Recent research revealed that videogame training boosts neuronal plasticity emerging in a range of cognitive improvements accompanied by structural and functional brain changes in healthy subjects. A reduction of neuronal plasticity has been suggested in patients with schizophrenia as a pathobiological model of cognitive deficits as well as positive and negative symptoms. Here we test whether videogame related improvements regarding cognition and neuronal plasticity can be transferred to this patient group and even reduce symptoms. Therefore, we conducted a training study in which patients with schizophrenia and healthy controls were randomly assigned to train with a 3D or 2D platformer videogame or read an E-book (active control) for 8 weeks, 30 minutes a day. After training, we observed significant increases in sustained attention (MATRICS Consensus Cognitive Battery) in both video gaming groups compared to the active control group in patients and healthy subjects which was significantly correlated with increased functional connectivity in a predefined hippocampal-prefrontal network. Most importantly, we observed significant improvements in negative symptoms (PANSSneg), general psychopathology (PANSSgen) and perceived mental health recovery (RAS) in patients trained with videogames compared to E-book reading. There was no significant difference in neuronal plasticity (cognition, functional connectivity) between patients and healthy controls. No outcome differences were observed for the 3D versus 2D version of the videogame training. Of note, critical and difficult-to-treat symptoms of schizophrenia namely cognitive deficits, negative symptoms and perceived mental health recovery improved the most. Hence, bringing to bear the core properties of videogames like fostering initiative, goal setting, decision making, in combination with joy and gratification, may constitute a closer to real life training as compared to current psychiatric treatment settings. Further research is needed to explore videogame training as possible adjunctive treatment options in complex mental disorders.
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