Mental rotation of faces in healthy aging and Alzheimer's disease

Augmented reality-based affective training for improving care communication skill and empathy

It is important for caregivers of people with dementia (PwD) to have good patient communication skills as it has been known to reduce the behavioral and psychological symptoms of dementia (BPSD) of PwD as well as caregiver burnout. However, acquiring such skills often requires one-on-one affective training, which can be costly. In this study, we propose affective training using augmented reality (AR) for supporting the acquisition of such skills. The system uses see-through AR glasses and a nursing training doll to train the user in both practical nursing skills and affective skills such as eye contact and patient communication. The experiment was conducted with 38 nursing students. The participants were assigned to either the Doll group, which only used a doll for training, or the AR group, which used both a doll and the AR system. The results showed that eye contact significantly increased and the face-to-face distance and angle decreased in the AR group, while the Doll group had no significant difference. In addition, the empathy score of the AR group significantly increased after the training. Upon analyzing the correlation between personality and changes of physical skills, we found a significant positive correlation between the improvement rate of eye contact and extraversion in the AR group. These results demonstrated that affective training using AR is effective for improving caregivers' physical skills and their empathy for their patients. We believe that this system will be beneficial not only for dementia caregivers but for anyone looking to improve their general communication skills.

Topological differences and confounders of mental rotation in cervical dystonia and blepharospasm

Mental rotation (mR) bases on imagination of actual movements. It remains unclear whether there is a specific pattern of mR impairment in focal dystonia. We aimed to investigate mR in patients with cervical dystonia (CD) and blepharospasm (BS) and to assess potential confounders. 23 CD patients and 23 healthy controls (HC) as well as 21 BS and 19 hemifacial spasm (HS) patients were matched for sex, age, and education level. Handedness, finger dexterity, general reaction time, and cognitive status were assessed. Disease severity was evaluated by clinical scales. During mR, photographs of body parts (head, hand, or foot) and a non-corporal object (car) were displayed at different angles rotated within their plane. Subjects were asked to judge laterality of the presented image by keystroke. Both speed and correctness were evaluated. Compared to HC, CD and HS patients performed worse in mR of hands, whereas BS group showed comparable performance. There was a significant association of prolonged mR reaction time (RT) with reduced MoCA scores and with increased RT in an unspecific reaction speed task. After exclusion of cognitively impaired patients, increased RT in the mR of hands was confined to CD group, but not HS. While the question of whether specific patterns of mR impairment reliably define a dystonic endophenotype remains elusive, our findings point to mR as a useful tool, when used carefully with control measures and tasks, which may be capable of identifying specific deficits that distinguish between subtypes of dystonia.

Spatial orientation, postural control and the vestibular system in healthy elderly and Alzheimer's dementia

Background

While extensive research has been advancing our understanding of the spatial and postural decline in healthy elderly (HE) and Alzheimer's disease (AD), much less is known about how the vestibular system contributes to the spatial and postural processing in these two populations. This is especially relevant during turning movements in the dark, such as while walking in our garden or at home at night, where the vestibular signal becomes central. As the prevention of falls and disorientation are of serious concern for the medical service, more vestibular-driven knowledge is necessary to decrease the burden for HE and AD patients with vestibular disabilities.

Overview of the article

The review briefly presents the current "non-vestibular based" knowledge (i.e. knowledge based on research that does not mention the "vestibular system" as a contributor or does not investigate its effects) about spatial navigation and postural control during normal healthy ageing and AD pathology. Then, it concentrates on the critical sense of the vestibular system and explores the current expertise about the aspects of spatial orientation and postural control from a vestibular system point of view. The norm is set by first looking at how healthy elderly change with age with respect to their vestibular-guided navigation and balance, followed by the AD patients and the difficulties they experience in maintaining their balance or during navigation.

Conclusion

Vestibular spatial and vestibular postural deficits present a considerable disadvantage and are felt not only on a physical but also on a psychological level by all those affected. Still, there is a clear need for more (central) vestibular-driven spatial and postural knowledge in healthy and pathological ageing, which can better facilitate our understanding of the aetiology of these dysfunctions. A possible change can start with the more frequent implementation of the "vestibular system examination/rehabilitation/therapy" in the clinic, which can then lead to an improvement of future prognostication and disease outcome for the patients.

Efficacy of Corsi Block Tapping Task training for improving visuospatial skills: a non-randomized two-group study

Even though impaired visuospatial abilities can negatively affect daily functioning, there are very few training programs that attempt to improve visuospatial abilities. The purpose of this study was to examine if a single training session with a computerized version of the Corsi Block Tapping Task could improve mental rotation skills. Fifty-three young adults were assigned to one of two groups: (1) control group (mean age = 21.4; 10 females), who had 20 min of rest after their baseline assessment, or (2) training group (mean age = 21.5; 17 females), who had 20 min of training on the Corsi Block Tapping Task after their baseline assessment. The primary outcome was reaction time on a computer-based mental rotation task, and it was assessed both before and after the rest or training. There was a significant interaction between time (pre vs. post) and group (control vs. training) on mental rotation performance (p = 0.04), with the training group performing on average 124 ms faster on accurate trials than the control group at post-test. This preliminary study suggested that improving mental rotation may be feasible through targeted cognitive training. Future studies will consider multiple sessions of Corsi Block Tapping Task training to maximize training benefits (i.e., dose-response), as well as longer term retention in cognitively intact and impaired individuals.

An adaptive measure of visuospatial impairment in Dementia with Lewy Bodies

Background

Dementia with Lewy bodies (DLB) is a common cause of dementia with poor prognosis and high hospitalization rates. DLB is frequently misdiagnosed, with clinical features that overlap significantly with other diseases including Parkinson's disease (PD). Clinical instruments that discriminate and track the progression of cognitive impairment in DLB are needed.

Objectives

The current study was designed to assess the utility of a mental rotation (MR) task for assessing visuospatial impairments in early DLB.

Methods

Accuracy of 22 DLB patients, 22 PD patients and 22 age‐matched healthy controls in the MR task were compared at comparing shapes with 0°, 45° and 90° rotations.

Results

Healthy controls and PD patients performed at similar levels while the DLB group were significantly impaired. Further, impairment in the visuospatial and executive function measures correlated with MR poor outcomes.

Conclusion

These findings support the MR task as an objective measure of visuospatial impairment with the ability to adjust difficulty to suit impairments in a DLB population. This would be a useful tool within clinical trials.

Measurement of individual differences in face-identity processing abilities in older adults

BACKGROUND

Face-identity processing declines with age. Few studies have examined whether face-identity processing abilities can be measured independently from general cognitive abilities in older adults (OA). This question has practical implications for the assessment of face-identity processing abilities in OA and theoretical implications for the notion of face processing as a specific ability. The present study examined the specificity of face memory and face matching abilities in OA aged 50 + .

METHODS

Performance of younger adults (YA) and OA was measured on face tasks: Cambridge Face Memory Task (CFMT), the Glasgow Face Matching Task (GFMT), holistic processing; and tasks of general cognition: fluid intelligence, selective attention, and mental rotation. Data were analyzed using multiple regression models encompassing (i) the CFMT/GFMT and measures of general cognition; and (ii) all face processing tasks.

RESULTS

Across the two age groups, models encompassing all face tasks were significant and accounted for more variance in the data than models encompassing the CFMT/GFMT and measures of general cognition. General cognitive abilities accounted for 17% of variance for the GFMT (p < 0.01) and 3% for the CFMT (p > 0.05).

DISCUSSION

Our results suggest that face memory can be measured independently from general cognition using the CFMT in OA. Implications for the notion of a general face processing factor across the adult lifespan are discussed.

Technical Challenges for Smooth Interaction With Seniors With Dementia: Lessons From Humanitude™

Due to cognitive and socio-emotional decline and mental diseases, senior citizens, especially people with dementia (PwD), struggle to interact smoothly with their caregivers. Therefore, various care techniques have been proposed to develop good relationships with seniors. Among them, Humanitude is one promising technique that provides caregivers with useful interaction skills to improve their relationships with PwD, from four perspectives: face-to-face interaction, verbal communication, touch interaction, and helping care receivers stand up (physical interaction). Regardless of advances in elderly care techniques, since current social robots interact with seniors in the same manner as they do with younger adults, they lack several important functions. For example, Humanitude emphasizes the importance of interaction at a relatively intimate distance to facilitate communication with seniors. Unfortunately, few studies have developed an interaction model for clinical care communication. In this paper, we discuss the current challenges to develop a social robot that can smoothly interact with PwDs and overview the interaction skills used in Humanitude as well as the existing technologies.

High Cysteine Membrane Proteins (HCMPs) Are Up-Regulated During Giardia-Host Cell Interactions

Giardia intestinalis colonizes the upper small intestine of humans and animals, causing the diarrheal disease giardiasis. This unicellular eukaryotic parasite is not invasive but it attaches to the surface of small intestinal epithelial cells (IECs), disrupting the epithelial barrier. Here, we used an in vitro model of the parasite’s interaction with host IECs (differentiated Caco-2 cells) and RNA sequencing (RNAseq) to identify differentially expressed genes (DEGs) in Giardia, which might relate to the establishment of infection and disease induction. Giardia trophozoites interacted with differentiated Caco-2 cells for 1.5, 3, and 4.5 h and at each time point, 61, 89, and 148 parasite genes were up-regulated more than twofold, whereas 209, 265, and 313 parasite genes were down-regulated more than twofold. The most abundant DEGs encode hypothetical proteins and members of the High Cysteine Membrane Protein (HCMP) family. Among the up-regulated genes we also observed proteins associated with proteolysis, cellular redox balance, as well as lipid and nucleic acid metabolic pathways. In contrast, genes encoding kinases, regulators of the cell cycle and arginine metabolism and cytoskeletal proteins were down-regulated. Immunofluorescence imaging of selected, up-regulated HCMPs, using C-terminal HA-tagging, showed localization to the plasma membrane and peripheral vesicles (PVs). The expression of the HCMPs was affected by histone acetylation and free iron-levels. In fact, the latter was shown to regulate the expression of many putative giardial virulence factors in subsequent RNAseq experiments. We suggest that the plasma membrane localized and differentially expressed HCMPs play important roles during Giardia-host cell interactions.

Neurobiological Aspects of Face Recognition: The Role of Oxytocin

Face recognition is an important index in the formation of social cognition and neurodevelopment in humans. Changes in face perception and memory are connected with altered sociability, which is a symptom of numerous brain conditions including autism spectrum disorder (ASD). Various brain regions and neuropeptides are implicated in face processing. The neuropeptide oxytocin (OT) plays an important role in various social behaviors, including face and emotion recognition. Nasal OT administration is a promising new therapy that can address social cognition deficits in individuals with ASD. New instrumental neurotechnologies enable the assessment of brain region activation during specific social tasks and therapies, and can characterize the involvement of genes and peptides in impaired neurodevelopment. The present review sought to discuss some of the mechanisms of the face distinguishing process, the ability of OT to modulate social cognition, as well as new perspectives and technologies for research and rehabilitation of face recognition.

Classification images characterize age-related deficits in face discrimination

Face perception is impaired in older adults, but the cause of this decline is not well understood. We examined this issue by measuring Classification Images (CIs) in a face discrimination task in younger and older adults. Faces were presented in static, white visual noise, and face contrast was varied with a staircase to maintain an accuracy rate of ≈71%. The noise fields were used to construct a CI using the method described by Nagai et al. (2013) and each observer's CI was cross-correlated with the visual template of a linear ideal discriminator to obtain an estimate of the absolute efficiency of visual processing. Face discrimination thresholds were lower in younger than older adults. Like Sekuler, Gaspar, Gold, and Bennett (2004), we found that CIs from younger adults contained structure near the eyes and brows, suggesting that those observers consistently relied on information conveyed by pixels in those regions of the stimulus. CIs obtained from older adults were noticeably different: CIs from only two older adults exhibited structure near the eye/brow regions, and CIs from the remaining older observers showed no obvious structure. Nevertheless, face discrimination thresholds in both groups were strongly and similarly correlated with the cross-correlation between the CI and the ideal template, suggesting that despite older observers' lack of consistent structure, the CI method is sensitive to between-subject differences in older observers' perceptual strategy.

Cognitive Vulnerability in Aging May Be Modulated by Education and Reserve in Healthy People

Aging is related to a deterioration of cognitive performance and to multiple alterations in the brain. Even before the beginning of a noticeable cognitive decline, the framework which holds cognitive function experiences these alterations. From a system-vulnerability point of view of cognition, the deterioration associated with age would be the collection of repercussions during a life. Brain function and structure are modified in a multidimensional way, which could concern different aspects like structural integrity, functional activity, connectivity, or glucose metabolism. From this point of view, the effects of aging could affect the most brain systems and their functional activity. In this study, we analyze the functional development of three cognitive domains in relation to aging, educational level, and cognitive reserve (CR). A total of 172 healthy subjects were divided into two age groups (young and old), and completed a battery of classic neuropsychological tests. The tests were organized and analyzed according to three cognitive domains: working memory and flexibility, visuoconstructive functions, and declarative memory. Subjects also completed a questionnaire on CR. Results showed that the performance in all cognitive domains decreased with age. In particular, tests related to working memory, flexibility, and visuoconstructive abilities were influenced by age. Nevertheless, this effect was attenuated by effects of education, mainly in visuoconstructive domain. Surprisingly, visual as well as verbal memory tests were not affected either by aging, education, or CR. Brain plasticity plays a prominent role in the aging process, but, as other studies have shown, the plasticity mechanism is quite different in healthy vs. pathological brains. Moreover, this plasticity brain mechanism could be modulated by education and CR. Specially, cognitive domains as working memory, some executive functions and the visuoconstructive abilities seem to be modulated by education. Therefore, it seems to be crucial, to propose mechanisms of maintenance of a healthy and enriched brain, since it promotes auto-regulatory mechanisms of well-aging.

Self-Face Recognition in Schizophrenia: An Eye-Tracking Study

Self-face recognition has been shown to be impaired in schizophrenia (SZ), according to studies using behavioral tasks implicating cognitive demands. Here, we employed an eye-tracking methodology, which is a relevant tool to understand impairments in self-face recognition deficits in SZ because it provides a natural, continuous and online record of face processing. Moreover, it allows collecting the most relevant and informative features each individual looks at during the self-face recognition. These advantages are especially relevant considering the fundamental role played by the patterns of visual exploration on face processing. Thus, this paper aims to investigate self-face recognition deficits in SZ using eye-tracking methodology. Visual scan paths were monitored in 20 patients with SZ and 20 healthy controls. Self, famous, and unknown faces were morphed in steps of 20%. Location, number, and duration of fixations on relevant areas were recorded with an eye-tracking system. Participants performed a passive exploration task (no specific instruction was provided), followed by an active decision making task (individuals were explicitly requested to recognize the different faces). Results showed that patients with SZ had fewer and longer fixations compared to controls. Nevertheless, both groups focused their attention on relevant facial features in a similar way. No significant difference was found between groups when participants were requested to recognize the faces (active task). In conclusion, using an eye tracking methodology and two tasks with low levels of cognitive demands, our results suggest that patients with SZ are able to: (1) explore faces and focus on relevant features of the face in a similar way as controls; and (2) recognize their own face.

The Concept of Missing Incidents in Persons with Dementia

Behavioral symptoms of dementia often present the greatest challenge for informal caregivers. One behavior, that is a constant concern for caregivers, is the person with dementia leaving a designated area such that their whereabouts become unknown to the caregiver or a missing incident. Based on an extensive literature review and published findings of their own research, members of the International Consortium on Wandering and Missing Incidents constructed a preliminary missing incidents model. Examining the evidence base, specific factors within each category of the model were further described, reviewed and modified until consensus was reached regarding the final model. The model begins to explain in particular the variety of antecedents that are related to missing incidents. The model presented in this paper is designed to be heuristic and may be used to stimulate discussion and the development of effective preventative and response strategies for missing incidents among persons with dementia.

Spatial abilities and aging: a meta-analysis

BACKGROUND/STUDY CONTEXT: Age-related effects in performance on spatial tasks have been well documented, with results suggesting a negative effect on performance in older samples. Although meta-analyses have been conducted examining performance on specific spatial tasks, it appears that data incorporating a variety of tasks have not yet been integrated into a single meta-analyses.

METHODS

The present study examined age-related effects on spatial abilities in a multilevel meta-analysis of 137 effect sizes, drawn from 80 samples dated between 1958 and 2011. In addition to sample characteristics (education, year of publication, and age range), procedural factors (spatial ability category, spatial task, dependent variable, task setting, and medium of administration) were also considered. The standardized mean difference (Cohen's d) was used as the effect size measure in meta-analytic calculations.

RESULTS

RESULTS revealed a large (mean d = 1.01) age-related decrease in spatial performance on psychometric tests. Specifically, older adults (mean age range = 63-79.5 years) performed worse on psychometric tests than younger adults (mean age range = 17-28.6 years). Interestingly, this age effect was unaffected by factors such as specific test, test category (mental rotation, spatial perception, or spatial visualization), timing conditions, and group or individual administration. However, measures of response time produced significantly larger effects of age than measures of accuracy on spatial performance.

CONCLUSION

The present analysis demonstrates a clear pattern of negative age effects in spatial ability across the literature. Although these effects are unaffected by the specific spatial component under investigation or testing conditions, speed of processing was shown to be an important factor in spatial performance. The need to report more thoroughly on characteristics of young and old participants in future studies is also emphasized.