Exergame as medicine? Functional brain adaptations linked to cognitive changes in neurocognitive disorders: exploratory randomized controlled trial.

The home program was associated with promising changes in memory-task brain activity and memory accuracy. It combined exercise, cognitive practice and breathing biofeedback, so this study cannot identify which component produced the changes.

Manser P, Rosio M, Schmidt A, Michels L, de Bruin ED.
GeroScience · Publication date: 2026-09-22
Added to site: 2026-09-25
DOI: 10.1007/s11357-026-02540-0

Electronic publication date verified in Europe PMC; first indexed 2026-09-23. This source date is separate from the site's addition date.

Modalities

Biofeedback, Breathing training, Exergaming, fMRI

Clinical focus

Mild neurocognitive disorder, Memory, Home-based training

Population

Older adults with mild neurocognitive disorder, 57% with biomarker-supported Alzheimer's etiology

Sample

32 participants analyzed, 18 in Brain-IT and 14 in usual care

Intervention / method

Twelve weeks of home-based personalized physical, motor and cognitive exergaming with integrated biofeedback breathing, 120 minutes per week, plus usual care

Comparator

Usual care alone

Clinician summary

The intervention favored reduced hippocampal hyperactivation during memory encoding and compensatory activation in the right precuneus and middle cingulate gyrus that correlated with retrieval-accuracy change. No intervention-related serious adverse events occurred.

How to interpret the findings

Small exploratory imaging sample, 28% women, multiple disease etiologies and no long-term clinical-progression outcome. The prespecified ROI-to-ROI results did not survive family-wise error correction, prompting an exploratory bilateral hippocampal seed-to-voxel analysis. The multimodal intervention prevents attribution to breathing biofeedback alone.

Equipment and disclosures

Dividat AG provided Senso Flex systems free of charge for the study; this does not establish vendor-specific efficacy.

Investigator-initiated study funded by Synapsis Foundation-Dementia Research Switzerland, Gebauer Stiftung and Fondation Dalle Molle. Dividat AG supplied systems but reportedly had no study or publication role. The authors declared no competing interests.

Related evidence

Compare findings from the same clinical area, including mixed results.