Detect Alzheimer’s earlier thanks to a video game

A video game to help diagnose Alzheimer’s disease? I don’t know about you guys, but when I read this kind of title I tend to roll my eyes. It is true that at a time when caregivers are being pushed to the brink by the cross-effects of a pandemic and the deterioration of their working conditions, offering them to help them with a video game seems, at best, a illusion, at worst, a provocation …

However, the Sea Hero Quest project, developed by our research teams in collaboration with caregivers, aims to cover a real need expressed by the latter.

The idea is to develop a test that can assess the sense of direction to detect Alzheimer’s disease as soon as possible, of which spatial disorientation is an early symptom. Rest assured, just because you think you have a bad sense of direction doesn’t mean you’re at a higher risk of developing dementia. Many cultural and demographic factors, such as age, gender, level of education, or sleep habits, influence our ability to orient ourselves.

And this is precisely a problem for doctors: how do you know if Mr. Martin has a bad score on the spatial orientation test because he is developing dementia or if it has always been so? One solution is to compare the performance of Mr. Martin with that of others with the same demographic characteristics. This will ensure that your poor performance is not only related to your profile, but is potentially pathological. Comparing the patient’s behavior with that of thousands of people like him would make the test much more accurate and tailor-made.

4 million participants in the scientific study

But to make all these comparisons, you need a database with people, a lot of people. Much more than the few dozen participants who usually recruit in neuroscience or psychology studies. With Sea Hero Quest, we’ve taken advantage of a fraction of the billions of hours a week humans spend playing video games. We have, in collaboration with the study of game design Glitchers, developed a space-oriented video game for smartphones and tablets. The player plays the captain of a small ship that has to solve increasingly complex aquatic mazes. These virtual tests correspond to classic tasks in the scientific literature, which we have made fun of. If they want, players can also answer some questions about their demographic profile. According to our results, performance in this game is effectively predictive of real-world space performance, not a mere reflection of video game skills. Ugh.

Introducing the Sea Hero Quest VR video game.

It worked beyond our expectations. Between 2016 and 2019, more than 4 million players from all over the world downloaded and played Sea Hero Quest. At that moment, we are stunned, mesmerized by the flow of data that accumulates on our servers. If we had wanted to try so many participants in a “classic” way, directly in our laboratory, it would have taken 1,000 years and would have cost 100,000,000 euros.

This data set is unprecedented in behavioral science. In addition to assisting in the diagnosis of Alzheimer’s disease, it answers questions that have so far remained unresolved. For example, about the difference between men and women in terms of space navigation. Numerous scientific studies have reported an advantage for humans in certain space skill tasks, but it has never been fully understood where this difference comes from. With the Sea Hero Quest dataset, we were able to estimate the magnitude of this gender gap in 53 countries. We have observed that the latter was proportional to the equality between men and women in the country where we live, as measured by the Global Report on the Gender Gap at the World Economic Forum. This report compares men’s and women’s access to employment, health, education and political bodies. Therefore, there are few gender differences in space navigation in the Scandinavian countries, much more so in Egypt or Saudi Arabia. This means that the sociocultural dimension plays an important role in these cognitive gender differences.

And Sea Hero Quest is a perfect tool for research.

Our sense of direction depends on where we grew up

In an article published last week on the cover of the journal Nature, we looked at another cultural factor: the influence of where we grow in our sense of direction in adulthood. We know that if you grow a mouse in a cage “enriched” with games and mazes, it has an impact on the shape of your brain and your cognitive functions compared to a mouse that would have grown up in a simpler cage. But because it is forbidden to put children in cages, this result has never been reproduced in humans.

Thanks to the Sea Hero Quest game, we can compare the cognitive functions of people who grew up in a multitude of places. We first observed that players who grew up in cities have, on average, a poorer sense of direction than those who grew up outside of cities, regardless of age, gender, or level of education. But again, the magnitude of this difference varies greatly from country to country. In some countries like the US, Argentina or Canada, living in a city is really harmful, while in France, Romania or India there is no significant difference between city and country. But where do these variations from one country to another come from?

Countries with the largest differences have more cities with a grid plan, such as Chicago, Buenos Aires, or Toronto. And, in fact, it is much easier to navigate these cities than the tormented streets of Paris, Prague or New Delhi. Growing up in a grid city, you have less of a sense of direction than growing up in the countryside, where road networks are less organized and distances to travel greater, and this is noticeable in adulthood.

The key period that permanently shapes our sense of direction is childhood, when our brain is in full development. By contrast, where players live when they play is not statistically related to their spatial skills. That’s not to say it’s impossible to improve as an adult, but more work is needed!

“Man is only the silhouette of his native landscape,” said the poet Shaul Tchernichovsky, and this result does not prove him wrong.

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