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Garcia S, Askew RL, Kavcic V, Shair S, Bhaumik AK, Rose E, Campbell S, May N, Hampstead BM, Dodge HH, Heidebrink JL, Paulson HL, Giordani B. Mild Cognitive Impairment Subtype Performance in Comparison to Healthy Older Controls on the NIH Toolbox and Cogstate. Alzheimer Dis Assoc Disord 2023; 37:328-334. [PMID: 37862614 PMCID: PMC10873007 DOI: 10.1097/wad.0000000000000587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 09/06/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Early detection is necessary for the treatment of dementia. Computerized testing has become more widely used in clinical trials; however, it is unclear how sensitive these measures are to early signs of neurodegeneration. We investigated the use of the NIH Toolbox-Cognition (NIHTB-CB) and Cogstate-Brief computerized neuropsychological batteries in the identification of mild cognitive impairment (MCI) versus healthy older adults [healthy control (HC)] and amnestic (aMCI) versus nonamnestic MCI (naMCI). Exploratory analyses include investigating potential racial differences. METHODS Two hundred six older adults were diagnosed as aMCI (n = 58), naMCI (n = 15), or cognitively healthy (HC; n = 133). RESULTS The NIH Toolbox-CB subtests of Flanker, Picture Sequence Memory, and Picture Vocabulary significantly differentiated MCI from HC. Further, subtests from both computerized batteries differentiated patients with aMCI from those with naMCI. Although the main effect of race differences was noted on tests and in diagnostic groups was significant, there were no significant race-by-test interactions. CONCLUSIONS Computer-based subtests vary in their ability to help distinguish MCI subtypes, though these tests provide less expensive and easier-to-administer clinical screeners to help identify patients early who may qualify for more comprehensive evaluations. Further work is needed, however, to refine computerized tests to achieve better precision in distinguishing impairment subtypes.
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Affiliation(s)
- Sarah Garcia
- Psychology Department, Stetson University, DeLand, FL, USA
| | | | | | - Sarah Shair
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Arijit K Bhaumik
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Edna Rose
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Stephen Campbell
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Nicolas May
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Benjamin M. Hampstead
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Hiroko H. Dodge
- Layton Aging and Alzheimer’s Disease Center, Department of Neurology, Oregon Health & Science University, Portland, OR
| | - Judith L Heidebrink
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Henry L Paulson
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
| | - Bruno Giordani
- Departments of Psychiatry, Neurology, Psychology, and School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
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Zheng Y, Liu C, Lai NYG, Wang Q, Xia Q, Sun X, Zhang S. Current development of biosensing technologies towards diagnosis of mental diseases. Front Bioeng Biotechnol 2023; 11:1190211. [PMID: 37456720 PMCID: PMC10342212 DOI: 10.3389/fbioe.2023.1190211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
The biosensor is an instrument that converts the concentration of biomarkers into electrical signals for detection. Biosensing technology is non-invasive, lightweight, automated, and biocompatible in nature. These features have significantly advanced medical diagnosis, particularly in the diagnosis of mental disorder in recent years. The traditional method of diagnosing mental disorders is time-intensive, expensive, and subject to individual interpretation. It involves a combination of the clinical experience by the psychiatrist and the physical symptoms and self-reported scales provided by the patient. Biosensors on the other hand can objectively and continually detect disease states by monitoring abnormal data in biomarkers. Hence, this paper reviews the application of biosensors in the detection of mental diseases, and the diagnostic methods are divided into five sub-themes of biosensors based on vision, EEG signal, EOG signal, and multi-signal. A prospective application in clinical diagnosis is also discussed.
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Affiliation(s)
- Yuhan Zheng
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
- Ningbo Research Center, Ningbo Innovation Center, Zhejiang University, Ningbo, China
- Robotics Institute, Ningbo University of Technology, Ningbo, China
| | - Chen Liu
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
- Ningbo Research Center, Ningbo Innovation Center, Zhejiang University, Ningbo, China
| | - Nai Yeen Gavin Lai
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
| | - Qingfeng Wang
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo China, Ningbo, China
| | - Qinghua Xia
- Ningbo Research Center, Ningbo Innovation Center, Zhejiang University, Ningbo, China
| | - Xu Sun
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
- Nottingham Ningbo China Beacons of Excellence Research and Innovation Institute, University of Nottingham Ningbo China, Ningbo, China
| | - Sheng Zhang
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China
- Ningbo Research Center, Ningbo Innovation Center, Zhejiang University, Ningbo, China
- School of Mechanical Engineering, Zhejiang University, Hangzhou, China
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3
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Exarchos TP, Whelan R, Tarnanas I. Dynamic Reconfiguration of Dominant Intrinsic Coupling Modes in Elderly at Prodromal Alzheimer's Disease Risk. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1424:1-22. [PMID: 37486474 DOI: 10.1007/978-3-031-31982-2_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Large-scale human brain networks interact across both spatial and temporal scales. Especially for electro- and magnetoencephalography (EEG/MEG), there are many evidences that there is a synergy of different subnetworks that oscillate on a dominant frequency within a quasi-stable brain temporal frame. Intrinsic cortical-level integration reflects the reorganization of functional brain networks that support a compensation mechanism for cognitive decline. Here, a computerized intervention integrating different functions of the medial temporal lobes, namely, object-level and scene-level representations, was conducted. One hundred fifty-eight patients with mild cognitive impairment underwent 90 min of training per day over 10 weeks. An active control (AC) group of 50 subjects was exposed to documentaries, and a passive control group of 55 subjects did not engage in any activity. Following a dynamic functional source connectivity analysis, the dynamic reconfiguration of intra- and cross-frequency coupling mechanisms before and after the intervention was revealed. After the neuropsychological and resting state electroencephalography evaluation, the ratio of inter versus intra-frequency coupling modes and also the contribution of β1 frequency was higher for the target group compared to its pre-intervention period. These frequency-dependent contributions were linked to neuropsychological estimates that were improved due to intervention. Additionally, the time-delays of the cortical interactions were improved in {δ, θ, α2, β1} compared to the pre-intervention period. Finally, dynamic networks of the target group further improved their efficiency over the total cost of the network. This is the first study that revealed a dynamic reconfiguration of intrinsic coupling modes and an improvement of time-delays due to a target intervention protocol.
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Affiliation(s)
| | - Robert Whelan
- Trinity College Institute of Neurosciences, Trinity College, Dublin, Ireland
| | - Ioannis Tarnanas
- Altoida Inc, Houston, TX, USA
- Global Brain Health Institute, Trinity College, Dublin, Ireland
- University of California, San Francisco, CA, USA
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4
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Reggente N. VR for Cognition and Memory. Curr Top Behav Neurosci 2023; 65:189-232. [PMID: 37440126 DOI: 10.1007/7854_2023_425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
This chapter will provide a review of research into human cognition through the lens of VR-based paradigms for studying memory. Emphasis is placed on why VR increases the ecological validity of memory research and the implications of such enhancements.
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Affiliation(s)
- Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA.
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5
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Abstract
IMPORTANCE Virtual reality (VR) is a promising tool with the potential to enhance care of cognitive and affective disorders in the aging population. VR has been implemented in clinical settings with adolescents and children; however, it has been less studied in the geriatric population. OBJECTIVE The objective of this study is to determine the existing levels of evidence for VR use in clinical settings and identify areas where more evidence may guide translation of existing VR interventions for older adults. DESIGN AND MEASUREMENTS We conducted a systematic review in PubMed and Web of Science in November 2019 for peer-reviewed journal articles on VR technology and its applications in older adults. We reviewed article content and extracted the number of study participants, study population, goal of the investigation, the level of evidence, and categorized articles based on the indication of the VR technology and the study population. RESULTS The database search yielded 1554 total results, and 55 articles were included in the final synthesis. The most represented study design was cross-sectional, and the most common study population was subjects with cognitive impairment. Articles fell into three categories for VR Indication: Testing, Training, and Screening. There was a wide variety of VR environments used across studies. CONCLUSIONS Existing evidence offers support for VR as a screening and training tool for cognitive impairment in older adults. VR-based tasks demonstrated validity comparable to some paper-based assessments of cognition, though more work is needed to refine diagnostic specificity. The variety of VR environments used shows a need for standardization before comparisons can be made across VR simulations. Future studies should address key issues such as usability, data privacy, and confidentiality. Since most literature was generated from high-income countries (HICs), it remains unclear how this may be translated to other parts of the world.
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Zhu K, Lin R, Li H. Study of virtual reality for mild cognitive impairment: A bibliometric analysis using CiteSpace. Int J Nurs Sci 2022; 9:129-136. [PMID: 35079614 PMCID: PMC8766785 DOI: 10.1016/j.ijnss.2021.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 12/04/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
Objectives Non-invasive and low-cost virtual reality (VR) technology is important for early evaluation and intervention in mild cognitive impairment (MCI). This study aimed to demonstrate the current status of overseas and domestic research as well as the focus and frontier of VR technology among individuals with MCI through a bibliometric analysis. Methods Studies from the core collection of Web of Science™ between 1995 and 2020 were used; furthermore, CiteSpace 5.7 R3 was utilized to analyse information on authors/cited authors, keywords, burst words, and cited references. Results In total, 230 publications were identified. Most studies were published in the USA (45 publications) and Italy (41 publications), where Guiseppe Riva ranks first (14 publications), and Tarnanas I is the author with the highest centrality (0.44). The hot topics in VR applications in the MCI population are ‘physical activity,’ ‘people,’ ‘single-blind,’ ‘disease,’ ‘walking,’ ‘technology,’ ‘working memory,’ and ‘risk’ in recent years. The keyword ‘mild cognitive impairment’ has attracted extensive attention since 2012, showing the strongest citation outbreak (8.28). The clustering results of the literature show the research types and emerging trends, including ‘exergame,’ ‘serious games,’ ‘spatial navigation,’ ‘activities of daily living,’ ‘exercise,’ ‘enriched environment’ and ‘wayfinding.‘ Conclusions Cognitive assessment and nonpharmacological intervention research on patients with MCI have become the focus of dementia prevention in recent years. Virtual technology, combined with traditional methods such as exercise therapy, provides new ideas for innovative cognitive evaluation and cognitive intervention.
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Affiliation(s)
- Kaiyan Zhu
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong Lin
- The School of Nursing, Fujian Medical University, Fuzhou, China
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China
| | - Hong Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
- Research Center for Nursing Theory and Practice, Fujian Provincial Hospital, Fuzhou, China
- Corresponding author.
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7
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Wen D, Li R, Jiang M, Li J, Liu Y, Dong X, Saripan MI, Song H, Han W, Zhou Y. Multi-dimensional conditional mutual information with application on the EEG signal analysis for spatial cognitive ability evaluation. Neural Netw 2021; 148:23-36. [PMID: 35051867 DOI: 10.1016/j.neunet.2021.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
This study aims to explore an effective method to evaluate spatial cognitive ability, which can effectively extract and classify the feature of EEG signals collected from subjects participating in the virtual reality (VR) environment; and evaluate the training effect objectively and quantitatively to ensure the objectivity and accuracy of spatial cognition evaluation, according to the classification results. Therefore, a multi-dimensional conditional mutual information (MCMI) method is proposed, which could calculate the coupling strength of two channels considering the influence of other channels. The coupled characteristics of the multi-frequency combination were transformed into multi-spectral images, and the image data were classified employing the convolutional neural networks (CNN) model. The experimental results showed that the multi-spectral image transform features based on MCMI are better in classification than other methods, and among the classification results of six band combinations, the best classification accuracy of Beta1-Beta2-Gamma combination is 98.3%. The MCMI characteristics on the Beta1-Beta2-Gamma band combination can be a biological marker for the evaluation of spatial cognition. The proposed feature extraction method based on MCMI provides a new perspective for spatial cognitive ability assessment and analysis.
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Affiliation(s)
- Dong Wen
- Institute of Artificial Intelligence, University of Science and Technology Beijing, Beijing, China
| | - Rou Li
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Mengmeng Jiang
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Jingjing Li
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Yijun Liu
- School of Science, Yanshan University, Qinhuangdao, China
| | - Xianling Dong
- Department of Biomedical Engineering, Chengde Medical University, Chengde, China
| | - M Iqbal Saripan
- Faculty of Engineering, Universiti Putra Malaysia, Serdang, Malaysia
| | - Haiqing Song
- Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Wei Han
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
| | - Yanhong Zhou
- School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China.
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8
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Shahidul Islam M, Al‐Majid AM, Azam M, Prakash Verma V, Barakat A, Haukka M, Domingo LR, Elgazar AA, Mira A, Badria FA. Synthesis of Spirooxindole Analogs Tethered Pyrazole Scaffold as Acetylcholinesterase Inhibitors. ChemistrySelect 2021. [DOI: 10.1002/slct.202103255] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Mohammad Shahidul Islam
- Department of Chemistry College of Science King Saud University P.O. Box 2455 Riyadh 11451 Saudi Arabia
- Department of Chemistry Banasthali Vidyapith Banasthali- 304022 Rajasthan India
| | | | - Mohammad Azam
- Department of Chemistry College of Science King Saud University P.O. Box 2455 Riyadh 11451 Saudi Arabia
| | - Ved Prakash Verma
- Department of Chemistry Banasthali Vidyapith Banasthali- 304022 Rajasthan India
| | - Assem Barakat
- Department of Chemistry College of Science King Saud University P.O. Box 2455 Riyadh 11451 Saudi Arabia
- Department of Chemistry, Faculty of Science Alexandria University, P.O. Box 426, Ibrahimia Alexandria 21321 Egypt
| | - Matti Haukka
- Department of Chemistry University of Jyväskylä, P.O. Box 35 FI-40014 Jyväskylä Finland
| | - Luis R. Domingo
- Department of Organic Chemistry University of Valencia, Dr. Moliner 50 46100 Burjassot, Valencia Spain
| | - Abdullah A. Elgazar
- Department of Pharmacognosy, Faculty of Pharmacy Kafrelsheikh University Kafrelsheikh 33516 Egypt
| | - Amira Mira
- Department of Pharmacognosy, Faculty of Pharmacy Mansoura University Mansoura 35516 Egypt
| | - Farid A. Badria
- Department of Pharmacognosy, Faculty of Pharmacy Mansoura University Mansoura 35516 Egypt
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9
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Kim E, Han J, Choi H, Prié Y, Vigier T, Bulteau S, Kwon GH. Examining the Academic Trends in Neuropsychological Tests for Executive Functions Using Virtual Reality: Systematic Literature Review. JMIR Serious Games 2021; 9:e30249. [PMID: 34822341 PMCID: PMC8663439 DOI: 10.2196/30249] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 08/31/2021] [Accepted: 09/19/2021] [Indexed: 01/19/2023] Open
Abstract
Background In neuropsychology, fully immersive virtual reality (VR) has been spotlighted as a promising tool. It is considered that VR not only overcomes the existing limitation of neuropsychological tests but is also appropriate for treating executive functions (EFs) within activities of daily living (ADL) due to its high ecological validity. While fully immersive VR offers new possibilities of neuropsychological tests, there are few studies that overview the intellectual landscape and academic trends in the research related to mainly targeted EFs with fully immersive VR. Objective The objective of this study is to get an overview of the research trends that use VR in neuropsychological tests and to analyze the research trends using fully immersive VR neuropsychological tests with experimental articles. Methods This review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were searched in three web databases using keywords related to VR, EFs, and cognitive abilities. The study was conducted in two steps, keyword analysis and in-depth systematic review. In the web database search from 2000 to 2019, 1167 articles were initially collected, of which 234 articles in the eligibility phase were used to conduct keyword analysis and a total of 47 articles were included for systematic review. Results In keyword analysis, the number of articles focused on dementia including the keywords “MCI,” “SCD,” and “dementia” were highlighted over the period, rather than other symptoms. In addition, we identified that the use of behavioral and physiological data in virtual environments (VEs) has dramatically increased in recent studies. In the systematic review, we focused on the purpose of study, assessment, treatment, and validation of usability and structure. We found that treatment studies and uncategorized studies including presence and cybersickness issues have emerged in the recent period. In addition, the target symptoms and range of participants were diversified. Conclusions There has been a continuously increasing interest in dealing with neuropsychology by using fully immersive VR. Target cognitive abilities have been diversified, as well as target symptoms. Moreover, the concept of embodied cognition was transplanted in this research area.
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Affiliation(s)
- Euisung Kim
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
| | - Jieun Han
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
| | - Hojin Choi
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Yannick Prié
- Laboratory of Digital Science of Nantes (LS2N), CNRS UMR6004, Nantes Université, Nantes, France
| | - Toinon Vigier
- Laboratory of Digital Science of Nantes (LS2N), CNRS UMR6004, Nantes Université, Nantes, France
| | - Samuel Bulteau
- CHU Nantes, Psychiatry Department, Nantes, France.,INSERM U1246, SPHERE, University of Nantes, University of Tours, Nantes, France
| | - Gyu Hyun Kwon
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
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10
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Bottiroli S, Bernini S, Cavallini E, Sinforiani E, Zucchella C, Pazzi S, Cristiani P, Vecchi T, Tost D, Sandrini G, Tassorelli C. The Smart Aging Platform for Assessing Early Phases of Cognitive Impairment in Patients With Neurodegenerative Diseases. Front Psychol 2021; 12:635410. [PMID: 33790839 PMCID: PMC8005545 DOI: 10.3389/fpsyg.2021.635410] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/05/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease. Methods: Ninety-one subjects (mean age = 70.29 ± 7.70 years)—healthy older adults (HCs, n = 23), patients with single-domain amnesic mild cognitive impairment (aMCI, n = 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI, n = 20), and patients with mild Alzheimer's disease (mild AD, n = 25)—were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups. Results: The findings revealed significant between-group differences in all the Smart Aging indices: accuracy (p < 0.001), time (p < 0.001), distance (p < 0.001), and total Smart Aging score (p < 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used. Conclusion: These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases.
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Affiliation(s)
- Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy.,National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Sara Bernini
- National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Elena Cavallini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Elena Sinforiani
- National Neurological Institute C. Mondino Foundation, Pavia, Italy
| | - Chiara Zucchella
- Neurology Unit, Department of Neurosciences, Verona University Hospital, Verona, Italy
| | - Stefania Pazzi
- Consorzio di Bioingegneria Medica e Informatica CBIM, Pavia, Italy
| | - Paolo Cristiani
- Consorzio di Bioingegneria Medica e Informatica CBIM, Pavia, Italy
| | - Tomaso Vecchi
- National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Daniela Tost
- Computer Graphics Division Research Centre for Biomedical Engineering (CREB), Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Giorgio Sandrini
- National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- National Neurological Institute C. Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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11
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Fernández Montenegro JM, Villarini B, Angelopoulou A, Kapetanios E, Garcia-Rodriguez J, Argyriou V. A Survey of Alzheimer's Disease Early Diagnosis Methods for Cognitive Assessment. SENSORS (BASEL, SWITZERLAND) 2020; 20:E7292. [PMID: 33353076 PMCID: PMC7766748 DOI: 10.3390/s20247292] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/09/2020] [Accepted: 12/16/2020] [Indexed: 12/22/2022]
Abstract
Dementia is a syndrome that is characterised by the decline of different cognitive abilities. A high rate of deaths and high cost for detection, treatments, and patients care count amongst its consequences. Although there is no cure for dementia, a timely diagnosis helps in obtaining necessary support, appropriate medication, and maintenance, as far as possible, of engagement in intellectual, social, and physical activities. The early detection of Alzheimer Disease (AD) is considered to be of high importance for improving the quality of life of patients and their families. In particular, Virtual Reality (VR) is an expanding tool that can be used in order to assess cognitive abilities while navigating through a Virtual Environment (VE). The paper summarises common AD screening and diagnosis techniques focusing on the latest approaches that are based on Virtual Environments, behaviour analysis, and emotions recognition, aiming to provide more reliable and non-invasive diagnostics at home or in a clinical environment. Furthermore, different AD diagnosis evaluation methods and metrics are presented and discussed together with an overview of the different datasets.
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Affiliation(s)
| | - Barbara Villarini
- Department of Computer Science, University of Westminster, London W1W 7BY, UK; (B.V.); (A.A.); (E.K.)
| | - Anastassia Angelopoulou
- Department of Computer Science, University of Westminster, London W1W 7BY, UK; (B.V.); (A.A.); (E.K.)
| | - Epaminondas Kapetanios
- Department of Computer Science, University of Westminster, London W1W 7BY, UK; (B.V.); (A.A.); (E.K.)
| | | | - Vasileios Argyriou
- Department of Networks and Digital Media, Kingston University, London KT1 2EE, UK; (J.M.F.M.); (V.A.)
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12
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Lazarou I, Stavropoulos TG, Meditskos G, Andreadis S, Kompatsiaris IY, Tsolaki M. Long-Term Impact of Intelligent Monitoring Technology on People with Cognitive Impairment: An Observational Study. J Alzheimers Dis 2020; 70:757-792. [PMID: 31256141 DOI: 10.3233/jad-190423] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Interactive smart home systems are particularly useful for people with cognitive impairment. OBJECTIVE To investigate the long-term effects of Assistive Technology (AT) combined with tailored non-pharmacological interventions for people with cognitive impairment. METHODS 18 participants (12 with mild cognitive impairment and 6 with Alzheimer's disease) took part in the study that we evenly allocated in one of three groups: 1) experimental group (EG), 2) control group 1 (CG1), and 3) control group 2 (CG2). EG received the system installed at home for 4 to 12 months, during which they received tailored non-pharmacological interventions according to system observations. CG1 received tailored interventions for the same period, but only according to state-of-the-art self-reporting methods. Finally, CG2 neither had a system installation nor received interventions. All groups underwent neuropsychological assessment before and after the observational period. RESULTS After several months of continuously monitoring at home and deployment of tailored interventions, the EG showed statistically significant improvement in cognitive function, compared to the CG1 and CG2. Moreover, EG participants, who received the sensor-based system, have shown improvement in domains such as sleep quality and daily activity, as measured by the multi-sensor system. In addition, the feedback collected from the participants concludes that the long-term use of the multi-sensor system by people with cognitive impairment can be both feasible and beneficial. CONCLUSION Deploying a sensor-based system at real home settings of people with cognitive limitations living alone and maintaining its use long-term is not only possible, but also beneficial for clinical decision making in order to tackle cognitive, functional, and behavioral related problems.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Georgios Meditskos
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Stelios Andreadis
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Ioannis Yiannis Kompatsiaris
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece
| | - Magda Tsolaki
- Information Technologies Institute, Center for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Macedonia, Greece.,1st Department of Neurology, U.H. "AHEPA", Medical School, Faculty of Healthy Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Macedonia, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD - Alzheimer Hellas), Thessaloniki, Macedonia, Greece
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13
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Buegler M, Harms R, Balasa M, Meier IB, Exarchos T, Rai L, Boyle R, Tort A, Kozori M, Lazarou E, Rampini M, Cavaliere C, Vlamos P, Tsolaki M, Babiloni C, Soricelli A, Frisoni G, Sanchez-Valle R, Whelan R, Merlo-Pich E, Tarnanas I. Digital biomarker-based individualized prognosis for people at risk of dementia. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2020; 12:e12073. [PMID: 32832589 PMCID: PMC7437401 DOI: 10.1002/dad2.12073] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 12/23/2022]
Abstract
Background Research investigating treatments and interventions for cognitive decline fail due to difficulties in accurately recognizing behavioral signatures in the presymptomatic stages of the disease. For this validation study, we took our previously constructed digital biomarker‐based prognostic models and focused on generalizability and robustness of the models. Method We validated prognostic models characterizing subjects using digital biomarkers in a longitudinal, multi‐site, 40‐month prospective study collecting data in memory clinics, general practitioner offices, and home environments. Results Our models were able to accurately discriminate between healthy subjects and individuals at risk to progress to dementia within 3 years. The model was also able to differentiate between people with or without amyloid neuropathology and classify fast and slow cognitive decliners with a very good diagnostic performance. Conclusion Digital biomarker prognostic models can be a useful tool to assist large‐scale population screening for the early detection of cognitive impairment and patient monitoring over time.
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Affiliation(s)
| | | | - Mircea Balasa
- Global Brain Health Institute San Francisco, California USA
| | | | - Themis Exarchos
- Bioinformatics and Human Electrophysiology Laboratory Corfu Greece
| | - Laura Rai
- Trinity College Institute of Neuroscience College Green, Dublin Ireland
| | - Rory Boyle
- Trinity College Institute of Neuroscience College Green, Dublin Ireland
| | - Adria Tort
- Institut d'Investigació Biomèdica August Pi i Sunyer Carrer del Rosselló, Barcelona Spain
| | - Maha Kozori
- Greek Association for Alzheimer's Disease and Related Disorders, Thessaloniki Greece
| | - Eutuxia Lazarou
- Greek Association for Alzheimer's Disease and Related Disorders, Thessaloniki Greece
| | | | | | | | - Magda Tsolaki
- 1st Department of Neurology AHEPA University Hospital, Thessaloniki Greece.,Information Technologies Institute Centre for Research and Technology Hellas (CERTH); Aristotle University of Thessaloniki, Thermi Greece
| | - Claudio Babiloni
- Department of Physiology and Pharmacology University of Rome, Roma Italy.,San Raffaele Cassino, Cassino (FR), Italy
| | - Andrea Soricelli
- 1st Department of Neurology AHEPA University Hospital, Thessaloniki Greece.,University of Naples Parthenope, Napoli Italy
| | - Giovanni Frisoni
- University of Geneva, Geneva Switzerland.,Laboratory of Neuroimaging and Alzheimer's Epidemiology IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia Italy.,Memory Clinic and LANVIE, Geneva Switzerland.,University of Brescia, Brescia Italy
| | - Raquel Sanchez-Valle
- IDIBAPS Neurological Tissue Bank Hospital Clinic, Barcelona Spain.,Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona Spain.,Alzheimer's Disease and Other Cognitive Disorders Unit Hospital Clínic Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona Spain
| | - Robert Whelan
- Trinity College Institute of Neuroscience College Green, Dublin Ireland
| | | | - Ioannis Tarnanas
- Altoida Inc. Houston, Texas USA.,Global Brain Health Institute San Francisco, California USA.,Hellenic Initiative Against Alzheimer's Disease, Johns Hopkins Precision Medicine Center, Baltimore, Maryland, United States and BiHeLab, Ionian University, Kerkira, Greece
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14
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Andrade Ferreira LD, Ferreira H, Cavaco S, Cameirão M, I Badia SB. User Experience of Interactive Technologies for People With Dementia: Comparative Observational Study. JMIR Serious Games 2020; 8:e17565. [PMID: 32755894 PMCID: PMC7439148 DOI: 10.2196/17565] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/15/2020] [Accepted: 06/09/2020] [Indexed: 01/22/2023] Open
Abstract
Background Serious games (SGs) are used as complementary approaches to stimulate patients with dementia. However, many of the SGs use out-of-the-shelf technologies that may not always be suitable for such populations, as they can lead to negative behaviors, such as anxiety, fatigue, and even cybersickness. Objective This study aims to evaluate how patients with dementia interact and accept 5 out-of-the-shelf technologies while completing 10 virtual reality tasks. Methods A total of 12 participants diagnosed with dementia (mean age 75.08 [SD 8.07] years, mean Mini-Mental State Examination score 17.33 [SD 5.79], and mean schooling 5.55 [SD 3.30]) at a health care center in Portugal were invited to participate in this study. A within-subject experimental design was used to allow all participants to interact with all technologies, such as HTC VIVE, head-mounted display (HMD), tablet, mouse, augmented reality (AR), leap motion (LM), and a combination of HMD with LM. Participants’ performance was quantified through behavioral and verbal responses, which were captured through video recordings and written notes. Results The findings of this study revealed that the user experience using technology was dependent on the patient profile; the patients had a better user experience when they use technologies with direct interaction configuration as opposed to indirect interaction configuration in terms of assistance required (P=.01) and comprehension (P=.01); the participants did not trigger any emotional responses when using any of the technologies; the participants’ performance was task-dependent; the most cost-effective technology was the mouse, whereas the least cost-effective was AR; and all the technologies, except for one (HMD with LM), were not exposed to external hazards. Conclusions Most participants were able to perform tasks using out-of-the-shelf technologies. However, there is no perfect technology, as they are not explicitly designed to address the needs and skills of people with dementia. Here, we propose a set of guidelines that aim to help health professionals and engineers maximize user experience when using such technologies for the population with dementia.
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Affiliation(s)
- Luis Duarte Andrade Ferreira
- NOVA LINCS, Dep de Informática, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal.,Madeira Interactive Technologies Institute, Universidade Madeira, Funchal, Portugal
| | - Henrique Ferreira
- Madeira Interactive Technologies Institute, Universidade Madeira, Funchal, Portugal.,Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Sofia Cavaco
- NOVA LINCS, Dep de Informática, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Mónica Cameirão
- NOVA LINCS, Dep de Informática, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal.,Madeira Interactive Technologies Institute, Universidade Madeira, Funchal, Portugal.,Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| | - Sergi Bermúdez I Badia
- NOVA LINCS, Dep de Informática, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Lisboa, Portugal.,Madeira Interactive Technologies Institute, Universidade Madeira, Funchal, Portugal.,Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
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15
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Wang S, Yin H, Li G, Jia Y, Leng M, Meng Q, Wang C, Chen L. Detection of Mild Cognitive Impairment Based on Virtual Reality: A Scoping Review. Curr Alzheimer Res 2020; 17:126-140. [PMID: 32183674 DOI: 10.2174/1567205017666200317100421] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 12/09/2019] [Accepted: 02/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND To delay the decline in cognition and reduce the incidence of dementia, the precise detection of Mild Cognitive Impairment (MCI) is necessary. The application of Virtual Reality (VR) technology in this detection can overcome the shortage of traditional paper-and-pencil tests. OBJECTIVE This review aimed to summarize the research progress of the detection of MCI using VR. METHODS Eight databases from their inception to November 19, 2019, were systematically searched for studies applying VR in the detection of MCI. A thematic analysis was conducted according to the specific detection purpose and the main corresponding cognitive domains assessed were summarized; characteristics of the VR applications were also summarized. RESULTS Twenty-eight studies were finally included. The detection purposes included discrimination between healthy controls and those with MCI, discrimination between aMCI subtypes, detection of MCI patients at risk of Alzheimer's Disease (AD), and discrimination between MCI and AD. VR tasks assessing spatial memory were applicable for all detection purposes, and the assessment of combinations of memory and executive function seemed more sensitive. Executive function and intentional episodic memory could be assessed to discriminate among healthy controls, individuals with MCI and those with AD. Incidental episodic memory was effective in detecting MCI with hippocampal atrophy. The most common characteristics of the VR applications were the use of semi-immersion, joysticks or gamepad interactions and simple, one-time behavioral assessments. CONCLUSION VR applications are promising in the detection of MCI, but further research is needed for clinical use.
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Affiliation(s)
- Shuo Wang
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Huiru Yin
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Guichen Li
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Yong Jia
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Minmin Leng
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Qiuyan Meng
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
| | - Chunyan Wang
- Senior Officials Inpatient Ward, First Hospital of Jilin University, Changchun, 130000, China
| | - Li Chen
- School of Nursing, Jilin University, 965 Xinjiang Street, Changchun, 130000, China
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16
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Lombardi G, Crescioli G, Cavedo E, Lucenteforte E, Casazza G, Bellatorre A, Lista C, Costantino G, Frisoni G, Virgili G, Filippini G. Structural magnetic resonance imaging for the early diagnosis of dementia due to Alzheimer's disease in people with mild cognitive impairment. Cochrane Database Syst Rev 2020; 3:CD009628. [PMID: 32119112 PMCID: PMC7059964 DOI: 10.1002/14651858.cd009628.pub2] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) due to Alzheimer's disease is the symptomatic predementia phase of Alzheimer's disease dementia, characterised by cognitive and functional impairment not severe enough to fulfil the criteria for dementia. In clinical samples, people with amnestic MCI are at high risk of developing Alzheimer's disease dementia, with annual rates of progression from MCI to Alzheimer's disease estimated at approximately 10% to 15% compared with the base incidence rates of Alzheimer's disease dementia of 1% to 2% per year. OBJECTIVES To assess the diagnostic accuracy of structural magnetic resonance imaging (MRI) for the early diagnosis of dementia due to Alzheimer's disease in people with MCI versus the clinical follow-up diagnosis of Alzheimer's disease dementia as a reference standard (delayed verification). To investigate sources of heterogeneity in accuracy, such as the use of qualitative visual assessment or quantitative volumetric measurements, including manual or automatic (MRI) techniques, or the length of follow-up, and age of participants. MRI was evaluated as an add-on test in addition to clinical diagnosis of MCI to improve early diagnosis of dementia due to Alzheimer's disease in people with MCI. SEARCH METHODS On 29 January 2019 we searched Cochrane Dementia and Cognitive Improvement's Specialised Register and the databases, MEDLINE, Embase, BIOSIS Previews, Science Citation Index, PsycINFO, and LILACS. We also searched the reference lists of all eligible studies identified by the electronic searches. SELECTION CRITERIA We considered cohort studies of any size that included prospectively recruited people of any age with a diagnosis of MCI. We included studies that compared the diagnostic test accuracy of baseline structural MRI versus the clinical follow-up diagnosis of Alzheimer's disease dementia (delayed verification). We did not exclude studies on the basis of length of follow-up. We included studies that used either qualitative visual assessment or quantitative volumetric measurements of MRI to detect atrophy in the whole brain or in specific brain regions, such as the hippocampus, medial temporal lobe, lateral ventricles, entorhinal cortex, medial temporal gyrus, lateral temporal lobe, amygdala, and cortical grey matter. DATA COLLECTION AND ANALYSIS Four teams of two review authors each independently reviewed titles and abstracts of articles identified by the search strategy. Two teams of two review authors each independently assessed the selected full-text articles for eligibility, extracted data and solved disagreements by consensus. Two review authors independently assessed the quality of studies using the QUADAS-2 tool. We used the hierarchical summary receiver operating characteristic (HSROC) model to fit summary ROC curves and to obtain overall measures of relative accuracy in subgroup analyses. We also used these models to obtain pooled estimates of sensitivity and specificity when sufficient data sets were available. MAIN RESULTS We included 33 studies, published from 1999 to 2019, with 3935 participants of whom 1341 (34%) progressed to Alzheimer's disease dementia and 2594 (66%) did not. Of the participants who did not progress to Alzheimer's disease dementia, 2561 (99%) remained stable MCI and 33 (1%) progressed to other types of dementia. The median proportion of women was 53% and the mean age of participants ranged from 63 to 87 years (median 73 years). The mean length of clinical follow-up ranged from 1 to 7.6 years (median 2 years). Most studies were of poor methodological quality due to risk of bias for participant selection or the index test, or both. Most of the included studies reported data on the volume of the total hippocampus (pooled mean sensitivity 0.73 (95% confidence interval (CI) 0.64 to 0.80); pooled mean specificity 0.71 (95% CI 0.65 to 0.77); 22 studies, 2209 participants). This evidence was of low certainty due to risk of bias and inconsistency. Seven studies reported data on the atrophy of the medial temporal lobe (mean sensitivity 0.64 (95% CI 0.53 to 0.73); mean specificity 0.65 (95% CI 0.51 to 0.76); 1077 participants) and five studies on the volume of the lateral ventricles (mean sensitivity 0.57 (95% CI 0.49 to 0.65); mean specificity 0.64 (95% CI 0.59 to 0.70); 1077 participants). This evidence was of moderate certainty due to risk of bias. Four studies with 529 participants analysed the volume of the total entorhinal cortex and four studies with 424 participants analysed the volume of the whole brain. We did not estimate pooled sensitivity and specificity for the volume of these two regions because available data were sparse and heterogeneous. We could not statistically evaluate the volumes of the lateral temporal lobe, amygdala, medial temporal gyrus, or cortical grey matter assessed in small individual studies. We found no evidence of a difference between studies in the accuracy of the total hippocampal volume with regards to duration of follow-up or age of participants, but the manual MRI technique was superior to automatic techniques in mixed (mostly indirect) comparisons. We did not assess the relative accuracy of the volumes of different brain regions measured by MRI because only indirect comparisons were available, studies were heterogeneous, and the overall accuracy of all regions was moderate. AUTHORS' CONCLUSIONS The volume of hippocampus or medial temporal lobe, the most studied brain regions, showed low sensitivity and specificity and did not qualify structural MRI as a stand-alone add-on test for an early diagnosis of dementia due to Alzheimer's disease in people with MCI. This is consistent with international guidelines, which recommend imaging to exclude non-degenerative or surgical causes of cognitive impairment and not to diagnose dementia due to Alzheimer's disease. In view of the low quality of most of the included studies, the findings of this review should be interpreted with caution. Future research should not focus on a single biomarker, but rather on combinations of biomarkers to improve an early diagnosis of Alzheimer's disease dementia.
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Affiliation(s)
- Gemma Lombardi
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Brambilla, 3FlorenceItaly50134
| | - Giada Crescioli
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Brambilla, 3FlorenceItaly50134
| | - Enrica Cavedo
- Pitie‐Salpetriere Hospital, Sorbonne UniversityAlzheimer Precision Medicine (APM), AP‐HP47 boulevard de l'HopitalParisFrance75013
| | - Ersilia Lucenteforte
- University of PisaDepartment of Clinical and Experimental MedicineVia Savi 10PisaItaly56126
| | - Giovanni Casazza
- Università degli Studi di MilanoDipartimento di Scienze Biomediche e Cliniche "L. Sacco"via GB Grassi 74MilanItaly20157
| | | | - Chiara Lista
- Fondazione I.R.C.C.S. Istituto Neurologico Carlo BestaNeuroepidemiology UnitVia Celoria, 11MilanoItaly20133
| | - Giorgio Costantino
- Ospedale Maggiore Policlinico, Università degli Studi di MilanoUOC Pronto Soccorso e Medicina D'Urgenza, Fondazione IRCCS Ca' GrandaMilanItaly
| | | | - Gianni Virgili
- University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA)Largo Brambilla, 3FlorenceItaly50134
| | - Graziella Filippini
- Carlo Besta Foundation and Neurological InstituteScientific Director’s Officevia Celoria, 11MilanItaly20133
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Zhou Y, Wen D, Lu H, Yao W, Liu Y, Qian W, Yuan J. The Current Research of Spatial Cognitive Evaluation and Training With Brain-Computer Interface and Virtual Reality. Front Neurosci 2020; 13:1439. [PMID: 32116484 PMCID: PMC7025557 DOI: 10.3389/fnins.2019.01439] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 12/20/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yanhong Zhou
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Dong Wen
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Huibin Lu
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory of Information Transmission and Signal Processing of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Wang Yao
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Yijun Liu
- School of Science, Yanshan University, Qinhuangdao, China
| | - Wenbo Qian
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory of Information Transmission and Signal Processing of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Jingpeng Yuan
- School of Information Science and Engineering, Yanshan University, Qinhuangdao, China
- The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
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18
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Liu Y, Tan W, Chen C, Liu C, Yang J, Zhang Y. A Review of the Application of Virtual Reality Technology in the Diagnosis and Treatment of Cognitive Impairment. Front Aging Neurosci 2019; 11:280. [PMID: 31680934 PMCID: PMC6813180 DOI: 10.3389/fnagi.2019.00280] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/01/2019] [Indexed: 11/23/2022] Open
Abstract
At present, with the development of an aging society and an increase in the number of elderly people, in order to ensure the ability and enthusiasm of the elderly to live independently, it is necessary to ensure that they can understand the world in a normal way. More and more elderly people have cognitive impairment, and virtual reality (VR) technology is more effective in cognitive diagnosis and treatment than traditional methods. This review article describes some studies on cognitive diagnosis and training for the elderly, and puts forward some suggestions for current studies, in the hopes that VR technology can be better applied to cognitive diagnosis and training.
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Affiliation(s)
- Yao Liu
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - Wenjun Tan
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China.,Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, China
| | - Chao Chen
- Key Laboratory of Complex System Control Theory and Application, Tianjin University of Technology, Tianjin, China
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jinzhu Yang
- Key Laboratory of Intelligent Computing in Medical Image, Ministry of Education, Northeastern University, Shenyang, China
| | - Yanchun Zhang
- Cyberspace Institute of Advanced Technology, Guangzhou University, Guangzhou, China.,Centre for Applied Informatics, College of Engineering and Science, Victoria University, Melbourne, VIC, Australia
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19
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Romero-Ayuso D, Castillero-Perea Á, González P, Navarro E, Molina-Massó JP, Funes MJ, Ariza-Vega P, Toledano-González A, Triviño-Juárez JM. Assessment of cognitive instrumental activities of daily living: a systematic review. Disabil Rehabil 2019; 43:1342-1358. [PMID: 31549907 DOI: 10.1080/09638288.2019.1665720] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning. MATERIALS AND METHODS An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. RESULTS After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. CONCLUSIONS In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.
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Affiliation(s)
- Dulce Romero-Ayuso
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Pascual González
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - Elena Navarro
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - José Pascual Molina-Massó
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - M Jesús Funes
- Mind, Brain and Behaviour Research Center (CIMCYC) and Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Rehabilitation and Traumatology Service, Virgen de Las Nieves University Hospital of Granada, Granada, Spain
| | - Abel Toledano-González
- Department of Psychology, Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
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20
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Erdogdu E, Kurt E, Duru AD, Uslu A, Başar-Eroğlu C, Demiralp T. Measurement of cognitive dynamics during video watching through event-related potentials (ERPs) and oscillations (EROs). Cogn Neurodyn 2019; 13:503-512. [PMID: 31741687 DOI: 10.1007/s11571-019-09544-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/15/2019] [Accepted: 06/11/2019] [Indexed: 11/24/2022] Open
Abstract
Event-related potentials (ERPs) and oscillations (EROs) are reliable measures of cognition, but they require time-locked electroencephalographic (EEG) data to repetitive triggers that are not available in continuous sensory input streams. However, such real-life-like stimulation by videos or virtual-reality environments may serve as powerful means of creating specific cognitive or affective states and help to investigate dysfunctions in psychiatric and neurological disorders more efficiently. This study aims to develop a method to generate ERPs and EROs during watching videos. Repeated luminance changes were introduced on short video segments, while EEGs of 10 subjects were recorded. The ERP/EROs time-locked to these distortions were analyzed in time and time-frequency domains and tested for their cognitive significance through a long term memory test that included frames from the watched videos. For each subject, ERPs and EROs corresponding to video segments of recalled images with 25% shortest and 25% longest reaction times were compared. ERPs produced by transient luminance changes displayed statistically significant fluctuations both in time and time-frequency domains. Statistical analyses showed that a positivity around 450 ms, a negativity around 500 ms and delta and theta EROs correlated with memory performance. Few studies mixed video streams with simultaneous ERP/ERO experiments with discrete task-relevant or passively presented auditory or somatosensory stimuli, while the present study, by obtaining ERPs and EROs to task-irrelevant events in the same sensory modality as that of the continuous sensory input, produces minimal interference with the main focus of attention on the video stream.
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Affiliation(s)
- Emel Erdogdu
- 1Institute of Psychology and Cognition Research, University of Bremen, 28359 Bremen, Germany.,2Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, 34093 Çapa, Istanbul, Turkey
| | - Elif Kurt
- 2Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, 34093 Çapa, Istanbul, Turkey.,3Aziz Sancar Institute of Experimental Medicine, Department of Neuroscience, Istanbul University, 34093 Çapa, Istanbul, Turkey
| | - Adil Deniz Duru
- 4Department of Physical Education and Sports Teaching, Faculty of Sport Sciences, Marmara University, 34815 Beykoz, Istanbul, Turkey
| | - Atilla Uslu
- 5Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, 34093 Çapa, Istanbul, Turkey
| | - Canan Başar-Eroğlu
- 1Institute of Psychology and Cognition Research, University of Bremen, 28359 Bremen, Germany.,6Department of Psychology, Faculty of Arts and Sciences, Izmir University of Economics, 35330 Balçova, Izmir, Turkey
| | - Tamer Demiralp
- 2Hulusi Behçet Life Sciences Research Laboratory, Istanbul University, 34093 Çapa, Istanbul, Turkey.,5Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, 34093 Çapa, Istanbul, Turkey
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21
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Zucchella C, Sinforiani E, Tamburin S, Federico A, Mantovani E, Bernini S, Casale R, Bartolo M. The Multidisciplinary Approach to Alzheimer's Disease and Dementia. A Narrative Review of Non-Pharmacological Treatment. Front Neurol 2018; 9:1058. [PMID: 30619031 PMCID: PMC6300511 DOI: 10.3389/fneur.2018.01058] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/21/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Alzheimer's disease (AD) and dementia are chronic diseases with progressive deterioration of cognition, function, and behavior leading to severe disability and death. The prevalence of AD and dementia is constantly increasing because of the progressive aging of the population. These conditions represent a considerable challenge to patients, their family and caregivers, and the health system, because of the considerable need for resources allocation. There is no disease modifying intervention for AD and dementia, and the symptomatic pharmacological treatments has limited efficacy and considerable side effects. Non-pharmacological treatment (NPT), which includes a wide range of approaches and techniques, may play a role in the treatment of AD and dementia. Aim: To review, with a narrative approach, current evidence on main NPTs for AD and dementia. Methods: PubMed and the Cochrane database of systematic reviews were searched for studies written in English and published from 2000 to 2018. The bibliography of the main articles was checked to detect other relevant papers. Results: The role of NPT has been largely explored in AD and dementia. The main NPT types, which were reviewed here, include exercise and motor rehabilitation, cognitive rehabilitation, NPT for behavioral and psychological symptoms of dementia, occupational therapy, psychological therapy, complementary and alternative medicine, and new technologies, including information and communication technologies, assistive technology and domotics, virtual reality, gaming, and telemedicine. We also summarized the role of NPT to address caregivers' burden. Conclusions: Although NPT is often applied in the multidisciplinary approach to AD and dementia, supporting evidence for their use is still preliminary. Some studies showed statistically significant effect of NPT on some outcomes, but their clinical significance is uncertain. Well-designed randomized controlled trials with innovative designs are needed to explore the efficacy of NPT in AD and dementia. Further studies are required to offer robust neurobiological grounds for the effect of NPT, and to examine its cost-efficacy profile in patients with dementia.
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Affiliation(s)
| | - Elena Sinforiani
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Stefano Tamburin
- Neurology Unit, University Hospital of Verona, Verona, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Angela Federico
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Elisa Mantovani
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sara Bernini
- Alzheimer's Disease Assessment Unit, Laboratory of Neuropsychology, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberto Casale
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
| | - Michelangelo Bartolo
- Neurorehabilitation Unit, Department of Rehabilitation, HABILITA, Bergamo, Italy
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22
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Lazarou I, Adam K, Georgiadis K, Tsolaki A, Nikolopoulos S, Yiannis Kompatsiaris I, Tsolaki M. Can a Novel High-Density EEG Approach Disentangle the Differences of Visual Event Related Potential (N170), Elicited by Negative Facial Stimuli, in People with Subjective Cognitive Impairment? J Alzheimers Dis 2018; 65:543-575. [PMID: 30103320 DOI: 10.3233/jad-180223] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Studies on subjective cognitive impairment (SCI) and neural activation report controversial results. OBJECTIVE To evaluate the ability to disentangle the differences of visual N170 ERP, generated by facial stimuli (Anger & Fear) as well as the cognitive deterioration of SCI, mild cognitive impairment (MCI), and Alzheimer's disease (AD) compared to healthy controls (HC). METHOD 57 people took part in this study. Images corresponding to facial stimuli of "Anger" and "Fear" were presented to 12 HC, 14 SCI, 17 MCI and 14 AD participants. EEG data were recorded by using a HD-EEG HydroCel with 256 channels. RESULTS Results showed that the amplitude of N170 can contribute in distinguishing the SCI group, since statistically significant differences were observed with the HC (p < 0.05) and the MCI group from HC (p < 0.001), as well as AD from HC (p = 0.05) during the processing of facial stimuli. Noticeable differences were also observed in the topographic distribution of the N170 amplitude, while localization analysis by using sLORETA images confirmed the activation of superior, middle-temporal, and frontal lobe brain regions. Finally, in the case of "Fear", SCI and HC demonstrated increased activation in the orbital and inferior frontal gyrus, respectively, MCI in the inferior temporal gyrus, and AD in the lingual gyrus. CONCLUSION These preliminary findings suggest that the amplitude of N170 elicited after negative facial stimuli could be modulated by the decline related to pathological cognitive aging and can contribute in distinguishing HC from SCI, MCI, and AD.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Katerina Adam
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece
| | - Kostas Georgiadis
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,Informatics Department, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Anthoula Tsolaki
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,Laboratory of Medical Physic, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Spiros Nikolopoulos
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece
| | | | - Magda Tsolaki
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Macedonia, Greece.,1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,Greek Alzheimer's Association and Related Disorders (GAADRD), Thessaloniki, Macedonia, Greece
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23
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Oliveira CR, Lopes Filho BJP, Esteves CS, Rossi T, Nunes DS, Lima MMBMP, Irigaray TQ, Argimon IIL. Neuropsychological Assessment of Older Adults With Virtual Reality: Association of Age, Schooling, and General Cognitive Status. Front Psychol 2018; 9:1085. [PMID: 30008689 PMCID: PMC6034167 DOI: 10.3389/fpsyg.2018.01085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/07/2018] [Indexed: 11/13/2022] Open
Abstract
The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a VR task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a VR task of multiple demands. It was also verified the possibility use of VR for neuropsychological assessment of older adults.
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Affiliation(s)
- Camila R. Oliveira
- Postgraduate Program in Psychology, Faculdade Meridional IMED, Passo Fundo, Brazil
| | - Brandel J. P. Lopes Filho
- Postgraduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane S. Esteves
- Postgraduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tainá Rossi
- Postgraduate Program in Psychology, Faculdade Meridional IMED, Passo Fundo, Brazil
| | - Daniela S. Nunes
- Postgraduate Program in Psychology, Faculdade Meridional IMED, Passo Fundo, Brazil
| | | | - Tatiana Q. Irigaray
- Postgraduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irani I. L. Argimon
- Postgraduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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24
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Wen D, Lan X, Zhou Y, Li G, Hsu SH, Jung TP. The Study of Evaluation and Rehabilitation of Patients With Different Cognitive Impairment Phases Based on Virtual Reality and EEG. Front Aging Neurosci 2018; 10:88. [PMID: 29666577 PMCID: PMC5891607 DOI: 10.3389/fnagi.2018.00088] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/15/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Dong Wen
- Department of Software Engineering, School of Information Science and Engineering, Yanshan University, Qinhuangdao, China.,The Key Laboratory for Computer Virtual Technology and System Integration of Hebei Province, Yanshan University, Qinhuangdao, China
| | - Xifa Lan
- Department of Neurology, First Hospital of Qinhuangdao, Qinhuangdao, China
| | - Yanhong Zhou
- Department of Computer Science and Technology, School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Guolin Li
- Department of Computer Science and Technology, School of Mathematics and Information Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, China
| | - Sheng-Hsiou Hsu
- Swartz Center for Computational Neuroscience, University of California, San Diego, San Diego, CA, United States
| | - Tzyy-Ping Jung
- Swartz Center for Computational Neuroscience, University of California, San Diego, San Diego, CA, United States
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25
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Raggi A, Tasca D, Ferri R. A brief essay on non-pharmacological treatment of Alzheimer's disease. Rev Neurosci 2018; 28:587-597. [PMID: 28422708 DOI: 10.1515/revneuro-2017-0002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/11/2017] [Indexed: 12/27/2022]
Abstract
Current pharmacological therapies for Alzheimer's disease (AD) do not modify its course and are not always beneficial. Therefore, the optimization of quality of life represents the best possible outcome achievable in all stages of the disease. Cognitive and behavioural rehabilitation represents the main therapeutic approach for this purpose, also in order to mitigate indirectly the burden of distress of family caregivers. The aim of this mini-review is to go through this theme by discussing cognitive activation, virtual reality and neuromodulation techniques. The practices summarized in this essay are not alternative but, often, complementary therapies to standardized pharmacological treatment. The present mini-review has found encouraging results but also the need for more conclusive evidence for all types of non-invasive/non-pharmacological treatment of AD.
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26
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Bottiroli S, Tassorelli C, Lamonica M, Zucchella C, Cavallini E, Bernini S, Sinforiani E, Pazzi S, Cristiani P, Vecchi T, Tost D, Sandrini G. Smart Aging Platform for Evaluating Cognitive Functions in Aging: A Comparison with the MoCA in a Normal Population. Front Aging Neurosci 2017; 9:379. [PMID: 29209200 PMCID: PMC5702318 DOI: 10.3389/fnagi.2017.00379] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022] Open
Abstract
Background: Smart Aging is a Serious games (SGs) platform in a 3D virtual environment in which users perform a set of screening tests that address various cognitive skills. The tests are structured as 5 tasks of activities of daily life in a familiar environment. The main goal of the present study is to compare a cognitive evaluation made with Smart Aging with those of a classic standardized screening test, the Montreal Cognitive Assessment (MoCA). Methods: One thousand one-hundred thirty-one healthy adults aged between 50 and 80 (M = 64.3 ± 8.3) were enrolled in the study. They received a cognitive evaluation with the MoCA and the Smart Aging platform. Participants were grouped according to their MoCA global and specific cognitive domain (i.e., memory, executive functions, working memory, visual spatial elaboration, language, and orientation) scores and we explored differences among these groups in the Smart Aging indices. Results: One thousand eighty-six older adults (M = 64.0 ± 8.0) successfully completed the study and were stratified according to their MoCA score: Group 1 with MoCA < 27 (n = 360); Group 2 with 27 ≥ MoCA < 29 (n = 453); and Group 3 with MoCA ≥ 29 (n = 273). MoCA groups significantly differed in most of the Smart Aging indices considered, in particular as concerns accuracy (ps < 0.001) and time (ps < 0.001) for completing most of the platform tasks. Group 1 was outperformed by the other two Groups and was slower than them in these tasks, which were those supposed to assess memory and executive functions. In addition, significant differences across groups also emerged when considering the single cognitive domains of the MoCA and the corresponding performances in each Smart Aging task. In particular, this platform seems to be a good proxy for assessing memory, executive functions, working memory, and visual spatial processes. Conclusion: These findings demonstrate the validity of Smart Aging for assessing cognitive functions in normal aging. Future studies will validate this platform also in the clinical aging populations.
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Affiliation(s)
- Sara Bottiroli
- Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy
| | - Cristina Tassorelli
- Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Chiara Zucchella
- UOC Neurologia A Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Elena Cavallini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sara Bernini
- Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy
| | - Elena Sinforiani
- Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy
| | - Stefania Pazzi
- Consorzio di Bioingegneria e Informatica Medica, Pavia, Italy
| | - Paolo Cristiani
- Consorzio di Bioingegneria e Informatica Medica, Pavia, Italy
| | - Tomaso Vecchi
- Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Daniela Tost
- Computer Graphics Division CREB, Universitat Politecnica de Catalunya, Barcelona, Spain
| | - Giorgio Sandrini
- Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Vallejo V, Wyss P, Rampa L, Mitache AV, Müri RM, Mosimann UP, Nef T. Evaluation of a novel Serious Game based assessment tool for patients with Alzheimer's disease. PLoS One 2017; 12:e0175999. [PMID: 28472049 PMCID: PMC5417424 DOI: 10.1371/journal.pone.0175999] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/04/2017] [Indexed: 12/27/2022] Open
Abstract
Despite growing interest in developing ecological assessment of difficulties in patients with Alzheimer's disease new methods assessing the cognitive difficulties related to functional activities are missing. To complete current evaluation, the use of Serious Games can be a promising approach as it offers the possibility to recreate a virtual environment with daily living activities and a precise and complete cognitive evaluation. The aim of the present study was to evaluate the usability and the screening potential of a new ecological tool for assessment of cognitive functions in patients with Alzheimer's disease. Eighteen patients with Alzheimer's disease and twenty healthy controls participated to the study. They were asked to complete six daily living virtual tasks assessing several cognitive functions: three navigation tasks, one shopping task, one cooking task and one table preparation task following a one-day scenario. Usability of the game was evaluated through a questionnaire and through the analysis of the computer interactions for the two groups. Furthermore, the performances in terms of time to achieve the task and percentage of completion on the several tasks were recorded. Results indicate that both groups subjectively found the game user friendly and they were objectively able to play the game without computer interactions difficulties. Comparison of the performances between the two groups indicated a significant difference in terms of percentage of achievement of the several tasks and in terms of time they needed to achieve the several tasks. This study suggests that this new Serious Game based assessment tool is a user-friendly and ecological method to evaluate the cognitive abilities related to the difficulties patients can encounter in daily living activities and can be used as a screening tool as it allowed to distinguish Alzheimer's patient's performance from healthy controls.
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Affiliation(s)
- Vanessa Vallejo
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Patric Wyss
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - Luca Rampa
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrei V. Mitache
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
| | - René M. Müri
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- Perception and Eye Movement Laboratory, Department of Neurology and Clinical Research, University Hospital Inselspital, University of Bern, Bern, Switzerland
| | - Urs P. Mosimann
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Private Hospital Wyss, Münchenbuchsee, Switzerland
| | - Tobias Nef
- Gerontechnology and Rehabilitation Group, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern Switzerland
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28
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Vallejo V, Wyss P, Chesham A, Mitache AV, Müri RM, Mosimann UP, Nef T. Evaluation of a new serious game based multitasking assessment tool for cognition and activities of daily living: Comparison with a real cooking task. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.01.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Fernandez Montenegro JM, Argyriou V. Cognitive evaluation for the diagnosis of Alzheimer's disease based on Turing Test and Virtual Environments. Physiol Behav 2017; 173:42-51. [PMID: 28137425 DOI: 10.1016/j.physbeh.2017.01.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 10/20/2016] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
Abstract
Alzheimer's screening tests are commonly used by doctors to diagnose the patient's condition and stage as early as possible. Most of these tests are based on pen-paper interaction and do not embrace the advantages provided by new technologies. This paper proposes novel Alzheimer's screening tests based on virtual environments and game principles using new immersive technologies combined with advanced Human Computer Interaction (HCI) systems. These new tests are focused on the immersion of the patient in a virtual room, in order to mislead and deceive the patient's mind. In addition, we propose two novel variations of Turing Test proposed by Alan Turing as a method to detect dementia. As a result, four tests are introduced demonstrating the wide range of screening mechanisms that could be designed using virtual environments and game concepts. The proposed tests are focused on the evaluation of memory loss related to common objects, recent conversations and events; the diagnosis of problems in expressing and understanding language; the ability to recognize abnormalities; and to differentiate between virtual worlds and reality, or humans and machines. The proposed screening tests were evaluated and tested using both patients and healthy adults in a comparative study with state-of-the-art Alzheimer's screening tests. The results show the capacity of the new tests to distinguish healthy people from Alzheimer's patients.
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Development and Feasibility of a Virtual Reality Task for the Cognitive Assessment of Older Adults: The ECO-VR. SPANISH JOURNAL OF PSYCHOLOGY 2016; 19:E95. [DOI: 10.1017/sjp.2016.96] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractCognitive assessment with virtual reality (VR) may have superior ecological validity for older adults compared to traditional pencil-and-paper cognitive assessment. However, few studies have reported the development of VR tasks. The aim of this study was to present the development, feasibility, content validity, and preliminary evidence of construct validity of an ecological task of cognitive assessment for older adults in VR (ECO-VR). The tasks were prepared based on theoretical and clinical backgrounds. We had 29 non-expert judges identify virtual visual stimuli and three-dimensional scenarios, and five expert judges assisted with content analysis and developing instructions. Finally, six older persons participated in three pilot studies and thirty older persons participated in the preliminary study to identify construct validity evidence. Data were analyzed by descriptive statistics and partial correlation. Target stimuli and three-dimensional scenarios were judged adequate and the content analysis demonstrated that ECO-VR evaluates temporo-spatial orientation, memory, language and executive functioning. We made significant changes to the instructions after the pilot studies to increase comprehensibility and reduce the completion time. The total score of ECO-VR was positively correlated mainly with performance in executive function (r = .172, p < .05) and memory tests (r = .488, p ≤ .01). The ECO-VR demonstrated feasibility for cognitive assessment in older adults, as well as content and construct validity evidences.
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Valladares-Rodríguez S, Pérez-Rodríguez R, Anido-Rifón L, Fernández-Iglesias M. Trends on the application of serious games to neuropsychological evaluation: A scoping review. J Biomed Inform 2016; 64:296-319. [PMID: 27815228 DOI: 10.1016/j.jbi.2016.10.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/12/2016] [Accepted: 10/31/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The dramatic technological advances witnessed in recent years have resulted in a great opportunity for changing the way neuropsychological evaluations may be performed in clinical practice. Particularly, serious games have been posed as the cornerstone of this still incipient paradigm-shift, as they have characteristics that make them especially advantageous in trying to overcome limitations associated with traditional pen-and-paper based neuropsychological tests: they can be easily administered and they can feature complex environments for the evaluation of neuropsychological constructs that are difficult to evaluate through traditional tests. The objective of this study was to conduct a scoping literature review in order to map rapidly the key concepts underpinning this research area during the last 25years on the use of serious games for neuropsychological evaluation. METHODS MEDLINE, PsycINFO, Scopus and IEEE Xplore databases were systematically searched. The main eligibility criteria were to select studies published in a peer-reviewed journal; written in English; published in the last 25years; focused on the human population, and classified in the neuropsychological field. Moreover, to avoid risk of bias, studies were selected by consensus of experts, focusing primarily in psychometric properties. Therefore, selected studies were analyzed in accordance with a set of dimensions of analysis commonly used for evaluating neuropsychological tests. RESULTS After applying the selected search strategy, 57 studies -including 54 serious games- met our selection criteria. The selected studies deal with visuospatial capabilities, memory, attention, executive functions, and complex neuropsychological constructs such as Mild Cognitive Impairment (MCI). Results show that the implementation of serious games for neuropsychological evaluation is tackled in several different ways in the selected studies, and that studies have so far been mainly exploratory, just aiming at testing the feasibility of the proposed approaches. DISCUSSION It may be argued that the limited number of databases used might compromise this study. However, we think that the finally included sample is representative, in spite of how difficult is to achieve an optimum and maximum scope. Indeed, this review identifies other research issues related to the development of serious games beyond their reliability and validity. The main conclusion of this review is that there is a great interest in the research community in the use of serious games for neuropsychological evaluation. This scoping review is pertinent, in accordance with the increasing number of studies published in the last three years, they demonstrate its potential as a serious alternative to classic neuropsychological tests. Nevertheless, more research is needed in order to implement serious games that are reliable, valid, and ready to be used in the everyday clinical practice.
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Dimitriadis SI, Tarnanas I, Wiederhold M, Wiederhold B, Tsolaki M, Fleisch E. Mnemonic strategy training of the elderly at risk for dementia enhances integration of information processing via cross-frequency coupling. ALZHEIMERS & DEMENTIA-TRANSLATIONAL RESEARCH & CLINICAL INTERVENTIONS 2016; 2:241-249. [PMID: 29067311 PMCID: PMC5651360 DOI: 10.1016/j.trci.2016.08.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction We sought to identify whether intensive 10-week mobile health mnemonic strategy training (MST) could shift the resting-state brain network more toward cortical-level integration, which has recently been proven to reflect the reorganization of the brain networks compensating the cognitive decline. Methods One hundred fifty-eight patients with mild cognitive impairment (MCI) were selected and participated in 10-week training lasting 90 min/d of memory training. They benefited from an initial and a follow-up neuropsychological evaluation and resting-state electroencephalography (EEG). Results At follow-up, MST revealed an extensive significant training effect that changed the network with an increase of synchronization between parietotemporal and frontal areas; frontalθ-parietalα2 causal strengthening as part of top-down inhibitory control; enhancement of sensorimotor connections in β band; and a general increase of cortical-level integration. More precisely, MST induced gain as an increase of the global cost efficiency (GCE) of the whole cortical network and a neuropsychological performance improvement, which was correlated with it (r = 0.32, P = .0001). The present study unfolded intervention changes based on EEG source activity via novel neuroinformatic tools for revealing intrinsic coupling modes in both amplitude-phase representations and in the mixed spectrospatiotemporal domain. Discussion Further work should identify whether the GCE enhancement of the functional cortical brain networks is a compensation mechanism to the brain network dysfunction or a more permanent neuroplasticity effect.
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Affiliation(s)
- Stavros I Dimitriadis
- Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.,Cardiff University Brain Research Imaging Center (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK.,Artificial Intelligence and Information Analysis Laboratory, Department of Informatics, Aristotle University, Thessaloniki, Greece.,NeuroInformatics Group, Department of Informatics, Aristotle University, Thessaloniki, Greece
| | - Ioannis Tarnanas
- Health-IS Lab, Chair of Information Management, Department of Management, ETH Zurich, Zurich, Switzerland.,3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark Wiederhold
- Division of Cognitive and Restorative Neurology, Virtual Reality Medical Center, San Diego, CA, USA
| | | | - Magda Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elgar Fleisch
- Health-IS Lab, Chair of Information Management, Department of Management, ETH Zurich, Zurich, Switzerland.,University of St. Gallen, St. Gallen, Switzerland
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Tarnanas I, Tsolaki A, Wiederhold M, Wiederhold B, Tsolaki M. Five-year biomarker progression variability for Alzheimer's disease dementia prediction: Can a complex instrumental activities of daily living marker fill in the gaps? ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:521-32. [PMID: 27239530 PMCID: PMC4879487 DOI: 10.1016/j.dadm.2015.10.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction Biomarker progressions explain higher variability in cognitive decline than baseline values alone. This study examines progressions of established biomarkers along with a novel marker in a longitudinal cognitive decline. Methods A total of 215 subjects were used with a diagnosis of normal, mild cognitive impairment (MCI) or Alzheimer's disease (AD) at baseline. We calculated standardized biomarker progression rates and used them as predictors of outcome within 5 years. Results Early cognitive declines were more strongly explained by fluorodeoxyglucose-positron emission tomography, precuneus and medial temporal cortical thickness, and the complex instrumental activities of daily living (iADL) marker progressions. Using Cox proportional hazards model, we found that these progressions were a significant risk factor for conversion from both MCI to AD (adjusted hazard ratio 1.45; 95% confidence interval 1.20–1.93; P = 1.23 × 10−5) and cognitively normal to MCI (adjusted hazard ratio 1.76; 95% confidence interval 1.32–2.34; P = 1.55 × 10−5). Discussion Compared with standard biological biomarkers, complex functional iADL markers could also provide predictive information for cognitive decline during the presymptomatic stage. This has important implications for clinical trials focusing on prevention in asymptomatic individuals.
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Affiliation(s)
- Ioannis Tarnanas
- Health-IS Lab, Department of Management, Technology and Economics, ETH Zurich, Zurich, Switzerland
- Piaget Research Foundation, Nürnberg, Germany
- Corresponding author. Tel.: +41-71-224-72-44; Fax: +41-632-97-75.
| | - Anthoula Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mark Wiederhold
- Division of Cognitive and Restorative Neurology, Virtual Reality Medical Center, San Diego, CA, USA
| | - Brenda Wiederhold
- Virtual Reality Medical Institute, Clos Chapelle aux Champs, Brussels, Belgium
| | - Magda Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Dimitriadis SI, Laskaris NA, Bitzidou MP, Tarnanas I, Tsolaki MN. A novel biomarker of amnestic MCI based on dynamic cross-frequency coupling patterns during cognitive brain responses. Front Neurosci 2015; 9:350. [PMID: 26539070 PMCID: PMC4611062 DOI: 10.3389/fnins.2015.00350] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/14/2015] [Indexed: 11/13/2022] Open
Abstract
The detection of mild cognitive impairment (MCI), the transitional stage between normal cognitive changes of aging and the cognitive decline caused by AD, is of paramount clinical importance, since MCI patients are at increased risk of progressing into AD. Electroencephalographic (EEG) alterations in the spectral content of brainwaves and connectivity at resting state have been associated with early-stage AD. Recently, cognitive event-related potentials (ERPs) have entered into the picture as an easy to perform screening test. Motivated by the recent findings about the role of cross-frequency coupling (CFC) in cognition, we introduce a relevant methodological approach for detecting MCI based on cognitive responses from a standard auditory oddball paradigm. By using the single trial signals recorded at Pz sensor and comparing the responses to target and non-target stimuli, we first demonstrate that increased CFC is associated with the cognitive task. Then, considering the dynamic character of CFC, we identify instances during which the coupling between particular pairs of brainwave frequencies carries sufficient information for discriminating between normal subjects and patients with MCI. In this way, we form a multiparametric signature of impaired cognition. The new composite biomarker was tested using data from a cohort that consists of 25 amnestic MCI patients and 15 age-matched controls. Standard machine-learning algorithms were employed so as to implement the binary classification task. Based on leave-one-out cross-validation, the measured classification rate was found reaching very high levels (95%). Our approach compares favorably with the traditional alternative of using the morphology of averaged ERP response to make the diagnosis and the usage of features from spectro-temporal analysis of single-trial responses. This further indicates that task-related CFC measurements can provide invaluable analytics in AD diagnosis and prognosis.
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Affiliation(s)
- Stavros I Dimitriadis
- Artificial Intelligence Information Analysis Lab, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece ; Neuroinformatics Group, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Nikolaos A Laskaris
- Artificial Intelligence Information Analysis Lab, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece ; Neuroinformatics Group, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Malamati P Bitzidou
- Artificial Intelligence Information Analysis Lab, Department of Informatics, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Ioannis Tarnanas
- Health-IS Lab, Chair of Information Management, ETH Zurich Zurich, Switzerland ; 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Magda N Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
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García-Betances RI, Arredondo Waldmeyer MT, Fico G, Cabrera-Umpiérrez MF. A succinct overview of virtual reality technology use in Alzheimer's disease. Front Aging Neurosci 2015; 7:80. [PMID: 26029101 PMCID: PMC4428215 DOI: 10.3389/fnagi.2015.00080] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/26/2015] [Indexed: 12/20/2022] Open
Abstract
We provide a brief review and appraisal of recent and current virtual reality (VR) technology for Alzheimer’s disease (AD) applications. We categorize them according to their intended purpose (e.g., diagnosis, patient cognitive training, caregivers’ education, etc.), focus feature (e.g., spatial impairment, memory deficit, etc.), methodology employed (e.g., tasks, games, etc.), immersion level, and passive or active interaction. Critical assessment indicates that most of them do not yet take full advantage of virtual environments with high levels of immersion and interaction. Many still rely on conventional 2D graphic displays to create non-immersive or semi-immersive VR scenarios. Important improvements are needed to make VR a better and more versatile assessment and training tool for AD. The use of the latest display technologies available, such as emerging head-mounted displays and 3D smart TV technologies, together with realistic multi-sensorial interaction devices, and neuro-physiological feedback capacity, are some of the most beneficial improvements this mini-review suggests. Additionally, it would be desirable that such VR applications for AD be easily and affordably transferable to in-home and nursing home environments.
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Affiliation(s)
- Rebeca I García-Betances
- Life Supporting Technologies (LifeSTech), ETSI Telecomunicaciones, Universidad Politécnica de Madrid , Madrid , Spain
| | | | - Giuseppe Fico
- Life Supporting Technologies (LifeSTech), ETSI Telecomunicaciones, Universidad Politécnica de Madrid , Madrid , Spain
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Tarnanas I, Papagiannopoulos S, Kazis D, Wiederhold M, Widerhold B, Tsolaki M. Reliability of a novel serious game using dual-task gait profiles to early characterize aMCI. Front Aging Neurosci 2015; 7:50. [PMID: 25954193 PMCID: PMC4406069 DOI: 10.3389/fnagi.2015.00050] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/26/2015] [Indexed: 11/17/2022] Open
Abstract
Background: As the population of older adults is growing, the interest in a simple way to detect characterize amnestic mild cognitive impairment (aMCI), a prodromal stage of Alzheimer’s disease (AD), is becoming increasingly important. Serious game (SG) -based cognitive and motor performance profiles while performing everyday activities and dual-task walking (DTW) “motor signatures” are two very promising markers that can be detected in predementia states. We aim to compare the consistency, or conformity, of measurements made by a custom SG with DTW (NAV), a SG without DTW (DOT), neuropsychological measures and genotyping as markers for early detection of aMCI. Methods: The study population included three groups: early AD (n = 86), aMCI (n = 65), and healthy control subjects (n = 76), who completed the custom SG tasks in three separate sessions over a 3-month period. Outcome measures were neuropsychological data across-domain and within-domain intra-individual variability (IIV) and DOT and NAV latency-based and accuracy-based IIV. IIV reflects a transient, within-person change in behavioral performance, either during different cognitive domains (across-domain) or within the same domain (within-domain). Test–retest reliability of the DOT and NAV markers were assessed using an intraclass correlation (ICC) analysis. Results: Results indicated that performance data, such as the NAV latency-based and accuracy-based IIV, during the task displayed greater reliability across sessions compared to DOT. During the NAV task-engagement, the executive function, planning, and motor performance profiles exhibited moderate to good reliability (ICC = 0.6–0.8), while during DOT, executive function and spatial memory accuracy profiles exhibited fair to moderate reliability (ICC = 0.3–0.6). Additionally, reliability across tasks was more stable when three sessions were used in the ICC calculation relative to two sessions. Discussion: Our findings suggest that “motor signature” data during the NAV tasks were a more reliable marker for early diagnosis of aMCI than DOT. This result accentuates the importance of utilizing motor performance data as a metric for aMCI populations where memory decline is often the behavioral outcome of interest. In conclusion, custom SG with DTW performance data provide an ecological and reliable approach for cognitive assessment across multiple sessions and thus can be used as a useful tool for tracking longitudinal change in observational and interventional studies on aMCI.
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Affiliation(s)
- Ioannis Tarnanas
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Sotirios Papagiannopoulos
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Dimitris Kazis
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Mark Wiederhold
- Division of Cognitive and Restorative Neurology, Virtual Reality Medical Center San Diego, CA, USA
| | - Brenda Widerhold
- Virtual Reality Medical Institute, Brussels Life Sciences Incubator, Catholic University's Woluwe Campus Brussels, Belgium
| | - Magda Tsolaki
- 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
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Snyder PJ. Introducing Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, an open access journal of the Alzheimer's Association. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2015; 1:1-4. [PMID: 27239487 PMCID: PMC4876895 DOI: 10.1016/j.dadm.2015.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Peter J Snyder
- Department of Neurology, Alpert Medical School of Brown University, and Lifespan Hospital System, Providence, RI, USA
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Muscio C, Tiraboschi P, Guerra UP, Defanti CA, Frisoni GB. Clinical trial design of serious gaming in mild cognitive impairment. Front Aging Neurosci 2015; 7:26. [PMID: 25814951 PMCID: PMC4356084 DOI: 10.3389/fnagi.2015.00026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 02/23/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Cristina Muscio
- Fondazione Europea Ricerca Biomedica, Centro Eccellenza Alzheimer Ospedale Briolini, Bergamo, Italy ; Department of Molecular and Translational Medicine, University of Brescia Brescia, Italy
| | - Pietro Tiraboschi
- Division of Neurology V/Neuropathology, Fondazione IRCCS Istituto Neurologico "Carlo Besta" Milan, Italy
| | - Ugo P Guerra
- Fondazione Poliambulanza, Nuclear Medicine Department Brescia, Italy
| | - Carlo A Defanti
- Fondazione Europea Ricerca Biomedica, Centro Eccellenza Alzheimer Ospedale Briolini, Bergamo, Italy
| | - Giovanni B Frisoni
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS Centro San Giovanni di Dio-Fatebenefratelli Brescia, Italy ; Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva Geneva, Switzerland
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Computerized and on-line neuropsychological testing for late-life cognition and neurocognitive disorders: are we there yet? Curr Opin Psychiatry 2015; 28:165-72. [PMID: 25602241 DOI: 10.1097/yco.0000000000000141] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Cost-effective, valid, efficient and accessible tests for the detection of late-life neurocognitive disorders are crucial, as early identification facilitates appropriate early intervention. Proponents of computerized neuropsychological assessment devices (CNADs) assert that technology-based assessments improve upon traditional neuropsychological tests. However, there remain fundamental questions of validity, reliability, normative data and administration, raising the question of whether CNADs are appropriate alternatives. RECENT FINDINGS Since publication of the 2012 American Academy of Clinical Neuropsychology and National Academy of Neuropsychology joint position paper outlining appropriate standards for CNAD development, the field has not significantly advanced, with the majority of recommendations inadequately addressed. SUMMARY Whilst there is a pressing need for innovative and readily applicable cognitive tests, these requirements do not outweigh the necessity for valid measures. Overall, the psychometric quality, standardization, normative data and administration advice of CNADs for neurocognitive disorders are lacking. Therefore, the risk of diagnostic errors is potentially high and poor clinical decisions could potentially arise, having significant impact upon individuals in terms of their well being and access to treatment. We recommend clinicians and researchers make informed decisions about CNAD suitability for their clients and their individual requirements based upon published psychometric and other test information.
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