Timing Game: A Conceptual and Methodological Framework for Temporal Processing Assessment in Digital Health
Resumo
Introduction: Deficits in temporal perception are sensitive transdiagnostic biomarkers for neurobiological conditions, including Parkinson’s disease, ADHD, and Autism Spectrum Disorder. However, objective assessment of these deficits is currently confined to specialized laboratory settings, thereby limiting their scalable clinical application. Objective: To address this translational gap, this paper proposes a conceptual and methodological framework for applying the Timing Game, a previously developed mobile serious game platform that implements nine established psychophysical temporal paradigms as accessible behavioral assessments, as a potential digital phenotyping tool for clinical informatics. Methodology: The platform features a dual-mode architecture that balances scientific rigor with user engagement: (1) an Arcade Mode focused on Ecological Momentary Assessment (EMA) for high-precision psychophysical control, and (2) a Story Mode that integrates identical tasks within a cohesive time-travel narrative to enhance adherence in longitudinal protocols, a hypothesis to be empirically tested in future studies. Grounded in the Computational Phenotype Hypothesis, this work proposes that the platform’s could produce high-granularity behavioral metrics, such as reaction time distributions and inter-response intervals, that could be use as scalable behavioral biomarkers and proxies for neural signatures of temporal processing errors relevant to clinical informatics and digital phenotyping. Results: This paper presents the application of the Timing Game within a digital phenotyping and clinical informatics framework, detailing its validation roadmap toward enabling scalable, ecologically valid temporal assessment for early detection and monitoring of neurobiological disorders.
Palavras-chave:
Temporal Processing, Serious Games for Health, Ecological Momentary Assessment, Digital Health, Clinical Informatics, Digital Biomarkers
Referências
Agostino, P. V., Gatto, E. M., Cesarini, M., Etcheverry, J. L., Sanguinetti, A., e Golombek, D. A. (2017). Deficits in temporal processing correlate with clinical progression in huntington’s disease. Acta Neurologica Scandinavica, 136(4):322–329.
Breska, A. e Ivry, R. B. (2018). Double dissociation of single-interval and rhythmic temporal prediction in cerebellar degeneration and parkinson’s disease. Proceedings of the National Academy of Sciences, 115(48):12283–12288.
Buhusi, C. V. e Meck, W. H. (2005). What makes us tick? functional and neural mechanisms of interval timing. Nature Reviews Neuroscience, 6(10):755–765.
Chan, A. S., Ding, Z., lok Lee, T., Sze, S. L., e Cheung, M.-C. (2023). Temporal processing deficit in children and adolescents with autism spectrum disorder: An online assessment. DIGITAL HEALTH, 9:20552076231171500.
Coull, J. T. e Nobre, A. C. (1998). Where and when to pay attention: The neural systems for directing attention to spatial locations and to time intervals as revealed by both pet and fmri. Journal of Neuroscience, 18(18):7426–7435.
Coutrot, A., Schmidt, S., Coutrot, L., Pittman, J., Hong, L., Wiener, J. M., Hölscher, C., Dalton, R. C., Hornberger, M., e Spiers, H. J. (2019). Virtual navigation tested on a mobile app is predictive of real-world wayfinding navigation performance. PLOS ONE, 14(3):1–15.
Cravo, A. M., Haddad, H., Claessens, P. M., e Baldo, M. V. (2013). Bias and learning in temporal binding: Intervals between actions and outcomes are compressed by prior bias. Consciousness and Cognition, 22(4):1174–1180.
de Vries, L. P., Baselmans, B. M. L., e Bartels, M. (2021). Smartphone-based ecological momentary assessment of well-being: A systematic review and recommendations for future studies. Journal of Happiness Studies, 22(5):2361–2408.
Doumas, I., Everard, G., Dehem, S., e Lejeune, T. (2021). Serious games for upper limb rehabilitation after stroke: A meta-analysis. Journal of NeuroEngineering and Rehabilitation, 18(1):89.
Falter, C. M., Noreika, V., Wearden, J. H., e Bailey, A. J. (2012). More consistent, yet less sensitive: Interval timing in autism spectrum disorders. Quarterly Journal of Experimental Psychology, 65(11):2093–2107. PMID: 22800511.
Fekonja, L. S., Forkel, S. J., Aydogan, D. B., Lioumis, P., Cacciola, A., Lucas, C. W., Tournier, J.-D., Vergani, F., Ritter, P., Schenk, R., Shams, B., Engelhardt, M. J., e Picht, T. (2025). Translational network neuroscience: Nine roadblocks and possible solutions. Network Neuroscience, 9(1):352–370.
Gentry, S. V., Gauthier, A., L’Estrade Ehrstrom, B., Wortley, D., Lilienthal, A., Tudor Car, L., Dauwels-Okutsu, S., Nikolaou, C. K., Zary, N., Campbell, J., e Car, J. (2019). Serious gaming and gamification education in health professions: Systematic review. J Med Internet Res, 21(3):e12994.
Grube, M., Cooper, F. E., Chinnery, P. F., e Griffiths, T. D. (2010). Dissociation of duration-based and beat-based auditory timing in cerebellar degeneration. Proceedings of the National Academy of Sciences, 107(25):11597–11601.
Hinault, T., D’Argembeau, A., Bowler, D. M., La Corte, V., Desaunay, P., Provasi, J., Platel, H., Tran The, J., Charretier, L., Giersch, A., e Droit-Volet, S. (2023). Time processing in neurological and psychiatric conditions. Neuroscience & Biobehavioral Reviews, 154:105430.
Hwang-Gu, S.-L. e Gau, S. S.-F. (2015). Interval timing deficits assessed by time reproduction dual tasks as cognitive endophenotypes for attention-deficit/hyperactivity disorder. PLOS ONE, 10(5):1–16.
Jazayeri, M. e Shadlen, M. N. (2010). Temporal context calibrates interval timing. Nature Neuroscience, 13(8):1020–1026.
Kent, L., Nelson, B., e Northoff, G. (2023). Can disorders of subjective time inform the differential diagnosis of psychiatric disorders? a transdiagnostic taxonomy of time. Early Intervention in Psychiatry, 17(3):231–243.
Laje, R., Cheng, K., e Buonomano, D. V. (2011). Learning of temporal motor patterns: An analysis of continuous versus reset timing. Frontiers in Integrative Neuroscience, Volume 5 - 2011.
Lemoine, L., Lunven, M., Bapst, B., Cleret de Langavant, L., de Gardelle, V., e Bachoud-Lévi, A.-C. (2021). The specific role of the striatum in interval timing: The huntington’s disease model. NeuroImage: Clinical, 32:102865.
Martino, D., Hartmann, A., Pelosin, E., Lagravinese, G., Delorme, C., Worbe, Y., e Avanzino, L. (2019). Motor timing in tourette syndrome: The effect of movement lateralization and bimanual coordination. Frontiers in Neurology, Volume 10 - 2019.
Marx, I., Weirich, S., Berger, C., Herpertz, S. C., Cohrs, S., Wandschneider, R., Höppner, J., e Häßler, F. (2017). Living in the fast lane: Evidence for a global perceptual timing deficit in childhood adhd caused by distinct but partially overlapping task-dependent cognitive mechanisms. Frontiers in Human Neuroscience, Volume 11 - 2017.
Merchant, H., Harrington, D. L., e Meck, W. H. (2013). Neural basis of the perception and estimation of time. Annual Review of Neuroscience, 36:313–336.
Merchant, H., Zarco, W., e Prado, L. (2008). Do we have a common mechanism for measuring time in the hundreds of millisecond range? evidence from multiple-interval timing tasks. Journal of Neurophysiology, 99(2):939–949. PMID: 18094101.
Niknam, S., Duraisamy, S., Botev, J., e Leiva, L. A. (2025a). Brain signatures of time perception in virtual reality. IEEE Transactions on Visualization and Computer Graphics, 31(5):2535–2545.
Niknam, S., Duraisamy, S., Botev, J., e Leiva, L. A. (2025b). Eeg-based prediction of perceptual timing errors in virtual reality. In 2025 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct), pages 168–173.
Onnela, J.-P. e Rauch, S. L. (2016). Harnessing smartphone-based digital phenotyping to enhance behavioral and mental health. Neuropsychopharmacology, 41(7):1691–1696.
Paton, J. J. e Buonomano, D. V. (2018). The neural basis of timing: Distributed mechanisms for diverse functions. Neuron, 98(4):687–705.
Pouplin, S., Bonnyaud, C., Bouchigny, S., Mégard, C., Bertholier, L., Goulamhoussen, R., Foulon, P., Bensmail, D., Barbot, F., e Roche, N. (2023). Feasibility of a serious game system including a tangible object for post stroke upper limb rehabilitation: a pilot randomized clinical study. Frontiers in Neurology, Volume 14 - 2023.
Radhakrishnan, K., Julien, C., O’Hair, M., Lee, G., DeMain, A. S., Leggio, K., Hebért Arsers, E. T., e Baranowski, T. (2022). A sensor-controlled digital game for heart failure self-care based on behavioral change frameworks. In 2022 IEEE 10th International Conference on Serious Games and Applications for Health(SeGAH), pages 1–6.
Roussel, U., Fléty, E., Agon, C., Viaud-Delmon, I., e Taffou, M. (2025). Using android smartphones to collect precise measures of reaction times to multisensory stimuli. Sensors, 25(19).
Teixeira, A., Gois, J., e Brandão, A. (2025a). Timing game: Development of a game for temporal perception research. In Anais Estendidos do XXIV Simpósio Brasileiro de Jogos e Entretenimento Digital, pages 324–330, Porto Alegre, RS, Brasil. SBC.
Teixeira, A. F., Brandão, A. L., Yasui, A. K., Cravo, A., e Gois, J. P. (2025b). The timing game for research on temporal perception. Journal on Interactive Systems, 16(1):733–748.
Terao, Y., Honma, M., Asahara, Y., Tokushige, S.-i., Furubayashi, T., Miyazaki, T., Inomata-Terada, S., Uchibori, A., Miyagawa, S., Ichikawa, Y., Chiba, A., Ugawa, Y., e Suzuki, M. (2021). Time distortion in parkinsonism. Frontiers in Neuroscience, Volume 15 - 2021.
Tokushige, S.-i., Terao, Y., Matsuda, S., Furubayashi, T., Sasaki, T., Inomata-Terada, S., Yugeta, A., Hamada, M., Tsuji, S., e Ugawa, Y. (2018). Does the clock tick slower or faster in parkinson’s disease? – insights gained from the synchronized tapping task. Frontiers in Psychology, Volume 9 - 2018.
Yang, Y. S., Ryu, G. W., Han, I., Oh, S., e Choi, M. (2018). Ecological momentary assessment using smartphone-based mobile application for affect and stress assessment. Healthcare Informatics Research, 24(4):381–386.
Zelaznik, H. N., Spencer, R. M. C., e Ivry, R. B. (2002). Dissociation of explicit and implicit timing in repetitive tapping and drawing movements. Journal of Experimental Psychology: Human Perception and Performance, 28(3):575–588.
Breska, A. e Ivry, R. B. (2018). Double dissociation of single-interval and rhythmic temporal prediction in cerebellar degeneration and parkinson’s disease. Proceedings of the National Academy of Sciences, 115(48):12283–12288.
Buhusi, C. V. e Meck, W. H. (2005). What makes us tick? functional and neural mechanisms of interval timing. Nature Reviews Neuroscience, 6(10):755–765.
Chan, A. S., Ding, Z., lok Lee, T., Sze, S. L., e Cheung, M.-C. (2023). Temporal processing deficit in children and adolescents with autism spectrum disorder: An online assessment. DIGITAL HEALTH, 9:20552076231171500.
Coull, J. T. e Nobre, A. C. (1998). Where and when to pay attention: The neural systems for directing attention to spatial locations and to time intervals as revealed by both pet and fmri. Journal of Neuroscience, 18(18):7426–7435.
Coutrot, A., Schmidt, S., Coutrot, L., Pittman, J., Hong, L., Wiener, J. M., Hölscher, C., Dalton, R. C., Hornberger, M., e Spiers, H. J. (2019). Virtual navigation tested on a mobile app is predictive of real-world wayfinding navigation performance. PLOS ONE, 14(3):1–15.
Cravo, A. M., Haddad, H., Claessens, P. M., e Baldo, M. V. (2013). Bias and learning in temporal binding: Intervals between actions and outcomes are compressed by prior bias. Consciousness and Cognition, 22(4):1174–1180.
de Vries, L. P., Baselmans, B. M. L., e Bartels, M. (2021). Smartphone-based ecological momentary assessment of well-being: A systematic review and recommendations for future studies. Journal of Happiness Studies, 22(5):2361–2408.
Doumas, I., Everard, G., Dehem, S., e Lejeune, T. (2021). Serious games for upper limb rehabilitation after stroke: A meta-analysis. Journal of NeuroEngineering and Rehabilitation, 18(1):89.
Falter, C. M., Noreika, V., Wearden, J. H., e Bailey, A. J. (2012). More consistent, yet less sensitive: Interval timing in autism spectrum disorders. Quarterly Journal of Experimental Psychology, 65(11):2093–2107. PMID: 22800511.
Fekonja, L. S., Forkel, S. J., Aydogan, D. B., Lioumis, P., Cacciola, A., Lucas, C. W., Tournier, J.-D., Vergani, F., Ritter, P., Schenk, R., Shams, B., Engelhardt, M. J., e Picht, T. (2025). Translational network neuroscience: Nine roadblocks and possible solutions. Network Neuroscience, 9(1):352–370.
Gentry, S. V., Gauthier, A., L’Estrade Ehrstrom, B., Wortley, D., Lilienthal, A., Tudor Car, L., Dauwels-Okutsu, S., Nikolaou, C. K., Zary, N., Campbell, J., e Car, J. (2019). Serious gaming and gamification education in health professions: Systematic review. J Med Internet Res, 21(3):e12994.
Grube, M., Cooper, F. E., Chinnery, P. F., e Griffiths, T. D. (2010). Dissociation of duration-based and beat-based auditory timing in cerebellar degeneration. Proceedings of the National Academy of Sciences, 107(25):11597–11601.
Hinault, T., D’Argembeau, A., Bowler, D. M., La Corte, V., Desaunay, P., Provasi, J., Platel, H., Tran The, J., Charretier, L., Giersch, A., e Droit-Volet, S. (2023). Time processing in neurological and psychiatric conditions. Neuroscience & Biobehavioral Reviews, 154:105430.
Hwang-Gu, S.-L. e Gau, S. S.-F. (2015). Interval timing deficits assessed by time reproduction dual tasks as cognitive endophenotypes for attention-deficit/hyperactivity disorder. PLOS ONE, 10(5):1–16.
Jazayeri, M. e Shadlen, M. N. (2010). Temporal context calibrates interval timing. Nature Neuroscience, 13(8):1020–1026.
Kent, L., Nelson, B., e Northoff, G. (2023). Can disorders of subjective time inform the differential diagnosis of psychiatric disorders? a transdiagnostic taxonomy of time. Early Intervention in Psychiatry, 17(3):231–243.
Laje, R., Cheng, K., e Buonomano, D. V. (2011). Learning of temporal motor patterns: An analysis of continuous versus reset timing. Frontiers in Integrative Neuroscience, Volume 5 - 2011.
Lemoine, L., Lunven, M., Bapst, B., Cleret de Langavant, L., de Gardelle, V., e Bachoud-Lévi, A.-C. (2021). The specific role of the striatum in interval timing: The huntington’s disease model. NeuroImage: Clinical, 32:102865.
Martino, D., Hartmann, A., Pelosin, E., Lagravinese, G., Delorme, C., Worbe, Y., e Avanzino, L. (2019). Motor timing in tourette syndrome: The effect of movement lateralization and bimanual coordination. Frontiers in Neurology, Volume 10 - 2019.
Marx, I., Weirich, S., Berger, C., Herpertz, S. C., Cohrs, S., Wandschneider, R., Höppner, J., e Häßler, F. (2017). Living in the fast lane: Evidence for a global perceptual timing deficit in childhood adhd caused by distinct but partially overlapping task-dependent cognitive mechanisms. Frontiers in Human Neuroscience, Volume 11 - 2017.
Merchant, H., Harrington, D. L., e Meck, W. H. (2013). Neural basis of the perception and estimation of time. Annual Review of Neuroscience, 36:313–336.
Merchant, H., Zarco, W., e Prado, L. (2008). Do we have a common mechanism for measuring time in the hundreds of millisecond range? evidence from multiple-interval timing tasks. Journal of Neurophysiology, 99(2):939–949. PMID: 18094101.
Niknam, S., Duraisamy, S., Botev, J., e Leiva, L. A. (2025a). Brain signatures of time perception in virtual reality. IEEE Transactions on Visualization and Computer Graphics, 31(5):2535–2545.
Niknam, S., Duraisamy, S., Botev, J., e Leiva, L. A. (2025b). Eeg-based prediction of perceptual timing errors in virtual reality. In 2025 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct), pages 168–173.
Onnela, J.-P. e Rauch, S. L. (2016). Harnessing smartphone-based digital phenotyping to enhance behavioral and mental health. Neuropsychopharmacology, 41(7):1691–1696.
Paton, J. J. e Buonomano, D. V. (2018). The neural basis of timing: Distributed mechanisms for diverse functions. Neuron, 98(4):687–705.
Pouplin, S., Bonnyaud, C., Bouchigny, S., Mégard, C., Bertholier, L., Goulamhoussen, R., Foulon, P., Bensmail, D., Barbot, F., e Roche, N. (2023). Feasibility of a serious game system including a tangible object for post stroke upper limb rehabilitation: a pilot randomized clinical study. Frontiers in Neurology, Volume 14 - 2023.
Radhakrishnan, K., Julien, C., O’Hair, M., Lee, G., DeMain, A. S., Leggio, K., Hebért Arsers, E. T., e Baranowski, T. (2022). A sensor-controlled digital game for heart failure self-care based on behavioral change frameworks. In 2022 IEEE 10th International Conference on Serious Games and Applications for Health(SeGAH), pages 1–6.
Roussel, U., Fléty, E., Agon, C., Viaud-Delmon, I., e Taffou, M. (2025). Using android smartphones to collect precise measures of reaction times to multisensory stimuli. Sensors, 25(19).
Teixeira, A., Gois, J., e Brandão, A. (2025a). Timing game: Development of a game for temporal perception research. In Anais Estendidos do XXIV Simpósio Brasileiro de Jogos e Entretenimento Digital, pages 324–330, Porto Alegre, RS, Brasil. SBC.
Teixeira, A. F., Brandão, A. L., Yasui, A. K., Cravo, A., e Gois, J. P. (2025b). The timing game for research on temporal perception. Journal on Interactive Systems, 16(1):733–748.
Terao, Y., Honma, M., Asahara, Y., Tokushige, S.-i., Furubayashi, T., Miyazaki, T., Inomata-Terada, S., Uchibori, A., Miyagawa, S., Ichikawa, Y., Chiba, A., Ugawa, Y., e Suzuki, M. (2021). Time distortion in parkinsonism. Frontiers in Neuroscience, Volume 15 - 2021.
Tokushige, S.-i., Terao, Y., Matsuda, S., Furubayashi, T., Sasaki, T., Inomata-Terada, S., Yugeta, A., Hamada, M., Tsuji, S., e Ugawa, Y. (2018). Does the clock tick slower or faster in parkinson’s disease? – insights gained from the synchronized tapping task. Frontiers in Psychology, Volume 9 - 2018.
Yang, Y. S., Ryu, G. W., Han, I., Oh, S., e Choi, M. (2018). Ecological momentary assessment using smartphone-based mobile application for affect and stress assessment. Healthcare Informatics Research, 24(4):381–386.
Zelaznik, H. N., Spencer, R. M. C., e Ivry, R. B. (2002). Dissociation of explicit and implicit timing in repetitive tapping and drawing movements. Journal of Experimental Psychology: Human Perception and Performance, 28(3):575–588.
Publicado
29/09/2026
Como Citar
TEIXEIRA, Alan Floriano; BRANDÃO, André Luiz; CRAVO, André Mascioli; GOIS, João Paulo.
Timing Game: A Conceptual and Methodological Framework for Temporal Processing Assessment in Digital Health. In: SIMPÓSIO BRASILEIRO DE JOGOS E ENTRETENIMENTO DIGITAL (SBGAMES), 25. , 2026, Goiânia/GO.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2026
.
p. 2766-2778.
DOI: https://doi.org/10.5753/sbgames.2026.25495.
