Our Research: Re-Mission™ Attitudes Study in the Brain

fMRI Scan
This is your brain on Re-Mission™

How does playing Re-Mission change real-life behavior?

Study Design

In collaboration with Dr. Brian Knutson at Stanford University, HopeLab conducted a study that used functional magnetic resonance imaging (fMRI) technology to analyze brain regions activated when people play Re-Mission. The study compared brain scans in 57 people who were randomly assigned to actively play Re-Mission or to passively watch the same recorded game play (similar to watching a movie, with the exact same information, but no direct participation in the game play events). Neural activity was measured during game play, and analyses relating regional brain activation to measures of game performance, emotional state, cancer-related attitudes and behavior were performed.


In Re-Mission, players pilot a microscopic robot named Roxxi as she travels through the bodies of fictional cancer patients, blasting away cancer cells and battling the side-effects of cancer and cancer treatments. Study results published in the scientific journal PLoS ONE in March, 2012 show that neural circuits implicated in reward (i.e., caudate, putamen, and nucleus accumbens) activated strongly while players were actively playing Re-Mission™ but not when they were resting, or when other players passively observed the same gameplay events. Activation of the “mesolimbic” neural circuits stems primarily from game play (interactivity) rather than from sensory stimulation show that strongly activates brain circuits involved in positive motivation.

This reward-related activation is associated with a shift in attitudes and emotions that has helped boost players’ adherence to prescribed chemotherapy and antibiotic treatments. The study provides new insights into how these effects might have occurred, revealing that active participation in game play events is key to activating the brain’s positive motivation circuits. These findings are consistent with results from a preliminary questionnaire-based study suggesting that a major component of Re-Mission’s effectiveness stems from its impact on individual emotional and motivational processes.

  • View Cole, S.W., Yoo, D.J., Knutson, B. (2012). Interactivity and Reward-Related Neural Activation During a Serious Videogame. PLoS ONE 
  • View related ICBM Abstracts

Collaborating Investigator

Brian Knutson, Ph.D., is an Associate Professor of Psychology at Stanford University. His laboratory studies brain processes involved in emotion (“affective neuroscience”). Dr. Knutson played a key role in developing the field of “neuro-economics” in a series of studies utilizing fMRI to understand the effects of motivation on learning, preference and judgment in the context of monetary loss and gain.

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