Effects of Exergame Balance Training with Variable Cognitive Motor Challenges on Serum BDNF, p-tau181, and Cognitive Functions in Adults with Mild Cognitive Impairment: A Randomized Trial.

Authors

Aruba Saeed, Imran Amjad, Abdullah Alzahrani, Muhammad Shafique, Heidi Haavik, Imran Khan Niazi

Published in

Games for health journal. Pages 2161783X261461636. Jul 30, 2026. Epub Jul 30, 2026.

Abstract

Cognitive-motor exergame balance training may increase attentional demands and neuronal processing, potentially affecting serum levels of brain-derived neurotrophic factor (BDNF), Aβ1-42, and p-tau181, as well as train cognitive abilities in adults with mild cognitive impairment (MCI). This study aimed to compare the effects of exergame balance training of mild, moderate, high-difficulty, and Wii Fit™ groups on blood serum levels of BDNF, Aβ1-42, p-tau181, and cognition function in adults with MCI.
In this four-arm, parallel group randomized clinical trial, 97 adults with MCI were randomly assigned to exergame balance training groups of mild, moderate, high-difficulty, and Wii Fit exergame as a control group. All participants received 40 min/session, 3 times/week for 8 weeks. Assessment of serum levels of p-tau181, Aβ1-42, BDNF, and cognitive functions was conducted at baseline, after weeks 4 and 8. A mixed-model analysis of covariance was used, with post-baseline measurements (weeks 4 and 8) specified as the within-subject factor and the corresponding baseline value entered as a covariate to adjust for initial between-group variability.
A significant group × time interaction was found for BDNF, F(3,92) = 6.413, P = 0.017, ηp² = 0.181; p-tau181, F(3,92) = 4.640, P = 0.040, ηp² = 0.138; attention, F(3,92) = 4.171, P = 0.045, ηp² = 0.057; abstraction, F(3,92) = 4.263, P = 0.043, ηp² = 0.058; and visuospatial skills, F(3,92) = 6.931, P < 0.001, ηp² = 0.234.
Cognitive-motor challenge-based exergame balance training was associated with an increase in serum BDNF, a reduction in p-tau181. In contrast, the Aβ1-42 levels remained stable. These changes were accompanied by improvement in selective cognitive functions (attention, abstraction, and visuospatial skills) in individuals with MCI. Greater effects were observed in moderate and high-difficulty groups, suggesting the importance of intervention intensity in promoting cognitive and neurobiological outcomes in MCI.

PMID:
42533557
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

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