Written by Alan Barker, Freelance Writer, British Science Festival 

Dr Emma Yhnell of Cardiff University is giving the Charles Darwin Award Lecture for agricultural, biological and medical sciences at the 2018 British Science Festival. Her lecture is called Hunting for Huntington’s treatment. Alan Barker met her to find out more.

Emma Yhnell's research looks at how computer games could train the brain in Huntington’s disease

I’ve heard of Huntington’s disease, but I’m not sure I know anything about it.

I often hear people say this to me: because Huntington’s disease is rare, sometimes people don’t know very much about it. That’s why I do lots of work to try and raise awareness and understanding of the disease among the general public.

Huntington’s disease has been described as like Alzheimer’s disease, Parkinson’s disease and schizophrenia, all rolled into one. It is a disease that affects the brain and causes problems with movement and your ability to think. And unfortunately, these problems get gradually worse over time. Because of the genetic nature of the disease if you have the disease-causing gene, there’s a 50% chance it might be passed on to your children, and at the moment there’s no treatment to prevent it getting worse.

That sounds pretty awful.

Yes, this is an absolutely awful disease. But there’s lots of exciting research helping people who are living with the knowledge that they may have Huntington’s disease. The first trial of an experimental drug has recently shown positive results. But rather than looking at drugs, my research looks at how computer games could train the brain in Huntington’s disease. So, one day, our ability with computer games could become a kind of medicine. It’s like a different kind of tablet!

One day, our ability with computer games could become a kind of medicine...

What kind of games?

The games specifically measure executive function, things going on at the front of the brain. So they include word tasks, number tasks, and puzzles.  It’s unlikely that something like Candy Crush will have any benefit because it hasn’t been specifically designed to train the brain! One of the things I’m interested in is whether people are able to play these games. It might be that some people prefer some kinds of games rather than others, or that some people need additional help with playing the games.

So did you involve patients in the design of the study?

Yes, certainly. When I was developing the study we involved people who were impacted by Huntington’s disease so that they could give us their views and insights into the study design. This study is a feasibility study that involves lots of public and patient involvement. My absolute dream is that we can have individualised medicine – that we can tailor a package of games for individual patients. I believe that because this type of research is ultimately designed to benefit the patient we should involve them in the design and development of the study.

Who does Huntington’s affect?

Predominantly people in their 30s to 50s, but this can vary hugely depending on the individual. We haven’t specified an age group for this study; we’re interested in the potential correlation between age and computer literacy. You might expect older people to be less keen on working with computers for example. Or another suggestion is that people who might be working tend to use computers all day and might not want to play computer games in the evening! These are all questions that my study is designed to answer.

It is also really important for me to consider things like access. That is why we’re interviewing friends, family members and carers of people who are affected by Huntington’s disease to get their views on brain training too. I was acutely aware that carers, who may often be family members, are often very busy and the last thing that I wanted to do was to add a further burden by asking them to help with facilitating brain-training games. So this is something that we’re also exploring as part of the study when we ask if people are able to play the computer games.

Access is a key consideration when researching brain training games

Aren’t we being told that we should spend less time on computers?

That’s a valid point. The World Health Organisation has recognised computer gaming as an addiction for the first time. We’re asking people to do this for three thirty-minute sessions a week; so it certainly shouldn’t take over your life! But we’ve had some really interesting feedback that in some cases this activity provides an element of bonding with a carer or family member – especially for people who are more advanced in their disease. So there’s a sense of social interaction that people really welcome and some participants are reporting that they see brain training as a stress relief and an opportunity to have some time to themselves.

How do we assess whether the brain training is working?

That’s a really good question! We’ve got a lot of tests to answer it because assessing whether brain training is working can be quite a challenge. Something I’m interested in is whether the brain training might improve quality of life – self-reported, in the form of a questionnaire. Does it actually improve motor function or cognition? We know, generally, that if you practise something, you tend to get better at it; and that’s one of the really big questions in this study. If you practise, say, a maths game, you might get really good at it, but will that new ability transfer into real life – being able to calculate a restaurant bill, for instance?  So, after the twelve-week trial, we ask people to fill in questionnaires and we also do our own cognitive assessments. And all that helps us assess whether we’re getting somewhere.

Hunting for a Huntington’s treatment takes place on Wednesday 12 September at 13.00, Middleton Hall, University of Hull. Book your tickets here.