Blocking trauma with coloured blocks (Image: Oli Scarff/Getty)

Manoeuvring the colourful tiles of Tetris can help block flashbacks of traumatic events, even after the memory has fixed itself in your mind. Playing the game could be an easy way to reduce the risk of post-traumatic stress disorder (PTSD).

After any event, there is a window of about six hours where memories are consolidated and cemented in the mind, says at the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, UK. Sleeping on the memory strengthens it further.

If an event is particularly traumatic, vivid memories of it can reoccur. These intrusive flashbacks are distressing for anyone, but in a proportion of cases they can persist and contribute to PTSD. For example, about half of people who have been raped go on to develop PTSD, as do a number of asylum seekers and people who have been tortured. About 20 per cent of people who have been in a serious car accident are affected by the condition.

There are effective treatments for people who are diagnosed with PTSD, but nothing currently exists to help prevent people from developing it in the days and weeks after the initial trauma.

Sleep on it

Holmes and her colleagues think a dose of Tetris could be the answer. In 2009, they showed that playing the game four hours after being exposed to trauma reduced the number of subsequent flashbacks. But getting the game into a person’s hands immediately after they have been raped, for example, won’t always be practical, so the team tested whether it could still work a day later – after the memory had been consolidated and slept on.

The team asked 52 people to watch video footage of distressing events. “They were clips from public safety videos, for example, so they were designed to stay with you,” says Holmes. A day later, the participants returned to the lab, where half of them looked at still images from the footage, a task designed to reactivate their memories of the video. This puts the memory back into the plastic state it was in before it was fully laid down, giving the team an opportunity to modify it. “It’s a bit like hard plasticine that’s a certain shape. When you warm it up, it becomes malleable and you can start reshaping it,” says Holmes.

Those people who saw the stills then spent 12 minutes playing Tetris while those who hadn’t just sat quietly for 12 minutes.

Over the following week, the group that had played the game experienced 51 per cent fewer intrusive memories of the traumatising video than the group that hadn’t. They also scored lower on the intrusive memory section of a questionnaire used to diagnose PTSD.

Visually demanding

Holmes thinks playing a game that requires visual processing like Tetris forms a “cognitive blockade”, diminishing the strength of the visual component of a trauma memory while it is malleable. The result is that you can still remember and describe what happened but the vivid, detailed images that are most disturbing are less easily triggered. Holmes thinks other visually demanding games such as Candy Crush, or different visual tasks altogether, could also work. “We started with Tetris because there is previous research showing that it uses up visual attention,” she says.

There is still a way to go before Tetris can become an established treatment, perhaps by being part of the support given at a police station after a person has been raped or at a detention centre for asylum seekers, for example. But the team is already testing the game in hospital emergency departments on people who have been involved in car accidents.

Checking the “dose” of gameplay required and how long the effect lasts are on the to-do list, but even if the effect is small or short-term it’s worthwhile, says Holmes. “Think of it like hand washing. Hand washing is not a fancy intervention, but it can reduce all sorts of illness. This is similar – if the experimental result translates, it could be a cheap preventative measure informed by science.”

Journal reference: Psychological Science, DOI:

If handled well, the rise of the digitally empowered patient could fulfil the wildest dreams of NHS policy-makers: a fitter, happier, more engaged public that sees the doctor less often. And when patients do make contact, they come armed with a diagnosis and data to back it up.

Apps and wearable technology already exist that can monitor sleep quality, calories, heart rate and physical activity. Soon we’ll be able to track blood pressure, glucose levels, blood oxygen content, respiration rate and temperature, not to mention emotional well-being. It won’t be long before will be detecting molecules in bodily fluids and diagnosing a complex array of conditions. “Within 10 years, I am quite sure that most smartphones or other gadgets will be able to do a serious amount of diagnosis,” says , president of telemedicine and eHealth at the Royal Society of Medicine.

“Within 10 years, phones and other gadgets will be able to do a serious amount of diagnosis”

That’s the dream, at least. But if what your watch or armband tells you causes anxiety, is hard to understand, or if there is a high rate of false positive results, the NHS could be overwhelmed. And if there is a high rate of false negatives, then people will be misleadingly reassured and so not see a doctor when they need to.

So what can be done to ensure the technology complements the NHS? The was set up last year partly to investigate how digital services can “support prevention and self-care”. “We want to encourage people to be part of the social movement that is actively encouraging healthy behaviours,” says Tim Kelsey, NHS England director for patients and information. Bruce Keogh, the service’s national medical director is also a fan: “These devices will put patients in the driving seat of their own care and allow us in the NHS to predict things, act early and keep people safe and healthy in their homes for as long as possible.”

A major goal is to provide people with a list of NHS-endorsed apps and eventually other self-care devices. The idea is that endorsement will allow doctors to trust and prescribe apps. To get to this point, independent trials will be needed to establish the efficiency of each one. “We need to know what the benefits are of the apps and devices,” says Lowe, who wants an app-testing equivalent to the randomised clinical trials used to assess drugs. “Once they’ve done it for apps, they can do it for wearables, and everything else.”

When there’s a set of high-quality apps and gadgets to choose from, the next task is to ensure the support systems are there to deal with the data these technologies create. These could include smart analytics that trawl through patient-generated data and alert the doctor to anything amiss. Or 24-hour support for products that send the data directly to the patient. This could be in the form of a website, a call centre staffed by medical professionals or even just an algorithm. “As long as you get good advice, after a while you probably wouldn’t care or notice whether it was a human doctor or a computerised doctor on the other end,” says Lowe.

Read more: “NHS game-changers: The key challenges to healthcare“

This article appeared in print under the headline “Wearable technology could revolutionise how we monitor health”

1. Open up the brain

The biggest hurdle to producing an effective treatment for dementia is getting drugs into the brain in sufficient quantities. “You can be as clever as you like working out how to develop a drug but if you can’t get it to the body part its useless,” says Matthew Wood, a neuroscientist at the University of Oxford. “It’s as much about getting them there as developing them.”

The problem is that our blood-brain barrier (BBB) – a tightly packed layer of cells that wrap around every blood vessel throughout the brain – blocks 98 per cent of our drugs arsenal from penetrating the brain. Next month, though, a team at Sunnybrook Research Institute in Toronto, Canada, will open up the BBB for the first time in humans by injecting microbubbles into the bloodstream and making them vibrate using ultrasound waves. This should mechanically force open the BBB for a few vital hours, allowing drugs to sneak into the brain.

The team hopes to start testing the technique with Alzheimer’s drugs within a year. “We have Alzheimer’s drugs that work in a dish – we just need to get them to the brain in high enough quantities,” says at Sunnybrook Hospital, who is conducting the trial.

2. Test drugs early

Another major hurdle for combating dementia is that the symptoms of the disease occur decades after the damage to the brain begins. Many researchers believe that because the drugs are taken too late into the disease.

A small population in Yarumal, Colombia, might be able to help. Here, thousands of people suffer from what locals call La Bobera – “the foolishness”. Once believed to be a curse put on the village by an angry priest, La Bobera makes the townspeople confused before robbing them of their memories. We know now that it is a form of early onset Alzheimer’s, caused by a rare mutation in a gene called PSEN1. About 5000 people in this community have the mutation, and they will be diagnosed with Alzheimer’s by the age of 45.

This gives researchers the unique opportunity to test Alzheimer’s drugs on the inhabitants – with the added knowledge of who will definitely get the disease and who won’t. The trial will begin later this year.

The world’s first blood test to predict Alzheimer’s disease before symptoms occur might lend a helping hand in recruiting volunteers elsewhere in the world. The test, which was developed in March, identifies 10 chemicals in the blood associated with Alzheimer’s two to three years before symptoms start. If a pre-clinical population could be identified with this blood test, it could be game changing. The latest guidance from the .

3. Link with diabetes

Some researchers think type 2 diabetes can set you on a path to Alzheimer’s. If so, there’s a way to fight back – take regular exercise and eat sensibly.

Type 2 diabetes is a risk factor for Alzheimer’s but there is growing evidence that the link between the two diseases could be stronger. Rats fed so that they develop diabetes have brains littered with amyloid plaques – one of the calling cards of Alzheimer’s. Other research suggests that the memory problems that often accompany type 2 diabetes could be a sign that someone is already in the early clutches of dementia.

If the connection holds up, it may be good news, as type 2 diabetes is essentially a lifestyle disease. “The real answer is that people should go to the gym and that would fix it,” says at the State University of New York. “Exercise reverses insulin sensitivity, cures type 2 diabetes, increases blood flow to the brain and spurs the growth of new neurons”.

4. Beat inflammation

The speed at which Alzheimer’s develops has been linked to whether patients suffer frequently from infections, such as cold and flu, or chronic inflammatory diseases including diabetes, coronary heart disease and obesity. This year, researchers announced that they have pieced together how this happens.

When parts of the body outside the brain are infected or chronically inflamed, the immune system becomes overactive, and this eventually spills over into the brain, damaging its ability to dispose of the beta-amyloid plaques that clog the brain and are thought to play a major role in Alzheimer’s. A trial is under way in the UK to see if an helps people with Alzheimer’s .

5. Antibody attack

Several pharmaceutical companies are developing monoclonal antibodies, which target amyloid plaques. However, trials of these drugs in people with mild-to-moderate Alzheimer’s have failed. It may be that clearing plaques is not enough – one antibody trial cleared the plaques but volunteers showed no clinical improvement. Recent studies suggest that tiny amyloid clumps called oligomers, which appear before larger plaques, might be key to fighting the disease. A attacks both plaques and oligomers – results from clinical trials are expected in 2016.

Such antibodies might be boosted by another technology from Roche – , which hijacks a natural transport mechanism used to transfer proteins from the blood into the brain. In animal studies, attaching the antibody to this “taxi service” increased by 50-fold the concentration of antibodies in the brains of mice.

(Image: Walk Again Project)

Juliano Pinto, a 29-year-old Brazilian who has paralysis in his lower body, took the first kick of the World Cup last night – using the power of his mind and a whole lot of cutting-edge technology.

Pinto used an exoskeleton controlled by his thoughts to take the first swing at the ball of the football tournament in yesterday’s opening ceremony in São Paulo, Brazil.

The exoskeleton belongs to the , an international collaboration using technology to overcome paralysis, led by Brazilian neuroscientist at Duke University in Durham, North Carolina. Pinto kicked the ball a short distance along a mat laid down near the touchline.

Since December, the project has been training eight paralysed people to use the suit, which supports the lower body and is controlled by brain activity detected by a cap of electrodes placed over the head. The brain signals are sent to a computer, which converts them into movement.

Lead robotic engineer , at the Technical University of Munich, Germany, says that there is a phenomenal amount of technology within the exoskeleton, including sensors that feed information about pressure and temperature back to the arms of the user, which still have sensation. The team hopes this will replicate to some extent the feeling of kicking a ball.

Unfortunately, many TV crews’ attention was elsewhere when Pinto took his kick, leading to criticism that the moment went under-documented.

“Not unsafe.” Those are the carefully chosen words that the latest panel convened by the used to describe a novel technique that would create babies using genetic material from three people.

The panel’s scientific report, released yesterday, means that the technique is now closer than ever to becoming a reality in the UK.

The idea is to allow women with faulty mitochondrial DNA to have a genetically related child without the fear of passing on DNA that could cause devastating, incurable diseases. Mitochondrial DNA is passed from mother to child in the egg. The technique has not yet been approved in the US or the UK – but is undergoing intense scrutiny in both countries.

Work done so far suggests that the technique – a modified form of IVF – is safe enough to try in clinical trials, the HFEA panel said, as long as several extra experiments are carried out first and children born as a result of the technique are followed up for an extensive period.

The UK government could vote to legalise the procedure this year and the extra assessments could be done in the next 18 months to two years, the panel estimate.

Three become one

The procedure uses a donor egg with normal mitochondrial DNA and a nucleus taken from the prospective mother’s egg, either before or after it is fertilised by her partner. The panel expects between 100 and 200 families to come forward for treatment every year in the UK.

Currently, families concerned about passing on faulty mitochondria can undergo but this doesn’t help women who have problems with all or most of their mitochondrial DNA.

The debate over the safety of mitochondrial replacement mirrors that over IVF. “Are these technologies safe and efficacious in humans?” said , panel chair and programme leader at the Medical Research Council’s research unit in Harwell. “We won’t know for sure until we do it in humans. All these questions were asked in the 1970s when IVF was a new technique. They were only answered when the first IVF child came along.”