Game Theory: A Q&A with Dr. Adam Gazzaley

Dr. Adam Gazzaley has studied attention, memory, and perception for 25 years. He earned his M.D. and Ph.D. in neuroscience at the Mount Sinai School of Medicine in New York before completing a clinical residency in neurology at the University of Pennsylvania and postdoctoral training in cognitive neuroscience at the University of California, Berkeley.


Today, he works as a professor in neurology, psychology, and psychiatry at the University of California, San Francisco, where he studies cognitive abilities as they relate to distraction and natural aging processes, being director of both the Neuroscience Imaging Center and the Gazzaley Lab. He has filed four different patents, served on 24 advisory boards, been a member on eight editorial boards, and given nearly 500 presentations around the world.

Gazzaley is also the co-founder and chief science advisor of Akili Interactive, a company developing therapeutic video games that self-adjust to better suit individual patients’ needs. Brain World recently had a conversation with Gazzaley about his research.

Brain World: How did you come to be interested in studying memory, perception, and attention, and how distraction and aging affect those abilities?

Adam Gazzaley: I’ve been studying the brain and aging for over 25 years now and my work had largely been in characterizing how the brain functions in terms of its higher-level abilities like attention, memory, and perception.

Recently, I became frustrated with just reporting on the issue and not actually taking any direct steps to help improve the functioning of people’s brains, so around eight years ago, I was motivated to move beyond the basic sciences into what I would call translational neuroscience and actually use our expertise in neuroscience methodology, and other emerging technologies, to create something new, and then validate it carefully using the same type of approaches we use in our research studies.

BW: Can we enhance our memory, perception, and attention?

AG: We have what I would say is a signal, the beginning of evidence, that we can improve these abilities, even in healthy adults using the type of video game closed-loop technologies that we’re creating. But we have more work to do to show that with larger populations and to reproduce those findings. But I would say I’m cautiously optimistic that we will use this technology in such a way to enhance cognitive abilities in people that engage in this type of training over a period of time.

BW: Video games?

AG: I sort of stumbled upon this idea of using video games, and closed-loop video games in particular, that we would customize and design from scratch, working with professionals in the video game industry. Then we would determine if the patients were having the effects just to improve the performance based on what is going on in the game or if there were other cognitive abilities that are not directly trained but are related to common brain mechanisms.

BW: You just mentioned closed-loop systems. What are they?

AG: A closed-loop system basically means that you intervene in some way. You record the impact, and you quantify — so you’re getting data in real time about how your intervention is affecting whatever you’re trying to impact. Then you use that data to update your intervention, to refine it. So if you get too much of an effect you push a little less. If you get too little, you push a little more. Then you apply it again, you record, you update, and you cycle over and over again. Refining, targeting, and personalizing at each loop, and that is the most effective way to change something.

BW: But how do closed-loop systems relate to these video games?

AG: Our video games are designed to update their challenge and give feedback in real time based on players’ performance metrics. So as you play the game, your response time, your accuracy, is being recorded. The game takes that data and then scales the challenge appropriately to you in real time so that you’re in that sweet spot where you’re being challenged just enough; just at the level where it’s pushing you appropriately and also giving feedback based on that real-time data, so that’s an example of the general closed-loop approach that we employ when creating new technologies.

BW: Aside from using video games to improve cognitive abilities, you also do a lot of work regarding distractibility. Are we more distracted because of smartphones?

AG: Our brains have certain strengths but they also have certain, very fundamental, limitations in terms of attention abilities and other aspects of cognitive control, and I would say that technology has really exacerbated the conflict between what we want to do (our very high-level goals) and what we’re actually capable of doing (how we enact our goals).

I do think that modern technology has increased distractibility and has challenged us in terms of processing information. [But] mobile technology also provides an incredible opportunity, from my perspective, in revolutionizing how we study and understand people’s brains and minds and how we can act to improve them. So I do see both sides and I think it confuses some people that I do tell both sides of that story, but I don’t think they’re incompatible. I think it’s reasonable to note how technology can help us, and be aware of how it challenges us. Then we have to design technology and use it in such a way that maximally serves our goals of improving the quality of our lives.

BW: Speaking of distractibility, can humans really multitask?

AG: It comes down to semantics. Let’s put it this way: Humans can certainly try to multitask, and if multitasking is defined as a behavior of engaging in more than one task at the same time or over a given period of time, then we do that all the time. The reason why it’s been challenged as a myth is because if you actually look at what’s going on in the brain, and here you define multitasking as parallel-processing, then that’s not what occurs when you have two attention-demanding tasks. Rather, what happens is that you switch between those attention networks that are necessary to do each of the tasks. So sure, you’re multitasking, but your brain isn’t doing that through parallel-processing, it’s doing that through task-switching.

BW: What in your research has most surprised you?

AG: I was surprised by how readily older adults really take to new technologies, including things that they’ve never used before like video games and tablets. They’re very optimistic in our ability to create technologies that many might think are only appropriate for young people (like virtual reality, augmented reality, and immersive 3-D video games). This technology also impacts many different populations that don’t have the high-tech exposure that young adults do.

BW: Is anybody else doing what you do?

AG: I think that there’s lots of interest in it. There’s just a whole wide variety on the design principles that are used in the development of the tools, as well as the emphasis that’s placed on the level of validation needed before marketing a product, so this is where the field is still finding itself right now. But I would say there’s enthusiasm around the world for what we would think of as experiential technologies, rather than solely relying on pharmaceuticals or traditional didactic education, as approaches to improving brain function.


BW: What’s next for you and your work?

AG: There are multiple domains. The video game technologies that we create, we want to continue to refine them, and then validate them as tools that improve cognition across a wide range of populations, from healthy to impaired, but we see other technologies that are emerging in the consumer space as being a part of this ecosystem. So virtual reality, augmented reality, artificial intelligence, motion capture, wearable physiological devices, all of these technologies have a role in creating tools to improve brain function, and that’s where we’re putting a lot of our effort.

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