{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T23:26:18Z","timestamp":1787354778747,"version":"build-2736575974"},"reference-count":67,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute of Health, Pakistan","award":["SG-21-63"],"award-info":[{"award-number":["SG-21-63"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Games for Health Journal"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Cognitive-motor exergame balance training may increase attentional demands and neuronal processing, potentially affecting serum levels of brain-derived neurotrophic factor (BDNF), A\u03b21\u201342, 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\u2122 groups on blood serum levels of BDNF, A\u03b21\u201342, p-tau181, and cognition function in adults with MCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>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, A\u03b21\u201342, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A significant group \u00d7 time interaction was found for BDNF,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (3,92) = 6.413,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.017,\n                      <jats:italic toggle=\"yes\">\u03b7p<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      0.181; p-tau181,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (3,92) = 4.640,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.040,\n                      <jats:italic toggle=\"yes\">\u03b7p<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      0.138; attention,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (3,92) = 4.171,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.045,\n                      <jats:italic toggle=\"yes\">\u03b7p<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      0.057; abstraction,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (3,92) = 4.263,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.043,\n                      <jats:italic toggle=\"yes\">\u03b7p<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      0.058; and visuospatial skills,\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      (3,92) = 6.931,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001,\n                      <jats:italic toggle=\"yes\">\u03b7p<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      <jats:italic toggle=\"yes\">=<\/jats:italic>\n                      0.234.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Cognitive-motor challenge-based exergame balance training was associated with an increase in serum BDNF, a reduction in p-tau181. In contrast, the A\u03b21\u201342 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2161783x261461636","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:37:17Z","timestamp":1785479837000},"page":"257-268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1177","volume":"15","author":[{"given":"Aruba","family":"Saeed","sequence":"first","affiliation":[{"name":"Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan."},{"name":"Faculty of Rehabilitation Sciences, Lahore University of Biological and Applied Sciences, Lahore, Pakistan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9528-0740","authenticated-orcid":false,"given":"Imran","family":"Amjad","sequence":"additional","affiliation":[{"name":"Riphah College of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan."},{"name":"Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Shafique","sequence":"additional","affiliation":[{"name":"Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Haavik","sequence":"additional","affiliation":[{"name":"Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imran Khan","family":"Niazi","sequence":"additional","affiliation":[{"name":"Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand."},{"name":"Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, Riyadh, Saudi Arabia."},{"name":"Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68542-5"},{"issue":"1","key":"e_1_3_3_3_1","first-page":"748212","article-title":"Working memory and executive function decline across normal aging, mild cognitive impairment, and Alzheimer\u2019s disease","volume":"2015","author":"Kirova A-M","year":"2015","unstructured":"2.Kirova A-M, , Bays RB, , Lagalwar S. 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