A new study:
Speed Games Turn Up the Ageing Brain’s Attention Chemistry, But Nobody Actually Got Smarter
In a double-blind randomised trial, 92 cognitively healthy adults aged 65 and over completed 35 hours of either speed-based computerised brain training (BrainHQ) or non-speeded computer games over 10 weeks. PET scans using the tracer [18F]FEOBV, which tags the vesicular acetylcholine transporter and therefore indexes presynaptic cholinergic terminal density, were acquired before and after. The trained group showed significant increases in cholinergic binding in the anterior cingulate, medial prefrontal cortex, insula and orbitofrontal cortex; controls showed essentially none. Between-group effect sizes were moderate-to-large (Cohen’s ds 0.77 to 0.91). However, these neurochemical changes did not correlate with any cognitive improvement, and the trial’s general executive function battery was flatly null.
Acetylcholine is the brain’s attention throttle. The basal forebrain sprays it across the cortex to sharpen the signal-to-noise ratio of whatever you are currently trying to pay attention to, and the projection neurons that do the spraying degenerate steadily with age. That degeneration is a plausible upstream driver of the everyday cognitive slippage of later life, and it is catastrophic in Alzheimer’s disease. The obvious question is whether the system is still plastic in a healthy 72-year-old, or whether the decline is a one-way ratchet.
This McGill-led trial provides the most direct human answer so far. The researchers used [18F]FEOBV PET, a tracer that binds the vesicular acetylcholine transporter and therefore counts cholinergic nerve terminals rather than inferring them from behaviour. Ninety-two older adults were randomised to speed-of-processing training or to strategy games matched for time, screen exposure, contact with staff and payment. Both groups did 70 sessions over ten weeks. Everyone was scanned before and after.
The trained group increased cholinergic terminal signal in a coherent, anatomically sensible set of regions: the anterior cingulate and medial prefrontal cortex, the right insula extending into caudate and putamen, and the left orbitofrontal cortex. These are the hubs of the salience and attention networks, precisely the circuits the training hammers. The control group’s scans did not move. The spatial pattern was not random noise; it overlapped the same regions that showed the steepest age-related cholinergic loss in the cross-sectional analysis of the same cohort.
The big idea is that a neuromodulatory system previously treated as a slowly draining battery behaves more like a muscle. Ten weeks of demanding, adaptive attentional work appears to expand presynaptic cholinergic capacity in the circuits doing the work. That is a mechanism, and mechanisms are what the cognitive training field has conspicuously lacked.
The deflating part is equally important. The neurochemical gains did not predict cognitive gains in any analysis. Participants got dramatically better at the two trained tasks, but the independent executive function battery showed no significant change in either group. So the paper demonstrates that the ageing cholinergic system is plastic. It does not demonstrate that making it plastic makes you think better. Those are different claims, and only the first one is supported here. [Confidence: High]
Actionable Insights
The honest take-home is narrow. Ten weeks of daily adaptive speed-of-processing training, 30 minutes a day, seven days a week, produced a roughly 8 to 18 percent increase in a marker of acetylcholine terminal density in attention-related brain regions. The between-group effect size was Cohen’s d of about 0.8 to 0.9. In plain terms, if you picked one trained person and one control at random, there is roughly a 74 percent chance the trained person’s brain change was larger. That is a solid, real-world-sized biological effect, not a statistical curiosity.
The caveat is that the biology did not cash out. Participants improved enormously on the two games they practised (effect size roughly d = 1.4, meaning about 85 percent of trained people beat the average control), and those gains held at three months. But on a separate test of general executive function, neither group improved at all, and the size of a person’s brain change had no relationship to their cognitive change.
Practical position: this supports cognitive training as a plausible way to maintain cholinergic hardware, at a real cost of about 35 hours. It does not yet support it as a way to get measurably sharper at anything you have not directly practised.
Context and Source
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Open Access Paper: Whole-brain cholinergic modulation following computerized cognitive training in healthy older adults: a [18F]FEOBV PET study
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Institution: Montreal Neurological Institute and Hospital, McGill University, Montréal, Canada. Co-authors from Posit Science Corporation, San Francisco, USA.
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Country: Canada (trial site and imaging), with US industry co-authorship.
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Journal: GeroScience (Springer, official journal of the American Aging Association)
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Trial: INHANCE, double-blind, parallel-group, active-controlled RCT.
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Impact Evaluation: The impact score of this journal is 6.0 (2025 JIF; CiteScore 8.3, Q1 in Aging), evaluated against a typical high-end range of 0 to 60+ for top general science, therefore this is a Medium impact journal.
