Exergames: neuroplastic hypothesis about cognitive improvement and biological effects on physical function of institutionalized older persons

Abstract

Exergames can be considered a dual task because the games are performed by a man-videogame interface, requiring cognitive and motor functions simultaneously. Although the literature has shown improvements of cognitive and physical functions due to exergames, the intrinsic mechanisms involved in these functional changes have still not been elucidated. The aims of the present study were (1) to demonstrate the known biological mechanisms of physical exercise regarding muscle adaptation and establish a relationship with exergames; and (2) to present a neurobiological hypothesis about the neuroplastic effects of exergames on the cognitive function of institutionalized older persons. These hypotheses are discussed.

Keywords: cognition; elderly; neuroplasticity; nursing-home; physical activity; virtual reality.

Figure 1

Physical effort during exercise on WBB (a hardware to play). It causes mechanic stress which stimulates Akt-mTOR pathway, IL-6, IL-10, and IL-1ra. Akt-mTOR pathway potentiates protein synthesis, IL-6 increases myonuclei differentiation, and IL-10 and IL-1ra increase chronic anti-inflammatory response. Both signaling result in muscle increased volume. IL: Interleukin; IL-1ra: antagonist receptor of IL-1; WBB: Wii Balance Board; NW: Nintendo Wii.

Figure 2

Central and peripheral mechanisms of exergame. (A) An individual playing exergame. (B) Exergame increases neural activation. Long-term neural activation stimulates neuroplasticity. (C) Exergame promotes a muscle fiber tension. Consequently, it increases the synthesis and secretion of trophic factors. Trophic factors traffic by vessels until blood-brain barrier and act on the brain potentiating neuroplasticity (dashed arrow). BDNF: Brain-derived neurotrophic factor; IGF-1: insulin-like growth factor 1; NW: Nintendo Wii; VEGF: vascular endothelial growth factor; WBB: Wii Balance Board (a hardware to play).