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Tetris is not only a widely used entertaining computer game, but has been used as a component in emerging psychological interventions targeting dysfunctional mental imagery, e.g., intrusive memories and imagery-based cravings. However, little is known about the neurobiological mechanisms underlying these interventions. Tetris gameplay has been hypothesized to disrupt dysfunctional mental imagery (e.g., imagery-based intrusive memories of adverse events) and cravings (e.g., substance use) by taxing visuospatial working memory. In line with this, the present study aimed to characterize brain areas involved in the visuospatial aspects of Tetris gameplay, by controlling for motor activity (button presses) and using gameplay instructions emphasizing mental rotation. Participants ( N  = 28) received mental rotation instructions and thereafter either played Tetris, or only pressed buttons as if playing Tetris (motor activity), while undergoing functional magnetic resonance imaging. Tetris gameplay (when using mental rotation instructions and controlling for motor activity) robustly activated brain areas located in the ventral and dorsal stream, with maximum peak activation in the inferior and mid temporal gyrus. To the best of our knowledge, this is the first study to characterize brain areas specifically associated with the visuospatial aspects of Tetris gameplay, by controlling for motor activity and when using mental rotation instructions. Results demonstrate that engaging in Tetris gameplay recruits an extensive brain circuitry previously tied to visuospatial processing. Thus, findings are consistent with the use of Tetris as an imagery-competing task as one of several components of emerging interventions targeting dysfunctional mental imagery.

The neural basis of Tetris gameplay: implicating the role of visuospatial processing