NIH Grant Supports Clinical Trial to Determine if Video Games Can Relieve Late-Life Depression

UConn Health will participate in a two-site study with University of Utah Health scientists led by Dr. Sarah Shizuko Morimoto who have received a five-year, $7.5-million grant from the National Institute of Mental Health.

Dr. David Steffens and Dr. Kevin Manning of the Department of Psychiatry (Photo: UConn Health JGelineau)

UConn Health will participate in a two-site study with University of Utah Health scientists led by Dr. Sarah Shizuko Morimoto who have received a five-year, $7.5-million grant from the National Institute of Mental Health (NIMH). The study will test whether a web-based intervention that resembles a video game can alleviate depression in older adults in the comfort and safety of their own homes.

Dr. David Steffens, professor and chair of psychiatry at UConn Health, began working with Morimoto several years ago and encouraged her innovative line of research. “This novel, computer-based intervention trains key areas of the brain to better problem-solve and manage emotions,” says Steffens. “Initial studies indicate that it may help both mood and cognition in older depressed adults.  We hope to confirm these findings in this two-site study at UConn Health and the University of Utah.”

The researchers are recruiting 250 volunteers, ages 60-85, who still feel depressed after receiving treatment for their illness to participate in the study. At UConn Health, we plan to enroll 100 older adults with major depression, some of who may be taking antidepressant medications but still have depression symptoms.

Depression in older adults is common, underdiagnosed, and undertreated, leading to disability, cognitive decline, and poor health outcomes. If patients have cognitive deficits and depression, they are two times less likely to respond to antidepressant medication. University of Utah Health researchers have developed an intervention that aims to reduce depression and cognitive impairment in older adults by improving the functions of brain regions that may have become damaged due to the aging process.

Dr. Kevin Manning, associate professor of psychiatry at UConn Health also uses Morimoto’s interventions Neurogrow and Ultimate Word Master for his K23 Career Development Award funded by the NIMH. Ultimate Word Master is a word game where participants must determine how different words are similar and match in certain categories of various complexity.

With Manning’s research, the games are used remotely by providing research participants with a tablet to use at home.

“During the pandemic, it was important to be able to provide older adults with a safe means to participate in clinical research,” says Manning.  “This intervention provides older adults with the chance to engage in cognitively stimulating activities from the comfort of their own home. We also will examine whether participating in computerized cognitive training will have a long-term benefit on mood and cognition.”

In previous research, the scientists found that 60­–70% of older patients who were unable to benefit from antidepressant medications and who played specially designed video games reported a 50% decline in depressive symptoms in just 30 days. Study participants were also better able to remember word lists than those in a control group, suggesting playing the games improved their brain function.

The new trial seeks to confirm these results on a larger scale and provide additional evidence that late-life depression with cognitive deficits shares a common neural circuitry that can be optimized by Neuroflex, a non-invasive, non-pharmaceutical set of specialized video games.

“Up to 60% of late-life patients who take antidepressants, such as fluoxetine (Prozac) or Sertraline (Zoloft), do not respond to these medications,” says Sarah Shizuko Morimoto, PsyD., leader of the new clinical trial and an Associate Professor of population health sciences at University of Utah Health. “Based on cognitive tests, we suspect that’s because parts of the brain are less functional due to aging and, when exposed to stress, do not allow older patients to bounce back as effectively as they may have when they were younger. These are the same brain structures that respond to antidepressants.”

Neuroflex is a digital solution to this problem that appears to not only relieve depressive symptoms but also improve cognitive function, Morimoto says.

Some evidence suggests that Neuroflex games may work by repairing damaged circuits in the brain’s frontal lobe, which seem to reduce the effectiveness of antidepressant medication.

Morimoto formed a collaboration with the University of Utah Therapeutic Games and App Lab (GApp Lab) to create Neurogrow, a video game in which players plant and tend to a virtual flower garden. Tasks include watering, fertilizing, and eliminating pesky bugs. Players get points for each of these activities. As they advance from level to level, the tasks get more complex. As a result, participants improve their attention, working memory, processing speed, and focus.

Another game, Think+, motivates players to focus on positive images and other affirmative stimuli to shift their attention from negative thoughts.

“Neuroflex is efficacious for mood and cognition and is easily disseminated,” Morimoto says. “It can be used anywhere there is internet access and does not require a physician or a Ph.D. It could potentially save costs and improve access to a cost-effective alternative to medication and psychotherapy.”

Steffens began working with Morimoto several years ago and will be the primary investigator at the UConn Health site.

To learn more about the clinical trial, call 801-587-1288.