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Righi S, Gavazzi G, Benedetti V, Raineri G, Viggiano MP. How the Effect of Virtual Reality on Cognitive Functioning Is Modulated by Gender Differences. Bioengineering (Basel) 2024; 11:408. [PMID: 38671829 PMCID: PMC11048133 DOI: 10.3390/bioengineering11040408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Virtual reality (VR) can be a promising tool to simulate reality in various settings but the real impact of this technology on the human mental system is still unclear as to how VR might (if at all) interfere with cognitive functioning. Using a computer, we can concentrate, enter a state of flow, and still maintain control over our surrounding world. Differently, VR is a very immersive experience which could be a challenge for our ability to allocate divided attention to the environment to perform executive functioning tasks. This may also have a different impact on women and men since gender differences in both executive functioning and the immersivity experience have been referred to by the literature. The present study aims to investigate cognitive multitasking performance as a function of (1) virtual reality and computer administration and (2) gender differences. To explore this issue, subjects were asked to perform simultaneous tasks (span forward and backward, logical-arithmetic reasoning, and visuospatial reasoning) in virtual reality via a head-mounted display system (HDMS) and on a personal computer (PC). Our results showed in virtual reality an overall impairment of executive functioning but a better performance of women, compared to men, in visuospatial reasoning. These findings are consistent with previous studies showing a detrimental effect of virtual reality on cognitive functioning.
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Affiliation(s)
- Stefania Righi
- Department of Neurofarba, University of Florence, Via di San Salvi 12, 50135 Florence, Italy; (G.G.); (V.B.); (G.R.); (M.P.V.)
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Martínez-Pernía D, Olavarría L, Fernández-Manjón B, Cabello V, Henríquez F, Robert P, Alvarado L, Barría S, Antivilo A, Velasquez J, Cerda M, Farías G, Torralva T, Ibáñez A, Parra MA, Gilbert S, Slachevsky A. The limitations and challenges in the assessment of executive dysfunction associated with real-world functioning: The opportunity of serious games. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-17. [PMID: 36827177 PMCID: PMC11177293 DOI: 10.1080/23279095.2023.2174438] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.
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Affiliation(s)
- David Martínez-Pernía
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Loreto Olavarría
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Victoria Cabello
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Fernando Henríquez
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Laboratory for Cognitive and Evolutionary Neuroscience (LaNCE), Department of Psychiatry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Philippe Robert
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d'Azur, Nice, France
| | - Luís Alvarado
- Departamento de Psiquiatría y Salud Mental Norte, Universidad de Chile, Santiago, Chile
| | - Silvia Barría
- Departamento de Ciencias Neurologicas Oriente, Facultad de Medicina, Universidad de Chile, and Servicio de Neurología, Hospital del Salvador, Santiago, Chile
| | - Andrés Antivilo
- Departamento de Ciencias Neurologicas Oriente, Facultad de Medicina, Universidad de Chile, and Servicio de Neurología, Hospital del Salvador, Santiago, Chile
| | - Juan Velasquez
- Facultad de Ciencias Físicas y Matemáticas, Web Intelligence Center, Universidad de Chile, Santiago, Chile
- Department of Industrial Engineering, Faculty of Physical and Mathematical Sciences, Instituto Sistemas Complejos de Ingeniería (ISCI), University of Chile, Santiago, Chile
| | - Mauricio Cerda
- Integrative Biology Program, Institute of Biomedical Sciences, and Center for Medical Informatics and Telemedicine, Faculty of Medicine, and Biomedical Neuroscience Institute, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gonzalo Farías
- Department of Neurology North, Faculty of Medicine, University of Chile, Santiago, Chile
- Center for advanced clinical research (CICA), Hospital Clínico Universidad de Chile, Chile
| | - Teresa Torralva
- Institute of Cognitive and Translational Neuroscience (INCYT), Instituto de Neurología Cognitiva Foundation, Favaloro University, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Trinity College Dublin (TCD), Dublin, Ireland
| | - Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Sam Gilbert
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Biomedical Science Institute, Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Flynn A, Barry M, Qi Koh W, Reilly G, Brennan A, Redfern S, Casey D. Introducing and Familiarising Older Adults Living with Dementia and Their Caregivers to Virtual Reality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16343. [PMID: 36498417 PMCID: PMC9736737 DOI: 10.3390/ijerph192316343] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Virtual Reality (VR) is increasingly being applied in dementia care across a range of applications and domains including health and wellbeing. Despite the commercial availability of VR, informants of design are not always aware of its functionality and capabilities, to meaningfully contribute to VR design. In designing VR applications for people living with dementia, it is recommended that older adults living with dementia and their support persons be involved in the design process using participatory approaches, thereby giving them a voice on the design of technology from the outset. A VR technology probe is a useful means of familiarising older adults living with dementia and their informal caregivers with the knowledge and understanding of interactive VR to employ technology that supports them to maintain their social health. This paper charts the implementation and evaluation of a VR technology probe, VR FOUNDations. To explore their experiences, nine older adults living with dementia and their nine informal caregivers trialled VR FOUNDations and completed semi-structured interviews after its use. Overall, older adults living with dementia and their informal caregivers perceived VR FOUNDations to achieve its aim of increasing understanding and inspiring future design decisions. The findings also identified promising positive experiences using a VR technology probe which may be indicative of its applicability to social health and wellbeing domains. This paper advocates for the structured design and implementation of VR technology probes as a prerequisite to the participatory design of VR applications for the health and wellbeing of people living with dementia. The use of such technology probes may afford older adults living with dementia and their informal caregivers the best opportunity to contribute to design decisions and participate in technology design to support their health and wellbeing.
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Affiliation(s)
- Aisling Flynn
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| | - Marguerite Barry
- Information and Communication Studies, ADAPT Centre, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Wei Qi Koh
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| | - Gearóid Reilly
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Attracta Brennan
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Sam Redfern
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
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Wang Y, Zhang X, Gao J, Zhang L, Jiang J. The effect of immersive virtual reality-based attentional bias modification on anxiety mitigation in healthy population. Psych J 2022; 11:956-967. [PMID: 35922380 DOI: 10.1002/pchj.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/02/2022] [Indexed: 11/06/2022]
Abstract
The present study compared an immersive virtual reality-based attentional bias modification (immersive VR-ABM) with the desktop version of the VR-ABM and an immersive virtual reality-based game (immersive VR-game) to examine the possible effect of the immersive presence on self-reported emotional reactions to a stressful task. One hundred and twenty participants were randomly assigned into three groups, and each group received a three-turn induction-intervention training. Anxiety symptoms were assessed at pre-induction, post-induction, and post-training. Results showed that virtual reality-based anxiety was induced and alleviated successfully in all three groups, but only the immersive VR-ABM group showed an accumulated effect on self-reported anxiety across sessions. The attentional bias based on probe latencies indicated no significant change in either the immersive or desktop VR-ABM groups. The present findings support the hypothesized VR-ABM's effect on self-reported anxiety at the immersive presence. The practical implications of using immersive VR-ABM are discussed for obtaining ecological validity.
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Affiliation(s)
- Yamin Wang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Xiaoxiang Zhang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Jidong Gao
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Leran Zhang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
| | - Jinhang Jiang
- Beijing Key Laboratory of Learning and Cognition, College of Psychology, Capital Normal University, Haidian, China
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Seinfeld S, Feuchtner T, Pinzek J, Muller J. Impact of Information Placement and User Representations in VR on Performance and Embodiment. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2022; 28:1545-1556. [PMID: 32877336 DOI: 10.1109/tvcg.2020.3021342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Human sensory processing is sensitive to the proximity of stimuli to the body. It is therefore plausible that these perceptual mechanisms also modulate the detectability of content in VR, depending on its location. We evaluate this in a user study and further explore the impact of the user's representation during interaction. We also analyze how embodiment and motor performance are influenced by these factors. In a dual-task paradigm, participants executed a motor task, either through virtual hands, virtual controllers, or a keyboard. Simultaneously, they detected visual stimuli appearing in different locations. We found that, while actively performing a motor task in the virtual environment, performance in detecting additional visual stimuli is higher when presented near the user's body. This effect is independent of how the user is represented and only occurs when the user is also engaged in a secondary task. We further found improved motor performance and increased embodiment when interacting through virtual tools and hands in VR, compared to interacting with a keyboard. This article contributes to better understanding the detectability of visual content in VR, depending on its location in the virtual environment, as well as the impact of different user representations on information processing, embodiment, and motor performance.
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Deblock-Bellamy A, Lamontagne A, McFadyen BJ, Ouellet MC, Blanchette AK. Virtual reality-based assessment of cognitive-locomotor interference in healthy young adults. J Neuroeng Rehabil 2021; 18:53. [PMID: 33752704 PMCID: PMC7983256 DOI: 10.1186/s12984-021-00834-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/03/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A recent literature review emphasized the importance of assessing dual-task (DT) abilities with tasks that are representative of community ambulation. Assessing DT ability in real-life activities using standardized protocols remains difficult. Virtual reality (VR) may represent an interesting alternative enabling the exposure to different scenarios simulating community walking. To better understand dual-task abilities in everyday life activities, the aims of this study were (1) to assess locomotor and cognitive dual-task cost (DTC) during representative daily living activities, using VR, in healthy adults; and 2) to explore the influence of the nature and complexity of locomotor and cognitive tasks on DTC. METHODS Fifteen healthy young adults (24.9 ± 2.7 years old, 8 women) were recruited to walk in a virtual 100 m shopping mall corridor, while remembering a 5-item list (DT condition), using an omnidirectional platform and a VR headset. Two levels of difficulty were proposed for the locomotor task (with vs. without virtual agent avoidance) and for the cognitive task (with vs. without items modification). These tasks were also performed in single task (ST) condition. Locomotor and cognitive DTC were measured by comparing performances in ST and DT conditions. Locomotor performance was characterized using walking speed, walking fluidity, and minimal distance between the participant and the virtual agent during avoidance. Cognitive performance was assessed with the number of items correctly recalled. Presence of DTC were determined with one-sample Wilcoxon signed-rank tests. To explore the influence of the tasks' complexity and nature on DTC, a nonparametric two-way repeated measure ANOVA was performed. RESULTS No locomotor interference was measured for any of the outcomes. A cognitive DTC of 6.67% was measured (p = .017) while participants performed simultaneously both complex locomotor and cognitive tasks. A significant interaction between locomotor task complexity and cognitive task nature (p = .002) was identified on cognitive DTC. CONCLUSIONS In challenging locomotor and cognitive conditions, healthy young adults present DTC in cognitive accuracy, which was influenced by the locomotor task complexity task and the cognitive task nature. A similar VR-based protocol might be used to investigate DT abilities in older adults and individuals with a stroke.
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Affiliation(s)
- Anne Deblock-Bellamy
- Center for interdisciplinary research in rehabilitation and social integration (Cirris), CIUSSS de la Capitale-Nationale, 525 Boulevard Wilfrid-Hamel, Quebec City, QC G1M 2S8 Canada
- Faculty of Medicine, Universite Laval, 1050 Avenue de la Medecine, Quebec City, QC G1V 0A6 Canada
| | - Anouk Lamontagne
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Jewish Rehabilitation Hospital, CISSS de Laval, 3205 Alton-Goldbloom Place, Laval, QC H7V 1R2 Canada
- School of Physical and Occupational Therapy, McGill University, 3654 Prom Sir-William-Osler, Montreal, QC H3G 1Y5 Canada
| | - Bradford J. McFadyen
- Center for interdisciplinary research in rehabilitation and social integration (Cirris), CIUSSS de la Capitale-Nationale, 525 Boulevard Wilfrid-Hamel, Quebec City, QC G1M 2S8 Canada
- Faculty of Medicine, Universite Laval, 1050 Avenue de la Medecine, Quebec City, QC G1V 0A6 Canada
- Department of Rehabilitation, Universite Laval, 1050 Avenue de la Medecine, Quebec City, QC G1V 0A6 Canada
| | - Marie-Christine Ouellet
- Center for interdisciplinary research in rehabilitation and social integration (Cirris), CIUSSS de la Capitale-Nationale, 525 Boulevard Wilfrid-Hamel, Quebec City, QC G1M 2S8 Canada
- Faculty of Social Sciences, School of Psychology, Universite Laval, 2325 rue des Bibliothèques, Quebec City, QC G1V 0A6 Canada
| | - Andreanne K. Blanchette
- Center for interdisciplinary research in rehabilitation and social integration (Cirris), CIUSSS de la Capitale-Nationale, 525 Boulevard Wilfrid-Hamel, Quebec City, QC G1M 2S8 Canada
- Faculty of Medicine, Universite Laval, 1050 Avenue de la Medecine, Quebec City, QC G1V 0A6 Canada
- Department of Rehabilitation, Universite Laval, 1050 Avenue de la Medecine, Quebec City, QC G1V 0A6 Canada
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Boller B, Ouellet É, Belleville S. Using Virtual Reality to Assess and Promote Transfer of Memory Training in Older Adults With Memory Complaints: A Randomized Controlled Trial. Front Psychol 2021; 12:627242. [PMID: 33776848 PMCID: PMC7994284 DOI: 10.3389/fpsyg.2021.627242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 02/19/2021] [Indexed: 11/20/2022] Open
Abstract
In this proof-of-concept study, we assessed the potential for immersive virtual reality (VR) to measure transfer following strategic memory training, and whether efficacy and transfer are increased when training is complemented by practice in an immersive virtual environment. Forty older adults with subjective memory complaints were trained with the method of loci. They were randomized to either a condition where they practiced the strategy in VR (n = 20) or a control condition where they were familiarized with VR using a non-memory task (n = 20). Training efficacy was measured with word recall, and transfer of the training benefit was measured with a recall task completed in two VR tasks (primary outcomes) as well as a self-report memory questionnaire (secondary outcomes). Testing was administered before (PRE), midway (POST 3), and after (POST 6) training. Participants improved their scores on word recall. Regarding transfer measures, participants improved their performance in the two VR recall tasks but not on the self-report memory questionnaire. No significant group effect was observed. Improvement was found when comparing PRE to POST 3 with no further improvement at POST 6. Thus, strategic memory training improved the memory of seniors with memory complaints on word recall and a transfer task relying on a VR scenario that resembles real-life. However, no evidence supporting an increase in transfer effects was found when enriching training with VR memory exercises.
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Affiliation(s)
- Benjamin Boller
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
| | - Émilie Ouellet
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Sylvie Belleville
- Research Centre, Institut Universitaire de Gériatrie de Montréal, Montréal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
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da Silva TD, da Silva PL, Valenzuela EDJ, Dias ED, Simcsik AO, de Carvalho MG, Fontes AMGG, Alberissi CADO, de Araújo LV, Brandão MVDC, Dawes H, Monteiro CBDM. Serious Game Platform as a Possibility for Home-Based Telerehabilitation for Individuals With Cerebral Palsy During COVID-19 Quarantine - A Cross-Sectional Pilot Study. Front Psychol 2021; 12:622678. [PMID: 33633648 PMCID: PMC7901904 DOI: 10.3389/fpsyg.2021.622678] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/04/2021] [Indexed: 12/22/2022] Open
Abstract
Introduction There is a need to maintain rehabilitation activities and motivate movement and physical activity during quarantine in individuals with Cerebral Palsy (CP). Objective This paper sets out to evaluate the feasibility and potential benefits of using computer serious game in a non-immersive virtual reality (VR) implemented and evaluated completely remotely in participants with CP for Home-Based Telerehabilitation during the quarantine period for COVID-19. Methods Using a cross-sectional design, a total of 44 individuals participated in this study between March and June 2020, 22 of which had CP (14 males and 8 females, mean age = 19 years, ranging between 11 and 28 years) and 22 typically developing individuals, matched by age and sex to the individuals with CP. Participants practiced a coincident timing game1 and we measured movement performance and physical activity intensity using the rating of perceived exertion Borg scale. Results All participants were able to engage with the VR therapy remotely, reported enjoying sessions, and improved performance in some practice moments. The most important result in this cross-sectional study was the significant increasing in rating of perceived exertion (through Borg scale) in both groups during practice and with CP presenting a higher rating of perceived exertion. Conclusion Children with CP enjoyed participating, were able to perform at the same level as their peers on certain activities and increased both their performance and physical activity intensity when using the game, supporting the use of serious games for this group for home therapy and interactive games. Clinical Trials Registration https://Clinicaltrials.gov, NCT04402034. Registered on May 20, 2020.
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Affiliation(s)
- Talita Dias da Silva
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Faculdade de Medicina, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Paula Lumy da Silva
- Fundação Hermínio Ometto (FHO-UNIARARAS), São Paulo, Brazil.,Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
| | - Elisa de Jesus Valenzuela
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
| | - Eduardo Dati Dias
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Amanda Orasmo Simcsik
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Mariana Giovanelli de Carvalho
- Departamento de Medicina (Cardiologia), Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Anne Michelli Gomes Gonçalves Fontes
- Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
| | - Camila Aparecida de Oliveira Alberissi
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Luciano Vieira de Araújo
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Murilo Vinícius da Costa Brandão
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil
| | - Helen Dawes
- Institute of Nursing and Allied Health Research, Oxford Brookes University, Oxford, United Kingdom.,Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
| | - Carlos Bandeira de Mello Monteiro
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo (PATER EACH USP), São Paulo, Brazil.,Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo (FOFITO - USP), São Paulo, Brazil
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In Medio Stat Virtus: intermediate levels of mind wandering improve episodic memory encoding in a virtual environment. PSYCHOLOGICAL RESEARCH 2020; 85:1613-1625. [PMID: 32447446 DOI: 10.1007/s00426-020-01358-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 05/09/2020] [Indexed: 10/24/2022]
Abstract
Episodic memory encoding is highly influenced by the availability of attentional resources. Mind wandering corresponds to a shift of attention toward task-unrelated thoughts. Few studies, however, have tested this link between memory encoding and mind wandering. The goal of the present work was to systematically investigate the influence of mind wandering during encoding on episodic memory performances in an ecological setting. Fifty-two participants were asked to navigate in a virtual urban environment. During the walk, they encountered different scenes that, unbeknownst to the participants, were target items presented in a subsequent recognition task associated with a Remember-Know-Guess paradigm. Each item triggered, after a random interval, a thought probe assessing current mind wandering. We found a significant linear positive relationship between the ratio of correctly recognized items and the overall mind wandering reported after the task. Moreover, we found a quadratic reversed U-shaped relationship between the probability of giving a 'Remember' response and both on-line and mind wandering reported a posteriori. The nearer to the medium value the level of mind wandering was, the higher was the probability to have a recollection-based recognition. Our results indicate that in a complex environment, the highest probability of actually remembering a scene would be when participants present a medium attentional level: neither distracted by inner thoughts nor too focused on the environment. This open attentional state would allow a better global processing of the environment by preventing one's attention from being captured by internal thoughts or narrowed by an over-focusing on the environment.
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10
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Pazzaglia C, Imbimbo I, Tranchita E, Minganti C, Ricciardi D, Lo Monaco R, Parisi A, Padua L. Comparison of virtual reality rehabilitation and conventional rehabilitation in Parkinson's disease: a randomised controlled trial. Physiotherapy 2019; 106:36-42. [PMID: 32026844 DOI: 10.1016/j.physio.2019.12.007] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/11/2019] [Accepted: 12/18/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare a 6-week virtual reality (VR) rehabilitation programme with a conventional rehabilitation programme in patients with Parkinson's disease. DESIGN Prospective, single-blinded, randomised controlled trial. SETTING Outpatients. PARTICIPANTS Fifty-one patients with Parkinson's disease were assigned at random to a VR rehabilitation programme or a conventional rehabilitation programme. INTERVENTIONS Both programmes ran for 6 consecutive weeks, with a 40-minute session three times per week. MAIN OUTCOME MEASURES The Balance Berg Scale (BBS) was used to measure balance. Secondary outcome measures were: Dynamic Gait Index (DGI) to evaluate ability to adapt gait to complex walking tasks; Disabilities of the Arm, Shoulder and Hand (DASH) scale to measure performance of the upper limb; and Short Form 36 (SF-36) to evaluate quality of life. RESULTS The VR rehabilitation programme led to an increase in BBS score {45.6 [standard deviation (SD) 7.9] vs 49.2 (SD 8.1), mean difference 3.6, 95% confidence interval (CI) 1.3 to 5.9; P=0.003}, DGI score [18.7 (SD 4.7) vs 20.2 (SD 4.2), mean difference 1.6, 95% CI 0.6 to 2.5; P=0.003] and SF-36 mental composite score [37.7 (SD 11.4) vs 43.5 (SD 9.2), mean difference 5.8, 95% CI 0.4 to 11.3; P=0.037], and a decrease in DASH scale score [29.6 (SD 17.5) vs 21.6 (SD 15.1), mean difference -7.9, 95% CI -13.7 to -2.2; P=0.009]. In contrast, the conventional rehabilitation programme only led to a decrease in DASH scale score [30.3 (SD 18.1) vs 25.1 (SD 15.8), mean difference -5.2, 95% CI -8.8 to -1.5; P=0.007]. CONCLUSION These findings suggest that rehabilitation is useful in Parkinson's disease, and the VR rehabilitation programme was more effective in determining overall improvement than the conventional rehabilitation programme. CLINICAL TRIAL REGISTRATION NUMBER NCT02807740.
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Affiliation(s)
- C Pazzaglia
- Department of Neurorehabilitation, IRCCS Don Carlo Gnocchi, Milan, Italy
| | - I Imbimbo
- Department of Neurorehabilitation, IRCCS Don Carlo Gnocchi, Milan, Italy
| | - E Tranchita
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - C Minganti
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - D Ricciardi
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Lo Monaco
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - A Parisi
- Department of Movement, Human and Health Sciences, Division of Health Sciences, University of Rome Foro Italico, Rome, Italy
| | - L Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy; UO Neuroriabilitazione ad Alta Intensità, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
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11
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Abstract
Although virtual reality (VR) is a promising tool for the investigation of episodic memory phenomena, to date there has been relatively little examination of how learning mechanisms operate in VR and how these processes might compare (or contrast) with learning that occurs in real life. Moreover, the existing literature on this topic is spread across several disciplines and uses various distinct apparatuses, thus obscuring whether the differences that exist between studies might be due to genuine theoretical discrepancies or may be more simply explained by accounting for methodological variations. The current review is designed to address and elucidate several issues relevant to psychological researchers interested in understanding and/or using this technological approach to study episodic memory phenomena. The principle objectives of the review are as follows: (a) defining and discussing the various VR systems currently used for research purposes, (b) compiling research of episodic memory effects in VR as they have been studied across several disciplines, and (c) surveying major topics in this body of literature (e.g., how virtual immersion has an impact on memory; transfer effects from VR to the real world). The content of this review is designed to serve as a resource for psychologists interested in learning more about the current state of research in this field and is intended to highlight the capabilities (and constraints) associated with using this technological approach in episodic memory research.
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12
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Martelli D, Prado A, Xia B, Verghese J, Agrawal SK. Development of a Virtual Floor Maze Test - Effects of Distal Visual Cues and Correlations With Executive Function in Healthy Adults. IEEE Trans Neural Syst Rehabil Eng 2019; 27:2229-2236. [PMID: 31478863 DOI: 10.1109/tnsre.2019.2938103] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Virtual reality (VR) is a useful tool to assess and improve spatial navigation, a complex skill and relevant marker for progression of dementia. A fully-immersive VR system that allows the user to physically navigate in the space can provide an ecologically valid environment for early detection and remediation of cognitive and navigational deficits. The aim of this study was to develop a virtual version of the floor maze test (VR-FMT), a navigational test that requires navigating through an unfamiliar two-dimensional floor maze. With the VR-FMT, mazes of desired complexity and walls of preferred height can be built to challenge navigational ability and mask visual clues. Fifty-five healthy adults completed the FMT in three different conditions: real environment (RE), virtual environment with no walls (VE-NW), and virtual environment with walls (VE-W). In addition, they completed two neuropsychological tests, the Trail Making Test and Digit Symbol Substitution Test. Results showed that the time to complete the maze in the VE was significantly higher than in the RE. The introduction of walls increased the number of errors, the completion time, and the length of the path. Only time to exit in the VE-W correlated with results of the cognitive tests. Participants were further subdivided on the basis of their time to exit the maze in the RE, VE-NW, and VE-W (low navigational time - LNT, and high navigational time - HNT). Only when analyzing the time to exit the maze in the VE-W, the LNT group outperformed the HNT group in all cognitive tests.
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13
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Muratore M, Tuena C, Pedroli E, Cipresso P, Riva G. Virtual Reality as a Possible Tool for the Assessment of Self-Awareness. Front Behav Neurosci 2019; 13:62. [PMID: 31019454 PMCID: PMC6458281 DOI: 10.3389/fnbeh.2019.00062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 03/13/2019] [Indexed: 11/17/2022] Open
Abstract
The absence of self-awareness is a crucial aspect in the symptomatology of various neurodegenerative disorders. This characteristic becomes relevant due to the strong implications it has on the patient’s quality of life, on the effects that functional dependence has on the caregiver and on the efficacy of the therapy. Faced with a construct as complex as self-awareness, there are in the literature investigations on different aspects of this phenomenon, such as the creation of cognitive models, the study of the neural substrate and the research of appropriate assessment methods that can reliably detect this function. With regard to the assessment methods, there are methodologies in the literature that provide complementary information. The first modality is a quantitatively online measurement based on the discrepancy between the estimate of the patient of his performance and his actual performance, but often neglecting the ecological validity and the real functioning of the subject. The second kind collecting subjective information on the actual daily functioning of the patient resulting from clinical observation or interviews with the subject and caregivers, but obtaining offline information on the functioning of the subject, liable to bias that may imply an overestimation or underestimation of subject’s ability. The absence of acknowledged metacognitive functional assessment with normative data to evaluate awareness winks at the emerging and increasingly consistent use of virtual reality (VR) also in the context of cognitive research and clinical assessment. This article aims to make a theoretical proposal regarding the use of this innovative and promising tool as a supplement to the assessment methods of self-awareness.
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Affiliation(s)
- Manuel Muratore
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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14
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Janouch C, Drescher U, Wechsler K, Haeger M, Bock O, Voelcker-Rehage C. Cognitive-Motor Interference in an Ecologically Valid Street Crossing Scenario. Front Psychol 2018; 9:602. [PMID: 29774001 PMCID: PMC5944128 DOI: 10.3389/fpsyg.2018.00602] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 04/10/2018] [Indexed: 11/22/2022] Open
Abstract
Laboratory-based research revealed that gait involves higher cognitive processes, leading to performance impairments when executed with a concurrent loading task. Deficits are especially pronounced in older adults. Theoretical approaches like the multiple resource model highlight the role of task similarity and associated attention distribution problems. It has been shown that in cases where these distribution problems are perceived relevant to participant's risk of falls, older adults prioritize gait and posture over the concurrent loading task. Here we investigate whether findings on task similarity and task prioritization can be transferred to an ecologically valid scenario. Sixty-three younger adults (20–30 years of age) and 61 older adults (65–75 years of age) participated in a virtual street crossing simulation. The participants' task was to identify suitable gaps that would allow them to cross a simulated two way street safely. Therefore, participants walked on a manual treadmill that transferred their forward motion to forward displacements in a virtual city. The task was presented as a single task (crossing only) and as a multitask. In the multitask condition participants were asked, among others, to type in three digit numbers that were presented either visually or auditorily. We found that for both age groups, street crossing as well as typing performance suffered under multitasking conditions. Impairments were especially pronounced for older adults (e.g., longer crossing initiation phase, more missed opportunities). However, younger and older adults did not differ in the speed and success rate of crossing. Further, deficits were stronger in the visual compared to the auditory task modality for most parameters. Our findings conform to earlier studies that found an age-related decline in multitasking performance in less realistic scenarios. However, task similarity effects were inconsistent and question the validity of the multiple resource model within ecologically valid scenarios.
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Affiliation(s)
- Christin Janouch
- Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
| | - Uwe Drescher
- Institute of Physiology and Anatomy, German Sport University Cologne, Cologne, Germany
| | - Konstantin Wechsler
- Institute of Physiology and Anatomy, German Sport University Cologne, Cologne, Germany
| | - Mathias Haeger
- Institute of Physiology and Anatomy, German Sport University Cologne, Cologne, Germany
| | - Otmar Bock
- Institute of Physiology and Anatomy, German Sport University Cologne, Cologne, Germany
| | - Claudia Voelcker-Rehage
- Faculty of Behavioral and Social Sciences, Institute of Human Movement Science and Health, Chemnitz University of Technology, Chemnitz, Germany
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15
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Bailey HD, Mullaney AB, Gibney KD, Kwakye LD. Audiovisual Integration Varies With Target and Environment Richness in Immersive Virtual Reality. Multisens Res 2018; 31:689-713. [PMID: 31264608 DOI: 10.1163/22134808-20181301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/26/2018] [Indexed: 11/19/2022]
Abstract
We are continually bombarded by information arriving to each of our senses; however, the brain seems to effortlessly integrate this separate information into a unified percept. Although multisensory integration has been researched extensively using simple computer tasks and stimuli, much less is known about how multisensory integration functions in real-world contexts. Additionally, several recent studies have demonstrated that multisensory integration varies tremendously across naturalistic stimuli. Virtual reality can be used to study multisensory integration in realistic settings because it combines realism with precise control over the environment and stimulus presentation. In the current study, we investigated whether multisensory integration as measured by the redundant signals effects (RSE) is observable in naturalistic environments using virtual reality and whether it differs as a function of target and/or environment cue-richness. Participants detected auditory, visual, and audiovisual targets which varied in cue-richness within three distinct virtual worlds that also varied in cue-richness. We demonstrated integrative effects in each environment-by-target pairing and further showed a modest effect on multisensory integration as a function of target cue-richness but only in the cue-rich environment. Our study is the first to definitively show that minimal and more naturalistic tasks elicit comparable redundant signals effects. Our results also suggest that multisensory integration may function differently depending on the features of the environment. The results of this study have important implications in the design of virtual multisensory environments that are currently being used for training, educational, and entertainment purposes.
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Affiliation(s)
| | | | - Kyla D Gibney
- Department of Neuroscience, Oberlin College, Oberlin, OH, USA
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16
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An ecological approach to the behavioral assessment of executive functions in anorexia nervosa. Psychiatry Res 2018; 259:283-288. [PMID: 29091830 DOI: 10.1016/j.psychres.2017.10.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 09/23/2017] [Accepted: 10/21/2017] [Indexed: 11/21/2022]
Abstract
The use of ecological tests to assess executive functions (EFs) in patients with anorexia nervosa (AN) has not examined extensively. The objective of this study was to analyze and compare the performance of patients with AN and healthy controls (HCs) on standard versus ecologically valid tests on EFs. Sixty-two females aged between 16 and 42 who were diagnosed with AN and 70 matched HCs completed 2 neuropsychological test batteries: standard tests (WCST, TMT, Stroop, ToL, fluency test) and the Behavioral Assessment of Dysexecutive Syndrome (BADS). On the standard tests, patients with AN produced more perseverative response and were slower than HCs in the TMT; in contrast, they scored as well as HCs on tasks that assessed categorization, interference in color naming, planning and semantic fluency. Conversely, there were differences in the ecological tests with patients with AN systematically slower in the resolution of complex tasks. Results demonstrated the power of ecological tests in capturing selective impairments in multifaceted and unstructured tests. Patients with AN experienced systematic deceleration in the resolution of ecological tasks. Also, the increased time needed to solve the tasks, was not reflected in overall improvement in performance. This evidence is further discussed with respect to central coherence.
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17
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Martínez-Pernía D, Núñez-Huasaf J, Del Blanco Á, Ruiz-Tagle A, Velásquez J, Gomez M, Robert Blesius C, Ibañez A, Fernández-Manjón B, Slachevsky A. Using game authoring platforms to develop screen-based simulated functional assessments in persons with executive dysfunction following traumatic brain injury. J Biomed Inform 2017; 74:71-84. [PMID: 28842292 DOI: 10.1016/j.jbi.2017.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 08/11/2017] [Accepted: 08/20/2017] [Indexed: 11/15/2022]
Abstract
The assessment of functional status is a critical component of clinical neuropsychological evaluations used for both diagnostic and therapeutic purposes in patients with cognitive brain disorders. There are, however, no widely adopted neuropsychological tests that are both ecologically valid and easily administered in daily clinical practice. This discrepancy is a roadblock to the widespread adoption of functional assessments. In this paper, we propose a novel approach using a serious game authoring platform (eAdventure) for creating screen-based simulated functional assessments. We created a naturalistic functional task that consisted of preparing a cup of tea (SBS-COT) and applied the assessment in a convenience sample of eight dyads of therapists/patients with mild executive dysfunction after traumatic brain injury. We had three main aims. First, we performed a comprehensive review of executive function assessment in activities of daily living. Second, we were interested in measuring the feasibility of this technology with respect to staffing, economic and technical requirements. Third, a serious game was administered to patients to study the feasibility of this technology in the clinical context (pre-screening test). In addition, quantitative (Technology Acceptance Model (TAM) questionnaires) and qualitative (semistructured interviews) evaluations were applied to obtain user input. Our results suggest that the staffing, economic and technical requirements of the SBS-COT are feasible. The outcomes of the pre-screening test provide evidence that this technology is useful in the functional assessment of patients with executive dysfunction. In relation to subjective data, the TAM questionnaire showed good user acceptability from a professional perspective. Interview analyses with professionals and patients showed positive experiences related to the use of the SBS-COT. Our work indicates that the use of these types of authoring platforms could have positive long-term implications for neuropsychological research, opening the door to more reproducible, cooperative and efficient research by allowing the facilitated production, reuse and sharing of neuropsychological assessment tools.
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Affiliation(s)
- David Martínez-Pernía
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile; Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile; Experiential Neurorehabilitation Research Department, Fundación Polibea, Spain
| | - Javier Núñez-Huasaf
- Los Muermos Primary Care Center and Reloncaví Health Service (SSDR), Los Muermos, Chile
| | - Ángel Del Blanco
- Departamento de Ingeniería del Software e Inteligencia Artificial, Facultad de Informática, Universidad Complutense de Madrid
| | - Amparo Ruiz-Tagle
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile
| | - Juan Velásquez
- Departamento de Ingeniería Industrial, Facultad de Ciencias Físicas y Matemáticas, Universidad de Chile, Santiago, Chile
| | - Mariela Gomez
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile
| | - Carl Robert Blesius
- Laboratory of Computer Science, Massachusetts General Hospital, Harvard Medical School
| | - Agustin Ibañez
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile; Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Universidad Autónoma del Caribe, Barranquilla, Colombia; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ACR), Sydney, Australia
| | - Baltasar Fernández-Manjón
- Departamento de Ingeniería del Software e Inteligencia Artificial, Facultad de Informática, Universidad Complutense de Madrid
| | - Andrea Slachevsky
- Center for Advanced Research in Education (CIAE), University of Chile, 8330014, Santiago, Chile; Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile; Physiopathology Department, ICBM, Department of Neuroscience and East Neuroscience Department, Faculty of Medicine, University of Chile, Avenida Salvador 486, Providencia, Santiago, Chile; Cognitive Neurology and Dementia, Neurology Department, Hospital del Salvador, Av. Salvador 386, Providencia, Santiago, Chile; Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile.
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18
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Belghali M, Chastan N, Davenne D, Decker LM. Improving Dual-Task Walking Paradigms to Detect Prodromal Parkinson's and Alzheimer's Diseases. Front Neurol 2017; 8:207. [PMID: 28588547 PMCID: PMC5438971 DOI: 10.3389/fneur.2017.00207] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 04/27/2017] [Indexed: 12/22/2022] Open
Abstract
Gait control is a complex movement, relying on spinal, subcortical, and cortical structures. The presence of deficits in one or more of these structures will result in changes in gait automaticity and control, as is the case in several neurodegenerative diseases, such as Alzheimer's disease (AD) and Parkinson's disease (PD). By reviewing recent findings in this field of research, current studies have shown that gait performance assessment under dual-task conditions could contribute to predict both of these diseases. Such suggestions are relevant mainly for people at putatively high risk of developing AD (i.e., older adults with mild cognitive impairment subtypes) or PD (i.e., older adults with either Mild Parkinsonian signs or LRRK2 G2019S mutation). Despite the major importance of these results, the type of cognitive task that should be used as a concurrent secondary task has to be selected among the plurality of tasks proposed in the literature. Furthermore, the key aspects of gait control that represent sensitive and specific "gait signatures" for prodromal AD or PD need to be determined. In the present perspective article, we suggest the use of a Stroop interference task requiring inhibitory attentional control and a set-shifting task requiring reactive flexibility as being particularly relevant secondary tasks for challenging gait in prodromal AD and PD, respectively. Investigating how inhibition and cognitive flexibility interfere with gait control is a promising avenue for future research aimed at enhancing early detection of AD and PD, respectively.
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Affiliation(s)
| | - Nathalie Chastan
- Normandie Université, UNICAEN, INSERM, COMETE, Caen, France.,Department of Neurophysiology, Normandie Université, UNIROUEN, Rouen University Hospital-Charles Nicolle, Rouen, France
| | - Damien Davenne
- Normandie Université, UNICAEN, INSERM, COMETE, Caen, France
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