After 10 weeks of using the game-like app BrainHQ, older adults showed significant improvements in cholinergic function, a key brain chemical system that tends to decline with age and affects attention, memory, and decision-making.

“The training restored cholinergic health to levels typically seen in someone 10 years younger,” said senior author Dr. Etienne de Villers-Sidani, an Associate Professor in McGill’s Department of Neurology and Neurosurgery and neurologist at The Neuro (Montreal Neurological Institute-Hospital).

“This is the first time any intervention, drug or non-drug, has been shown to do that in humans,” he said.

Because Alzheimer’s disease is linked to sharp declines in cholinergic health, the results help explain previous findings that such exercises can lower dementia risk and enhance cognitive performance. The researchers suggest this type of brain training could serve as a safer alternative to medication or work effectively alongside it.

Evidence-based brain game

BrainHQ features speed-based cognitive games that adapt to become more demanding as users improve, an approach supported by hundreds of scientific studies.

“A lot of people assume crossword puzzles or reading are enough to keep the brain sharp. But not all activities truly promote neuroplasticity,” said de Villers-Sidani.

Since BrainHQ is already commercially available, clinicians can discuss it with patients who want to take an active role in maintaining or improving brain health, he added.

Cutting-edge brain imaging at The Neuro

To observe brain changes, researchers used a specialized PET scan and tracer that makes cholinergic reserves visible, allowing them to measure activity before and after the training period.

“We used a rare technology,” said de Villers-Sidani. “The Neuro is one of the few centres worldwide that can produce the tracer and run the scan.”

The study included 92 healthy adults aged 65 and older. Participants were randomly assigned to either the BrainHQ program or an active control group that played recreational computer games. Both groups trained on tablets for 30 minutes a day over 10 weeks, but only the BrainHQ users showed measurable increases in cholinergic activity.

Researchers are now preparing a follow-up study to evaluate the program’s effects in individuals with early-stage dementia.

About the Study

“Effects of Computerized Cognitive Training on Vesicular Acetylcholine Transporter Levels using Fluoroethoxybenzovesamicol Positron Emission Tomography in Healthy Older Adults: Results from the INHANCE Randomized Clinical Trial” by Mouna Attarha and Etienne de Villers-Sidaniet al. is published in JMIR Serious Games.

The study was conducted independently by McGill researchers in collaboration with Posit Science, which provided access to BrainHQ. All data collection and analyses were led by McGill.

This research was supported by the National Institute on Aging of the National Institutes of Health. This content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.