Frontal activation patterns during Tetris game play and differences between high and low performers: a preliminary functional near-infrared spectroscopy study

Background: Tetris has recently expanded its place of activity not only to the original entertainment but also to clinical applications such as prevention of trauma flashback. However, to our knowledge, no studies focused on the cortical activation patterns themselves when playing Tetris in a natural form. This study aimed to investigate the activation patterns in the frontal cortex during naturally-performed Tetris for 90 seconds in 24 healthy subjects using functional near-infrared spectroscopy robust to artifacts by motion and electric devices. We also calculated the correlations of behavioral data with cortical activations, and compared the differences in activations between the high and low performers of Tetris. Results: The results demonstrated that significant activations in the frontal cortex during Tetris play had two factors, each showing a similar activation pattern. One of the factors was distributed over the lateral prefrontal cortex bilaterally, and the other was localized to the right prefrontal cortex. Moreover, in the high performers, the activations of the areas centered on the right dorsolateral prefrontal cortex (DLPFC) were estimated to increase and correlations of the activations between those areas and the other areas decrease compared with the low performers. Conclusions: It is suggested that high Tetris performers might reduce functional connectivity between activations of the areas centered on the right DLPFC and the other areas, and increase the local activations compared with low performers. It would be necessary to consider whether its visuospatial cognitive loads stimulate the appropriate areas of the subject’s brain to effectively utilize Tetris play for clinical interventions.