Association of Video Gaming With Cognitive Performance Among Children

Abstract

ImportanceAlthough most research has linked video gaming to subsequent increases in aggressive behavior in children after accounting for prior aggression, findings have been divided with respect to video gaming’s association with cognitive skills.ObjectiveTo examine the association between video gaming and cognition in children using data from the Adolescent Brain Cognitive Development (ABCD) study.Design, Setting, and ParticipantsIn this cross-sectional study, cognitive performance and blood oxygen level–dependent (BOLD) signal were compared in video gamers (VGs) and non–video gamers (NVGs) during response inhibition and working memory using task-based functional magnetic resonance imaging (fMRI) in a large data set of 9- and 10-year-old children from the ABCD study, with good control of demographic, behavioral, and psychiatric confounding factors. A sample from the baseline assessment of the ABCD 2.0.1 release in 2019 was largely recruited across 21 sites in the US through public, private, and charter elementary schools using a population neuroscience approach to recruitment, aiming to mirror demographic variation in the US population. Children with valid neuroimaging and behavioral data were included. Some exclusions included common MRI contraindications, history of major neurologic disorders, and history of traumatic brain injury. Collected data were analyzed between October 2019 and October 2020.ExposuresParticipants completed a self-reported screen time survey, including an item asking children to report the time specifically spent on video gaming. All fMRI tasks were performed by all participants.Main Outcomes and MeasuresCognitive performance and BOLD signal assessed with n-back and stop signal tasks on fMRI. Mental health symptoms were evaluated using the Child Behavior Checklist and included raw scores of behavioral (anxiety, depression, somatic, social, attention, rule breaking, and aggression concerns) and psychiatric categories (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnoses of depression, anxiety, somaticism, attention-deficit/hyperactivity disorder, oppositional-defiant disorder, and conduct disorder).ResultsA total of 2217 children (mean [SD] age, 9.91 [0.62] years; 1399 [63.1%] female) participated in this study. The final sample used in the stop signal task analyses consisted of 1128 NVGs (0 gaming hours per week) and 679 VGs who played at least 21 hours per week. The final sample used in the n-back analyses consisted of 1278 NVGs who had never played video games (0 hours per week of gaming) and 800 VGs who played at least 21 hours per week. The NVG vs VG groups did not differ on age, body mass index, or IQ, but did differ on sex, race and ethnicity, and combined parental income. The Child Behavior Checklist behavioral and mental health scores were higher in VGs, with attention problems, depression, and attention-deficit/hyperactivity disorder scores significantly higher in the VGs compared with the NVGs. The VGs performed better on both fMRI tasks compared with the NVGs; the differences were statistically significant but small. VGs had significantly shorter mean (SE) stop signal reaction times compared with NVGs (287.3 [9.8] vs 300.1 [9.6] milliseconds; P = .018) and correct mean (SE) go reaction times (514 [2.9] vs 552 [2.2] milliseconds; P = .001). Following a similar pattern, 0-back D' mean (SE) measures of the n-back task were significantly higher in VGs compared with NVGs (2.33 [0.03] vs 2.18 [0.03] milliseconds; P < .001). Similarly, 2-back D′ mean (SE) measures were significantly higher in VGs relative to NVGs (1.87 [0.03] vs 1.72 [0.02] milliseconds P < .002), and correct mean (SE) 2-back RT measures were significantly shorter in VGs relative to NVGs (1025 [4.8] vs 1069 [3.7] milliseconds; P < .002). Nonparametric analyses of fMRI data demonstrated a greater BOLD signal in VGs in the precuneus during inhibitory control. During working memory, a smaller BOLD signal was observed in VGs in parts of the occipital cortex and calcarine sulcus and a larger BOLD signal in the cingulate, middle, and frontal gyri and the precuneus.Conclusions and RelevanceIn this study, compared with NVGs, VGs were found to exhibit better cognitive performance involving response inhibition and working memory, as well as altered BOLD signal in key regions of the cortex responsible for visual, attention, and memory processing. The differences in reaction times, although small, were consistent with an association between videogaming and cognitive abilities that involve response inhibition and working memory and the underlying cortical pathways. Concerns about the association with mental health symptoms may warrant further study.