Neurotracker as a potential mean of active rehabilitation in children with atypical mild traumatic brain injury recovery: A pilot safety study

Extensive Familiarization Is Required Before Assessing Acute Changes in Multiple Object Tracking Performance

CONTEXT

The Neurotracker CORE assessment is an 8-minute multiple object tracking (MOT) program used in sport science research and clinical rehabilitation as a perceptual-cognitive training tool; however, it has garnered interest for its potential use as an acute assessment of cognitive performance. Although some data exist regarding the learning effect of repeated exposures, it is often overlooked with investigators focusing primarily on the presence of transfer effects to other cognitive realms. As a result, exclusive data on the effect of repeated testing, or subsequent periods of no testing (ie, detraining) on test-retest reliability, and on MOT performance are sparse.

DESIGN

Repeated-measures/reliability.

METHODS

Twenty-three recreationally active men and women completed 15 training sessions consisting of 2 CORE assessments per session (30 assessments). Participants were randomized to either 1 or 2 weeks of detraining prior to completing 15 retraining sessions (30 assessments). Training and retraining periods were divided into 10 blocks (3 assessments/block) for analysis. MOT speed threshold (MOT-ST), consistency, fastest trial score success speed, lowest trial score miss speed, the number of perfect, near misses, and significant miss trials within each block were used to determine performance. Intraclass correlation coefficient, standard error of measurement, and minimal detectable change were used to determine reliability.

RESULTS

Significant improvements in MOT-ST and fastest trial score success speed were noted within training blocks 1 to 6 and 1 to 7, respectively (P < .05). MOT-ST and fastest trial score success speed demonstrated excellent test-retest reliability between blocks 8 and 9. There was no effect of detraining period on performance during retraining.

CONCLUSIONS

Eighteen tests are necessary to overcome training effects and establish a reliable baseline when MOT-ST is used as the performance outcome. Detraining periods up to 2 weeks did not impact performance. The average of 3 discrete tests should be used when assessing MOT-ST performance.

A Protocol for Remote Cognitive Training Developed for Use in Clinical Populations During the COVID-19 Pandemic

Many traumatic brain injury (TBI) survivors face scheduling and transportation challenges when seeking therapeutic interventions. The COVID-19 pandemic created a shift in the use of at-home spaces for work, play, and research, inspiring the development of online therapeutic options. In the current study, we determined the feasibility of an at-home cognitive training tool (NeuroTrackerX) that uses anaglyph three-dimensional (3D) glasses and three-dimensional multiple object tracking (3D-MOT) software. We recruited 20 adults (10 female; mean age = 68.3 years, standard deviation [SD] = 6.75) as the at-home training group. We assessed cognitive health status for participants using a self-report questionnaire and the Mini-Mental State Examination (MMSE), and all participants were deemed cognitively healthy (MMSE >26). At-home participants loaned the necessary equipment (e.g., 3D glasses, computer equipment) from the research facilities and engaged in 10 training sessions over 5 weeks (two times per week). Participant recruitment, retention, adherence, and experience were used as markers of feasibility. For program validation, 20 participants (10 female; mean age = 63.39 years, SD = 12.22), who had previously completed at least eight sessions of the in-lab 3D-MOT program, were randomly selected as the control group. We assessed individual session scores, overall improvement, and learning rates between groups. Program feasibility is supported by high recruitment and retention, 90% participant adherence, and participants' ease of use of the program. Validation of the program is supported. Groups showed no differences in session scores (p > 0.05) and percentage improvement (p > 0.05) despite the differences in screen size and 3D technology. Participants in both groups showed significant improvements in task performance across the training sessions (p < 0.001). NeuroTrackerX provides a promising at-home option for cognitive training in cognitively healthy adults and may be a promising avenue as an at-home therapeutic for TBI survivors. This abstract was previously published on clinicaltrials.gov and can be found at: https://www.clinicaltrials.gov/ct2/show/NCT05278273.

Test-retest reliability of the neurotracker compared to the impact test for the management of mild traumatic brain injuries during two consecutive university sport seasons

INTRODUCTION

Neurocognitive assessment tools such as the Neurotracker and ImPACT have been proposed to optimize sports-related mild traumatic brain injury (mTBI) management. Baseline testing is recommended with such assessments to individualize monitoring of athletes' remission. While the ideal timeframe between baseline updates has been studied for the ImPACT, these data are missing for the Neurotracker.

OBJECTIVE

The current study aimed to compare the test-retest reliability of the ImPACT and Neurotracker for two consecutive seasons in university athletes participating in sports at risk for mTBI.

METHODS

At the start of two consecutive seasons, 30 athletes with no recent history of mTBI completed a baseline assessment including the Neurotracker and the ImPACT. The test-retest reliability of the results was analyzed by considering intra-class correlation (ICC), Becker's standardized mean difference (d_B) and Bland-Altman' plot of each outcome.

RESULTS

The Neurotracker and the Visual Motor Speed composite score of the ImPAC were the only outcomes with significative ICCs and acceptable d_B between the two seasons. Neurotracker was the only outcome with a significative bias (+0.179).

CONCLUSION

Our research suggests that the Neurotracker has an acceptable level of test-retest reliability after one year in comparison to the ImPACT.

Assessing the feasibility of a classroom-based visual attention training program targeting academics for students with extremely low IQ

BACKGROUND

This feasibility study investigated the viability of implementing a cognitive-based training program (NeuroTracker) and assessing its potential effects on academic performance for adolescents with extremely low IQ.

METHODS

Twenty-six adolescents aged between 11 and 16 years with a Wechsler-based IQs in the extremely low range (MIQ = 56.00, SDIQ = 13.89) completed 15 training sessions on either the NeuroTracker or an active control task; math and reading performance were assessed using clinically validated instruments before and after training. Recruitment and retention rates, adherence, and properties of the academic measures were assessed.

RESULTS

All recruited participants completed 15 training sessions within a 6-week period. Eighty-three percent of participants meeting initial inclusion criteria completed all stages of the study from baseline to post-intervention assessments. Some limitations of the academic measures were identified.

CONCLUSIONS

Results suggest that implementing NeuroTracker as a classroom-based intervention and using clinically validated outcome measures is feasible with this population.

Development and testing of a game-based digital intervention for working memory training in autism spectrum disorder

Autism spectrum disorder (ASD) is prevalent globally, yet it lacks cost-effective treatment approaches. Deficits in executive functions occur frequently in autism spectrum disorder and present a target for intervention. Here we report the design and development of five smartphone-based games for training working memory in children with ASD. These open-source games, available free of cost to the community, were designed to match the behavioral preferences and sensorimotor abilities of children with ASD. We then conducted a preliminary trial to test the effectiveness of a month-long intervention using these games. Although we did not see a significant change in the working memory of all children with a month-long training, children who performed better on the games also showed more improvement in their working memory, suggesting that a longer intervention with the games might be useful in improving working memory. Using a Hindi translation of the autism treatment evaluation checklist, we also tested the collateral gains of the training in reducing autistic symptoms. We found no significant change in the autistic symptoms after the intervention. Further, there was no correlation between the change in the working memory and the change in the autistic symptoms.

Topical Review: The Top Five Peripheral Vision Tools in Sport

SIGNIFICANCE

This study summarizes the empirical evidence on the use of peripheral vision for the most-researched peripheral vision tools in sports.

The objective of this review was to explain if and how the tools can be used to investigate peripheral vision usage and how empirical findings with these vision tools might be transferred to sports situations. The data sources used in this study were Scopus, ScienceDirect, and PubMed. We additionally searched the manufacturers' Web pages and used Google Scholar to find full texts that were not available elsewhere. Studies were included if they were published in a peer-reviewed journal, were written in English language, and were conducted in a sports context. From the 10 searched tools, we included the 5 tools with most published studies. In our topical search, we identified 93 studies for the five most-used peripheral vision tools. Surprisingly, none of these studies used eye-tracking methods to control for the use of peripheral vision. Best "passive" control is achieved by tools using (foveal) secondary tasks (Dynavision D2 and Vienna Test System). Best transfer to sports tasks is expected for tools demanding action responses (FitLight, Dynavision D2). Tools are likely to train peripheral monitoring (NeuroTracker), peripheral reaction time (Dynavision D2, Vienna Test System), or peripheral preview (FitLight), whereas one tool did not show any link to peripheral vision processes (Nike SPARQ Vapor Strobe).

A critical systematic review of the Neurotracker perceptual-cognitive training tool

In this systematic review, we evaluate the scientific evidence behind “Neurotracker,” one of the most popular perceptual-cognitive training tools in sports. The tool, which is also used in rehabilitation and aging research to examine cognitive abilities, uses a 3D multiple object-tracking (MOT) task. In this review, we examine Neurotracker from both a sport science and a basic science perspective. We first summarize the sport science debate regarding the value of general cognitive skill training, based on tools such as Neurotracker, versus sport-specific skill training. We then consider the several hundred MOT publications in cognitive and vision science from the last 30 years that have investigated cognitive functions and object tracking processes. This literature suggests that the abilities underlying object tracking are not those advertised by the Neurotracker manufacturers. With a systematic literature search, we scrutinize the evidence for whether general cognitive skills can be tested and trained with Neurotracker and whether these trained skills transfer to other domains. The literature has major limitations, for example a total absence of preregistered studies, which makes the evidence for improvements for working memory and sustained attention very weak. For other skills as well, the effects are mixed. Only three studies investigated far transfer to ecologically valid tasks, two of which did not find any effect. We provide recommendations for future Neurotracker research to improve the evidence base and for making better use of sport and basic science findings.