playing Civilization knows this.

The next big thing for SmartBrain Technologies is support for the new generation of consoles. There is no doubt that Xbox 360 and PS3 versions of SMART are on their way. They also plan on continuing to improve the DVD system and expand it to include TV programs in an effort to continue expanding their market.

SmartBrain Technologies wants to target more than just the consumer sector. Patients can go to clinics that have the system to treat specific conditions. They can help patients cope with bi-polar disorder and rehabilitation following a brain injury. SMART systems are also being deployed in schools to help kids with ADHD in a group setting.

Targeting a wide range of people can have a significant impact. ADHD tends to run in families – my mother has it, and I’m sure one of my future kids will as well. There are a lot of people, my mom included, who don’t play videogames, and offering the SMART system in different formats means that she could still benefit from the technology. With much of the population either unresponsive to medication or unable to acquire it, neurofeedback may be the best therapy they can get.

The scientific evidence says that the SMART system can use videogames to treat ADHD. It offers an alternative to medication that is affordable enough to be used at home. In a clinical setting, it can help remedy other learning disabilities. It offers hope to those of us living with ADHD that we can use the videogames we love to be a little more normal.

Joel Gonzales is secretly a power ranger and runs Internet Superstars – a studio that makes games for charity.

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