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Cha SM. Mobile Application Applied for Cognitive Rehabilitation: A Systematic Review. Life (Basel) 2024; 14:891. [PMID: 39063644 PMCID: PMC11278363 DOI: 10.3390/life14070891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
The COVID-19 pandemic has increased the demand for home rehabilitation services, leading to the development and rising demand for cognitive rehabilitation apps. However, a comprehensive analysis of the content and effectiveness of these apps is needed. This study systematically reviewed and analyzed the literature on mobile apps for cognitive rehabilitation. One researcher and an external expert conducted the study selection, data extraction, and quality assessment following the PRISMA Checklist 2020 guidelines. Our review of 18 studies identified 8 randomized controlled trials (RCTs) (44.44%) of high quality and 10 non-RCT studies (55.56%) of moderate quality. Overall, 16 of the 18 studies (88.88%) demonstrated positive clinical implications for cognitive function after using cognitive rehabilitation apps. Eight studies showed a correlation between app use and improved cognitive function, and four highlighted the potential for cognitive function evaluation through apps. All studies employed various occupational therapy (OT) intervention approaches, with prevention being the most common (100%), followed by establishment and restoration (83.33%), maintenance (77.77%), and creation and promotion (38.88%). This study clinically validates the effectiveness of cognitive rehabilitation mobile applications from an occupational therapy perspective.
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Affiliation(s)
- Su-Min Cha
- Department of Occupational Therapy, Kyungnam University, Changwon 51767, Republic of Korea
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2
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Yao Y, Hasan WZW, Jiao W, Dong X, Ramli HR, Norsahperi NMH, Wen D. ChatGPT and BCI-VR: a new integrated diagnostic and therapeutic perspective for the accurate diagnosis and personalized treatment of mild cognitive impairment. Front Hum Neurosci 2024; 18:1426055. [PMID: 38895167 PMCID: PMC11183516 DOI: 10.3389/fnhum.2024.1426055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Affiliation(s)
- Yiduo Yao
- Department of Electrical and Electronic Engineering, Faculty of Engineering, University Putra Malaysia, Selangor, Malaysia
| | - W. Z. W. Hasan
- Department of Electrical and Electronic Engineering, Faculty of Engineering, University Putra Malaysia, Selangor, Malaysia
| | - Wenlong Jiao
- Brain Computer Intelligence and Intelligent Health Institute, School of Intelligence Science and Technology, University of Science and Technology Beijing, Chengde, China
| | - Xianling Dong
- Hebei International Research Center of Medical Engineering, Chengde Medical University, Hebei, China
| | - H. R. Ramli
- Department of Electrical and Electronic Engineering, Faculty of Engineering, University Putra Malaysia, Selangor, Malaysia
| | - N. M. H. Norsahperi
- Department of Electrical and Electronic Engineering, Faculty of Engineering, University Putra Malaysia, Selangor, Malaysia
| | - Dong Wen
- Brain Computer Intelligence and Intelligent Health Institute, School of Intelligence Science and Technology, University of Science and Technology Beijing, Chengde, China
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McMurray J, Levy A, Pang W, Holyoke P. Psychometric Evaluation of a Tablet-Based Tool to Detect Mild Cognitive Impairment in Older Adults: Mixed Methods Study. J Med Internet Res 2024; 26:e56883. [PMID: 38640480 PMCID: PMC11069099 DOI: 10.2196/56883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/05/2024] [Accepted: 03/19/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND With the rapid aging of the global population, the prevalence of mild cognitive impairment (MCI) and dementia is anticipated to surge worldwide. MCI serves as an intermediary stage between normal aging and dementia, necessitating more sensitive and effective screening tools for early identification and intervention. The BrainFx SCREEN is a novel digital tool designed to assess cognitive impairment. This study evaluated its efficacy as a screening tool for MCI in primary care settings, particularly in the context of an aging population and the growing integration of digital health solutions. OBJECTIVE The primary objective was to assess the validity, reliability, and applicability of the BrainFx SCREEN (hereafter, the SCREEN) for MCI screening in a primary care context. We conducted an exploratory study comparing the SCREEN with an established screening tool, the Quick Mild Cognitive Impairment (Qmci) screen. METHODS A concurrent mixed methods, prospective study using a quasi-experimental design was conducted with 147 participants from 5 primary care Family Health Teams (FHTs; characterized by multidisciplinary practice and capitated funding) across southwestern Ontario, Canada. Participants included health care practitioners, patients, and FHT administrative executives. Individuals aged ≥55 years with no history of MCI or diagnosis of dementia rostered in a participating FHT were eligible to participate. Participants were screened using both the SCREEN and Qmci. The study also incorporated the Geriatric Anxiety Scale-10 to assess general anxiety levels at each cognitive screening. The SCREEN's scoring was compared against that of the Qmci and the clinical judgment of health care professionals. Statistical analyses included sensitivity, specificity, internal consistency, and test-retest reliability assessments. RESULTS The study found that the SCREEN's longer administration time and complex scoring algorithm, which is proprietary and unavailable for independent analysis, presented challenges. Its internal consistency, indicated by a Cronbach α of 0.63, was below the acceptable threshold. The test-retest reliability also showed limitations, with moderate intraclass correlation coefficient (0.54) and inadequate κ (0.15) values. Sensitivity and specificity were consistent (63.25% and 74.07%, respectively) between cross-tabulation and discrepant analysis. In addition, the study faced limitations due to its demographic skew (96/147, 65.3% female, well-educated participants), the absence of a comprehensive gold standard for MCI diagnosis, and financial constraints limiting the inclusion of confirmatory neuropsychological testing. CONCLUSIONS The SCREEN, in its current form, does not meet the necessary criteria for an optimal MCI screening tool in primary care settings, primarily due to its longer administration time and lower reliability. As the number of digital health technologies increases and evolves, further testing and refinement of tools such as the SCREEN are essential to ensure their efficacy and reliability in real-world clinical settings. This study advocates for continued research in this rapidly advancing field to better serve the aging population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/25520.
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Affiliation(s)
- Josephine McMurray
- Lazaridis School of Business & Economics, Wilfrid Laurier University, Brantford, ON, Canada
- Health Studies, Faculty of Human and Social Sciences, Wilfrid Laurier University, Brantford, ON, Canada
| | - AnneMarie Levy
- Lazaridis School of Business & Economics, Wilfrid Laurier University, Brantford, ON, Canada
| | - Wei Pang
- Lazaridis School of Business & Economics, Wilfrid Laurier University, Brantford, ON, Canada
- Biomedical Informatics & Data Science, Yale University, New Haven, CT, United States
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Giannopoulou P, Vrahatis AG, Papalaskari MA, Vlamos P. The RODI mHealth app Insight: Machine-Learning-Driven Identification of Digital Indicators for Neurodegenerative Disorder Detection. Healthcare (Basel) 2023; 11:2985. [PMID: 37998477 PMCID: PMC10671821 DOI: 10.3390/healthcare11222985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
Neurocognitive Disorders (NCDs) pose a significant global health concern, and early detection is crucial for optimizing therapeutic outcomes. In parallel, mobile health apps (mHealth apps) have emerged as a promising avenue for assisting individuals with cognitive deficits. Under this perspective, we pioneered the development of the RODI mHealth app, a unique method for detecting aligned with the criteria for NCDs using a series of brief tasks. Utilizing the RODI app, we conducted a study from July to October 2022 involving 182 individuals with NCDs and healthy participants. The study aimed to assess performance differences between healthy older adults and NCD patients, identify significant performance disparities during the initial administration of the RODI app, and determine critical features for outcome prediction. Subsequently, the results underwent machine learning processes to unveil underlying patterns associated with NCDs. We prioritize the tasks within RODI based on their alignment with the criteria for NCDs, thus acting as key digital indicators for the disorder. We achieve this by employing an ensemble strategy that leverages the feature importance mechanism from three contemporary classification algorithms. Our analysis revealed that tasks related to visual working memory were the most significant in distinguishing between healthy individuals and those with an NCD. On the other hand, processes involving mental calculations, executive working memory, and recall were less influential in the detection process. Our study serves as a blueprint for future mHealth apps, offering a guide for enhancing the detection of digital indicators for disorders and related conditions.
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Affiliation(s)
- Panagiota Giannopoulou
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (P.G.); (A.G.V.)
| | - Aristidis G. Vrahatis
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (P.G.); (A.G.V.)
| | | | - Panagiotis Vlamos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (P.G.); (A.G.V.)
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Alopoudi A, Makri M, Alişoğlu B, Doğan A, Imbesi A, Karakoyun M, Lacapelle A, Navarro Roux MA, Pissa A, Tsolaki M. A Protocol for the Development and Assessment of a Non-Pharmacological Intervention Designed to Improve Cognitive Skills of Adults with Intellectual Disabilities: A Mixed Method Design. J Multidiscip Healthc 2023; 16:3215-3226. [PMID: 37933262 PMCID: PMC10625738 DOI: 10.2147/jmdh.s422859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/12/2023] [Indexed: 11/08/2023] Open
Abstract
Aim This paper describes the steps of a protocol for developing and assessing a non-pharmacological intervention, specifically a Serious Game, with the goal of improving eight cognitive skills in adults with Intellectual Disabilities. Serious games that focus on one deficit and/or are restricted to one disorder have been developed to improve the cognitive skills of people with Intellectual Disabilities. There is a lack of a single tool that targets various cognitive skills as well as a broader spectrum of disorders. Purpose The presentation of the protocol which describes the steps of developing a new Serious Game that will be evaluated in a randomised control trial intervention. Participants and Methods The protocol is divided into three stages: identification of cognitive deficits and development of the Serious Game, randomised control trial intervention- follow up assessment, and evaluation of the Serious Game by trainers and caregivers. The participants of the intervention are adults with Intellectual Disabilities. Results The protocol's results are expected to cover the development of a new Serious Game for specific cognitive functions of a mixed group of adults with Intellectual Disabilities, evaluating the structure and content of the game through neuropsychological assessments for participants and specific questionnaires for trainers and caregivers, evaluating the improvement of specific cognitive abilities in participants in the intervention; and measuring the possible improvement of the quality of life and social interaction of people with Intellectual Disabilities. Conclusion This is the first study to develop a protocol and implement and assess this new Serious Game. This Serious Game is expected to assist people with Intellectual Disabilities in cognitive and social aspects.
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Affiliation(s)
- Aristi Alopoudi
- Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Greece
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marina Makri
- Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Greece
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases Center for Interdisciplinary Research and Innovation (CIRI - Auth), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | | | | | | | | | - Alexia Pissa
- Synthesis Center for Research and Education Limited, Lefkosia, Cyprus
| | - Magda Tsolaki
- Greek Association of Alzheimer Disease and Related Disorders, Thessaloniki, Greece
- Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases Center for Interdisciplinary Research and Innovation (CIRI - Auth), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Liu Q, Song H, Yan M, Ding Y, Wang Y, Chen L, Yin H. Virtual reality technology in the detection of mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2023; 87:101889. [PMID: 36806377 DOI: 10.1016/j.arr.2023.101889] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND In recent years, virtual reality technology has developed the potential to help in the early detection of mild cognitive impairment (MCI). However, integrative evidence of its detection performance for mild cognitive impairment is lacking, and meta-analysis or systematic reviews are required to further determine the effectiveness of virtual reality technology in screening for MCI. METHODS Literature searches were performed for MCI screening tests in the Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus. The primary outcome was the performance of VR tests for MCI detection. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42022302139). RESULTS A total of 14 studies in 13 reports were eventually included. The combined data with the bivariate random-effects model gave a summary point of 0.89 sensitivity (95 % confidence interval [CI]: 0.82-0.94) and 0.91 specificity (95 % CI: 0.82-0.96). The SROC curve was plotted, the DOR was 79.25 (95 % CI: 22.59-277.99), and the AUC was 0.95 (95 % CI: 0.93-0.97). CONCLUSIONS Virtual reality-based tests have shown considerable detection performance in detecting MCI, and therefore, virtual reality-based tests can serve as recommended screening methods. Future studies can consider longitudinal assessment and follow-up programs to identify progressive changes.
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Affiliation(s)
- Qian Liu
- Jilin University School of Nursing, Changchun, China.
| | - Huali Song
- The First Hospital of Jilin University, Changchun, China.
| | - Mingli Yan
- Jilin University School of Nursing, Changchun, China.
| | - Yiwen Ding
- Jilin University School of Nursing, Changchun, China.
| | - Yinuo Wang
- Jilin University School of Nursing, Changchun, China.
| | - Li Chen
- Jilin University School of Nursing, Changchun, China.
| | - Huiru Yin
- Jilin University School of Nursing, Changchun, China.
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Liu LY, Xing Y, Zhang ZH, Zhang QG, Dong M, Wang H, Cai L, Wang X, Tang Y. Validation of a Computerized Cognitive Training Tool to Assess Cognitive Impairment and Enable Differentiation Between Mild Cognitive Impairment and Dementia. J Alzheimers Dis 2023; 96:93-101. [PMID: 37742644 DOI: 10.3233/jad-230416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Age-related cognitive decline is a chronic, progressive process that requires active clinical management as cognitive status changes. Computerized cognitive training (CCT) provides cognitive exercises targeting specific cognitive domains delivered by computer or tablet. Meanwhile, CCT can be used to regularly monitor the cognitive status of patients, but it is not clear whether CCT can reliably assess cognitive ability or be used to diagnose different stages of cognitive impairment. OBJECTIVE To investigate whether CCT can accurately monitor the cognitive status of patients with cognitive impairment as well as distinguish patients with dementia from patients with mild cognitive impairment (MCI). METHOD We included 116 patients (42 dementia and 74 MCI) in final analysis. Cognitive ability was assessed by averaging the patient performance on the CCT to determine the Cognitive Index. The validity of the Cognitive Index was evaluated by its correlation with neuropsychological tests, and internal consistency was measured to assess the reliability. Additionally, we determined the diagnostic ability of the Cognitive Index to detect dementia using receiver operating characteristic (ROC) analysis. RESULTS The Cognitive Index was highly correlated with the Montreal Cognitive Assessment (r = 0.812) and the Mini-Mental State Examination (r = 0.694), indicating good convergent validity, and the Cronbach's alpha coefficient was 0.936, indicating excellent internal consistency. The area under the ROC curve, sensitivity, and specificity of the Cognitive Index to diagnose dementia were 0.943, 83.3%, and 91.9%, respectively. CONCLUSIONS CCT can be used to assess cognitive status and detect dementia in patients with cognitive impairment.
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Affiliation(s)
- Li-Yang Liu
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Yi Xing
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Zi-Heng Zhang
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Qing-Ge Zhang
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Ming Dong
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Longjun Cai
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Xiaoyi Wang
- Beijing Wisdom Spirit Technology Co., Ltd., Beijing, China
| | - Yi Tang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
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8
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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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Sagaspe P, Amieva H, Dartigues JF, Olive J, de la Rivière JB, Chartier C, Taillard J, Philip P. Validity and diagnostic performance of a virtual reality-based supermarket application "MEMOSHOP" for assessing episodic memory in normal and pathological aging. Digit Health 2023; 9:20552076231218808. [PMID: 38144175 PMCID: PMC10748669 DOI: 10.1177/20552076231218808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Objective MEMOSHOP is a virtual reality (VR)-based supermarket application for assessing episodic memory in aging. The aim of this study was to examine its construct validity against the gold standard paper-and-pencil neuropsychological test for clinical memory assessment in mild cognitive impairment (MCI) in older adults. Methods Patients with isolated subjective cognitive complaints (SCCs) or MCI were recruited in the Bordeaux Memory Clinic (MEMENTO cohort). Cognitively normal elderly controls were also recruited. MEMOSHOP allows a near-ecological evaluation of episodic memory during a usual daily life activity, i.e. shopping at the supermarket. MEMOSHOP and the gold standard Free and Cued Selective Reminding Test (FCSRT: French adaptation) were administered to all participants to assess episodic memory. Non-parametric tests and receiver operating characteristic curves were computed to compare their performances. Results Twenty-nine patients (21 females, age = 71 years ±7) and 29 matched controls were evaluated. The performance trends observed with MEMOSHOP and FCSRT on free and cued recall were associated (p < .01) and comparable (p < .0001), without any participants' groups interaction. Although easier than FCSRT in free recall for participants, MEMOSHOP demonstrated better diagnostic performance based on cued recall in isolated SCCs/MCI patients (p < .05). Conclusion MEMOSHOP demonstrated its reliability and validity for VR-based episodic memory assessment in the early stage of MCI and is potentially of interest for use in memory clinic settings.
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Affiliation(s)
- Patricia Sagaspe
- CHU de Bordeaux, Pôle Neurosciences Cliniques, F-33000 Bordeaux, France
- Université de Bordeaux, UMR CNRS 6033 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, F-33076 Bordeaux, France
| | - Hélène Amieva
- CMRR, CHU Bordeaux, F-33000 Bordeaux, France
- INSERM U1219, Bordeaux Population Health Center, Université de Bordeaux, F-33076 Bordeaux, France
| | - Jean-François Dartigues
- CMRR, CHU Bordeaux, F-33000 Bordeaux, France
- INSERM U1219, Bordeaux Population Health Center, Université de Bordeaux, F-33076 Bordeaux, France
| | - Jérôme Olive
- Université de Bordeaux, UMR CNRS 6033 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, F-33076 Bordeaux, France
| | | | | | - Jacques Taillard
- Université de Bordeaux, UMR CNRS 6033 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, F-33076 Bordeaux, France
| | - Pierre Philip
- CHU de Bordeaux, Pôle Neurosciences Cliniques, F-33000 Bordeaux, France
- Université de Bordeaux, UMR CNRS 6033 SANPSY Sommeil, Addiction et NeuroPSYchiatrie, F-33076 Bordeaux, France
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Sohn M, Yang J, Sohn J, Lee JH. Digital healthcare for dementia and cognitive impairment: A scoping review. Int J Nurs Stud 2022; 140:104413. [PMID: 36821951 DOI: 10.1016/j.ijnurstu.2022.104413] [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: 04/29/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive disorders, such as Alzheimer's disease, are a global health problem. Digital healthcare technology is an innovative management tool for delaying the progression of dementia and mild cognitive impairment. Thanks to digital technology, the possibility of safe and effective care for patients at home and in the community is increasing, even in situations that threaten the continuity of care, such as the COVID-19 pandemic. However, it is difficult to select appropriate technology and alternatives due to the lack of comprehensive reviews on the types and characteristics of digital technology for cognitive impairment, including their effects and limitations. OBJECTIVE This study aims to identify the types of digital healthcare technology for dementia and mild cognitive impairment and comprehensively examine how its outcome measures were constructed in line with each technology's purpose. METHODS According to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines, a literature search was conducted in August 2021 using Medline (Ovid), EMBASE, and Cochrane library. The search terms were constructed based on Population-Concept-Context mnemonic: 'dementia', 'cognitive impairment', and 'cognitive decline'; digital healthcare technology, such as big data, artificial intelligence, virtual reality, robots, applications, and so on; and the outcomes of digital technology, such as accuracy of diagnosis and physical, mental, and social health. After grasping overall research trends, the literature was classified and analysed in terms of the type of service users and technology. RESULTS In total, 135 articles were selected. Since 2015, an increase in literature has been observed, and various digital healthcare technologies were identified. For people with mild cognitive impairment, technology for predicting and diagnosing the onset of dementia was studied, and for people with dementia, intervention technology to prevent the deterioration of health and induce significant improvement was considered. Regarding caregivers, many studies were conducted on monitoring and daily living assistive technologies that reduce the burden of care. However, problems such as data collection, storage, safety, and the digital divide persisted at different intensities for each technology type. CONCLUSIONS This study revealed that appropriate technology options and considerations may differ depending on the characteristics of users. It also emphasises the role of humans in designing and managing technology to apply digital healthcare technology more effectively.
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Affiliation(s)
- Minsung Sohn
- Division of Health and Medical Sciences, The Cyber University of Korea, Seoul, Republic of Korea
| | - JungYeon Yang
- Transdisciplinary Major in Learning Health Systems, Department of Public Health Science, Graduate School, Korea University, Republic of Korea
| | - Junyoung Sohn
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Jun-Hyup Lee
- Department of Health Policy and Management, College of Health Sciences, Korea University, Republic of Korea.
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Alopoudi A, Makri M, Alişoğlu B, DOĞAN A, Imbesi A, Karakoyun M, Lacapelle A, Navvaro Roux MA, Pissa A, Tsolaki M. Non pharmacological intervention for the improvement of cognitive skills of adults with Intellectual Disabilities (Mild and Moderate Intellectual Disability, Mild Cognitive Impairment, Autism Spectrum Disorder, Down Syndrome): mixed method study protocol for Game4CoSkills project (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/44386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
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12
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Sexton C, Solis M, Aharon-Peretz J, Alexopoulos P, Apostolova LG, Bayen E, Birkenhager B, Cappa S, Constantinidou F, Fortea J, Gerritsen DL, Hassanin HI, Ibanez A, Ioannidis P, Karageorgiou E, Korczyn A, Leroi I, Lichtwarck B, Logroscino G, Lynch C, Mecocci P, Molinuevo JL, Papatriantafyllou J, Papegeorgiou S, Politis A, Raman R, Ritchie K, Sanchez-Juan P, Sano M, Scarmeas N, Spiru L, Stathi A, Tsolaki M, Yener G, Zaganas I, Zygouris S, Carrillo M. Alzheimer's disease research progress in the Mediterranean region: The Alzheimer's Association International Conference Satellite Symposium. Alzheimers Dement 2022; 18:1957-1968. [PMID: 35184367 PMCID: PMC11066754 DOI: 10.1002/alz.12588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 01/28/2023]
Abstract
As research and services in the Mediterranean region continue to increase, so do opportunities for global collaboration. To support such collaborations, the Alzheimer's Association was due to hold its seventh Alzheimer's Association International Conference Satellite Symposium in Athens, Greece in 2021. Due to the COVID-19 pandemic, the meeting was held virtually, which enabled attendees from around the world to hear about research efforts in Greece and the surrounding Mediterranean countries. Research updates spanned understanding the biology of, treatments for, and care of people with Alzheimer's disease (AD_ and other dementias. Researchers in the Mediterranean region have outlined the local epidemiology of AD and dementia, and have identified regional populations that may expedite genetic studies. Development of biomarkers is expected to aid early and accurate diagnosis. Numerous efforts have been made to develop culturally specific interventions to both reduce risk of dementia, and to improve quality of life for people living with dementia.
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Affiliation(s)
- Claire Sexton
- Alzheimer's Association, 225 N Michigan Avenue, 17th Fl, Chicago, Illinois, USA
| | | | | | - Panagiotis Alexopoulos
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | | | - Eléonore Bayen
- Laboratoire d'imagerie biomédicale, Sorbonne Université, department of physical rehabilitation medicine, Pitié-Salpêtrière hospital, AP-HP, Paris, France
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Betty Birkenhager
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Stefano Cappa
- University School for Advanced Studies (IUSS-Pavia) and IRCCS Mondino Foundation, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, PV, Italy
| | - Fofi Constantinidou
- Department of Psychology & Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Juan Fortea
- Sant Pau Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Hany I Hassanin
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
- Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Agustin Ibanez
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Universidad de San Andres & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | | | | | | | - Iracema Leroi
- Trinity College Dublin, Global Brain Health Institute, Dublin, Ireland
| | - Bjorn Lichtwarck
- The Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain Department of Clinical Research in Neurology of the University of Bari at "Pia Fondazione Card G. Panico" Hospital Tricase (Le), Bari, Italy
- Department of Basic Medicine Neuroscience and Sense Organs University Aldo Moro Bari, Bari, Italy
| | - Chris Lynch
- Alzheimer's Disease International, London, UK
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - John Papatriantafyllou
- Third Age Center IASIS, Athens-Glyfada, Athens, Greece
- 1st University Neurology Department, Eginitio Hospital, Athens, Greece
- Ana Aslan International Foundation
| | - Sokratis Papegeorgiou
- 1st University Neurology Department, Eginitio Hospital, Athens, Greece
- National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Politis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Rema Raman
- Alzheimer's Therapeutic Research Institute, University of Southern California, CA, USA
| | | | - Pascual Sanchez-Juan
- Institute for Research Marqués de Valdecilla (IDIVAL), CIBERNED, University of Cantabria and Department of Neurology, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Mary Sano
- The Mount Sinai Hospital, New York, NY, USA
| | - Nikolas Scarmeas
- National and Kapodistrian University of Athens, Athens, Greece
- Columbia University, New York, NY, USA
| | - Luiza Spiru
- Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
- Ana Aslan International Foundation
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Magda Tsolaki
- 1st Department of Neurology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Makedonia, Greece
| | - Görsev Yener
- Faculty of Medicine, Izmir University of Economics, Izmir, Turkey
| | - Ioannis Zaganas
- Neurogenetics Laboratory, Medical School, University of Crete
| | - Stelios Zygouris
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Maria Carrillo
- Alzheimer's Association, 225 N Michigan Avenue, 17th Fl, Chicago, Illinois, USA
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13
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Zygouris S, Segkouli S, Triantafylidis A, Giakoumis D, Tsolaki M, Votis K, Tzovaras D. Usability of the Virtual Supermarket Test for Older Adults with and without Cognitive Impairment. J Alzheimers Dis Rep 2022; 6:229-234. [PMID: 35719712 PMCID: PMC9198784 DOI: 10.3233/adr-210064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
This study conducted a preliminary usability assessment of the Virtual Supermarket Test (VST), a serious game-based self-administered cognitive screening test for mild cognitive impairment (MCI). Twenty-four healthy older adults with subjective cognitive decline and 33 patients with MCI self-administered the VST and then completed the System Usability Scale (SUS). The average SUS score was 83.11 (SD = 14.6). The SUS score was unaffected by age, education, touch device familiarity, and diagnosis of MCI. SUS score correlated with VST performance (r = –0.496, p = 0.000). Results of this study indicate good usability of the VST.
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Affiliation(s)
- Stelios Zygouris
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Sofia Segkouli
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Andreas Triantafylidis
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Giakoumis
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Magdalini Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
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14
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Park JH. Does the virtual shopping training improve executive function and instrumental activities of daily living of patients with mild cognitive impairment? Asian J Psychiatr 2022; 69:102977. [PMID: 34998232 DOI: 10.1016/j.ajp.2021.102977] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022]
Abstract
To date, ecological validity of virtual shopping training for patients with mild cognitive impairment (MCI) has not been confirmed yet. Main objective of this study was to investigate effects of virtual shopping training on executive function and instrumental activities of daily living (IADL) in patients with MCI. 32 patients with MCI were randomly assigned to the experimental group that received virtual shopping training or the waitlist control group for a total of 16 sessions. To examine effects of virtual shopping training on executive function and IADL, Korean version of the Executive Function Performance Test (EFPT-K) and Korean Instrumental Activities of Daily living (K-IADL) were conducted. After the 16 sessions, the experimental group showed greater improvement in the EFPT-K (p < 0.001) and the K-IADL (p < 0.001) compared to the control group. These results suggest that virtual shopping training might be clinically beneficial to enhance executive function and IADL in patients with MCI.
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Affiliation(s)
- Jin-Hyuck Park
- Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea.
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15
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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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16
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Abstract
Internet-connected devices, including personal computers, smartphones, smartwatches, and voice assistants, have evolved into powerful multisensor technologies that billions of people interact with daily to connect with friends and colleagues, access and share information, purchase goods, play games, and navigate their environment. Digital phenotyping taps into the data streams captured by these devices to characterize and understand health and disease. The purpose of this article is to summarize opportunities for digital phenotyping in neurology, review studies using everyday technologies to obtain motor and cognitive information, and provide a perspective on how neurologists can embrace and accelerate progress in this emerging field.
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Affiliation(s)
- Anoopum S. Gupta
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
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17
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Jang S, Choi SW, Son SJ, Oh J, Ha J, Kim WJ, Roh HW, Kim KY, Lee S, Jung E, Cha W, Chae H, Kang S, Kwon JH, Kim IY, Lee JY, Shin HK, Ryu JS, Ahn R, Hong CH, Seok JH. Virtual reality-based monitoring test for MCI: A multicenter feasibility study. Front Psychiatry 2022; 13:1057513. [PMID: 36741575 PMCID: PMC9891464 DOI: 10.3389/fpsyt.2022.1057513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/19/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES As the significance of the early diagnosis of mild cognitive impairment (MCI) has emerged, it is necessary to develop corresponding screening tools with high ecological validity and feasible biomarkers. Virtual reality (VR)-based cognitive assessment program, which is close to the daily life of the older adults, can be suitable screening tools for MCI with ecological validity and accessibility. Meanwhile, dehydroepiandrosterone (DHEA) has been observed at a low concentration in the older adults with dementia or cognitive decline, indicating its potential as a biomarker of MCI. This study aimed to determine the efficacy and usability of a VR cognitive assessment program and salivary DHEA for screening MCI. METHODS The VR cognitive assessment program and the traditional Montreal Cognitive Assessment (MOCA) test were performed on 12 patients with MCI and 108 healthy older adults. The VR program operates in a situation of caring for a grandchild, and evaluates the memory, attention, visuospatial, and executive functions. An analysis of covariance (ANCOVA), a partial correlation analysis, and receiving operating characteristic (ROC) curve analysis were conducted for statistical analysis. RESULTS According to the ANCOVA, no significant difference in MOCA scores was found between the normal and MCI groups (F = 2.36, p = 0.127). However, the VR total score of the MCI group was significantly lower than that of the normal group (F = 8.674, p = 0.004). There was a significant correlation between the MOCA and VR scores in the total and matched subdomain scores. The ROC curve analysis also showed a larger area under the curve (AUC) for the VR test (0.765) than for the MOCA test (0.598), and the sensitivity and specificity of the VR program were 0.833 and 0.722, respectively. Salivary DHEA was correlated with VR total (R 2 = 0.082, p = 0.01) and attention scores (R 2 = 0.086, p = 0.009). CONCLUSION The VR cognitive test was as effective as the traditional MOCA test in the MCI classification and safe enough for older adults to perform, indicating its potential as a diagnostic tool. It has also been shown that salivary DHEA can be used as a biomarker for MCI.
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Affiliation(s)
- Sooah Jang
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Sun-Woo Choi
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Jooyoung Oh
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junghee Ha
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Jung Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Keun You Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - San Lee
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea
| | - Eunjin Jung
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woojin Cha
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Heonjoo Chae
- FNIKorea Co., Ltd., Gwacheon, Gyeonggi-do, Republic of Korea
| | - Suzi Kang
- FNIKorea Co., Ltd., Gwacheon, Gyeonggi-do, Republic of Korea
| | - Ji Hye Kwon
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - In-Young Kim
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Ju-Yeal Lee
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Hyun Kyung Shin
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Sun Ryu
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ryunsup Ahn
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea
| | - Chang Hyung Hong
- Department of Psychiatry, Ajou University, Suwon, Gyeonggi-do, Republic of Korea
| | - Jeong-Ho Seok
- Research Institute of Minds.AI, Co., Ltd., Seoul, Republic of Korea.,Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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18
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Park Y, Go TH, Hong SH, Kim SH, Han JH, Kang Y, Kang DR. Digital Biomarkers in Living Labs for Vulnerable and Susceptible Individuals: An Integrative Literature Review. Yonsei Med J 2022; 63:S43-S55. [PMID: 35040605 PMCID: PMC8790590 DOI: 10.3349/ymj.2022.63.s43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The study aimed to identify which digital biomarkers are collected and which specific devices are used according to vulnerable and susceptible individual characteristics in a living-lab setting. MATERIALS AND METHODS A literature search, screening, and appraisal process was implemented using the Web of Science, Pubmed, and Embase databases. The search query included a combination of terms related to "digital biomarkers," "devices that collect digital biomarkers," and "vulnerable and susceptible groups." After the screening and appraisal process, a total of 37 relevant articles were obtained. RESULTS In elderly people, the main digital biomarkers measured were values related to physical activity. Most of the studies used sensors. The articles targeting children aimed to predict diseases, and most of them used devices that are simple and can induce some interest, such as wearable device-based smart toys. In those who were disabled, digital biomarkers that measured location-based movement for the purpose of diagnosing disabilities were widely used, and most were measured by easy-to-use devices that did not require detailed explanations. In the disadvantaged, digital biomarkers related to health promotion were measured, and various wearable devices, such as smart bands and headbands were used depending on the purpose and target. CONCLUSION As the digital biomarkers and devices that collect them vary depending on the characteristics of study subjects, researchers should pay attention not only to the purpose of the study but also the characteristics of study subjects when collecting and analyzing digital biomarkers from living labs.
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Affiliation(s)
- YouHyun Park
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Tae-Hwa Go
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Se Hwa Hong
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Hwa Kim
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Hun Han
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
| | | | - Dae Ryong Kang
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea
- Department of Precision Medicine and Biostatistics, Yonsei University Wonju College of Medicine, Wonju, Korea.
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19
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Brai E, Tonacci A, Brugada-Ramentol V, D'Andrea F, Alberi L. Intercepting Dementia: Awareness and Innovation as Key Tools. Front Aging Neurosci 2021; 13:730727. [PMID: 34720991 PMCID: PMC8548759 DOI: 10.3389/fnagi.2021.730727] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/20/2021] [Indexed: 12/02/2022] Open
Abstract
Dementia is a common feature of several age-related brain diseases, leading to a progressive cognitive decline. Due to a growing aging rate, dementia-related disorders currently affect around 50 million people worldwide and by 2050 this number is expected to reach 150 million. Additionally to patients, these neurodegenerative pathologies have a strong impact on family members, caretakers, and other health professionals, therefore representing a public health burden that in 2020 accounted for over 1 trillion USD and is projected to nearly double in the next decade. To overcome this devastating condition, many organizations and collaborative networks sustain that only a complete understanding of dementia in its different characteristics can drive the scientific community towards the development of effective therapeutic approaches aiming at preventing its onset and halting its progression.In this work, we discuss two topics that represent fundamental resources in fighting dementia: (i) the importance of raising awareness about this condition to avoid stigma and gauging investment; and (ii) the introduction of novel screening measures to prevent and potentially revert cognitive decline. Finally, we discern how knowledge-based advocacy will help the rollout of clinical trials and the development of novel and timely pharmacological interventions.
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Affiliation(s)
- Emanuele Brai
- Brain Fit4Life, Fribourg, Switzerland.,Laboratory of Neuroplasticity, Department of Pharmaceutical Sciences, University of Piemonte Orientale, Novara, Italy
| | - Alessandro Tonacci
- Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy
| | | | - Federica D'Andrea
- School of Biomedical Sciences, University of West London, London, United Kingdom
| | - Lavinia Alberi
- Swiss Integrative Centre for Human Health (SICHH), Fribourg, Switzerland.,Department of Oncology, Microbiology and Immunology, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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20
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Tsai CF, Chen CC, Wu EHK, Chung CR, Huang CY, Tsai PY, Yeh SC. A Machine-Learning-Based Assessment Method for Early-Stage Neurocognitive Impairment by an Immersive Virtual Supermarket. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2124-2132. [PMID: 34623270 DOI: 10.1109/tnsre.2021.3118918] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder. Though it is not yet curable or reversible, research has shown that clinical intervention or intensive cognitive training at an early stage may effectively delay the progress of the disease. As a result, screening populations with mild cognitive impairment (MCI) or early AD via efficient, effective and low-cost cognitive assessments is important. Currently, a cognitive assessment relies mostly on cognitive tests, such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), which must be performed by therapists. Also, cognitive functions can be divided into a variety of dimensions, such as memory, attention, executive function, visual spatial and so on. Executive functions (EF), also known as executive control or cognitive control, refer to a set of skills necessary to perform higher-order cognitive processes, including working memory, planning, attention, cognitive flexibility, and inhibitory control. Along with the fast progress of virtual reality (VR) and artificial intelligence (AI), this study proposes an intelligent assessment method aimed at assessing executive functions. Utilizing machine learning to develop an automatic evidence-based assessment model, behavioral information is acquired through performing executive-function tasks in a VR supermarket. Clinical trials were performed individuals with MCI or early AD and six healthy participants. Statistical analysis showed that 45 out of 46 indices derived from behavioral information were found to differ significantly between individuals with neurocognitive disorder and healthy participants. This analysis indicates these indices may be potential bio-markers. Further, machine-learning methods were applied to build classifiers that differentiate between individuals with MCI or early AD and healthy participants. The accuracy of the classifier is up to 100%, demonstrating the derived features from the VR system were highly related to diagnosis of individuals with MCI or early AD.
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21
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Zygouris S, Iliadou P, Lazarou E, Giakoumis D, Votis K, Alexiadis A, Triantafyllidis A, Segkouli S, Tzovaras D, Tsiatsos T, Papagianopoulos S, Tsolaki M. Detection of Mild Cognitive Impairment in an At-Risk Group of Older Adults: Can a Novel Self-Administered Serious Game-Based Screening Test Improve Diagnostic Accuracy? J Alzheimers Dis 2021; 78:405-412. [PMID: 32986676 PMCID: PMC7683046 DOI: 10.3233/jad-200880] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Literature supports the use of serious games and virtual environments to assess cognitive functions and detect cognitive decline. This promising assessment method, however, has not yet been translated into self-administered screening instruments for pre-clinical dementia. OBJECTIVE The aim of this study is to assess the performance of a novel self-administered serious game-based test, namely the Virtual Supermarket Test (VST), in detecting mild cognitive impairment (MCI) in a sample of older adults with subjective memory complaints (SMC), in comparison with two well-established screening instruments, the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE). METHODS Two groups, one of healthy older adults with SMC (N = 48) and one of MCI patients (N = 47) were recruited from day centers for cognitive disorders and administered the VST, the MoCA, the MMSE, and an extended pencil and paper neuropsychological test battery. RESULTS The VST displayed a correct classification rate (CCR) of 81.91% when differentiating between MCI patients and older adults with SMC, while the MoCA displayed of CCR of 72.04% and the MMSE displayed a CCR of 64.89%. CONCLUSION The three instruments assessed in this study displayed significantly different performances in differentiating between healthy older adults with SMC and MCI patients. The VST displayed a good CCR, while the MoCA displayed an average CCR and the MMSE displayed a poor CCR. The VST appears to be a robust tool for detecting MCI in a population of older adults with SMC.
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Affiliation(s)
- Stelios Zygouris
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Network Aging Research, Heidelberg University, Germany
| | - Paraskevi Iliadou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Eftychia Lazarou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Dimitrios Giakoumis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Anastasios Alexiadis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Andreas Triantafyllidis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Sofia Segkouli
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | | | | | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
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22
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Maeng S, Hong JP, Kim WH, Kim H, Cho SE, Kang JM, Na KS, Oh SH, Park JW, Bae JN, Cho SJ. Effects of Virtual Reality-Based Cognitive Training in the Elderly with and without Mild Cognitive Impairment. Psychiatry Investig 2021; 18:619-627. [PMID: 34265200 PMCID: PMC8328838 DOI: 10.30773/pi.2020.0446] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/11/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to introduce a 4-week long fully immersive virtual reality-based cognitive training (VRCT) program that could be applied for both a cognitively normal elderly population and patients with mild cognitive impairment (MCI). In addition, we attempted to investigate the neuropsychological effects of the VRCT program in each group. METHODS A total of 56 participants, 31 in the MCI group and 25 in the cognitively normal elderly group, underwent eight sessions of VRCT for 4 weeks. In order to evaluate the effects of the VRCT, the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet was administered before and after the program. The program' s safety was assessed using a simulator sickness questionnaire (SSQ), and availability was assessed using the presence questionnaire. RESULTS After the eighth session of the VRCT program, cognitive improvement was observed in the ability to learn new information, visuospatial constructional ability, and frontal lobe function in both groups. At the baseline evaluation, based on the SSQ, the MCI group complained of disorientation and nausea significantly more than the cognitively normal elderly group did. However, both groups showed a reduction in discomfort as the VRCT program progressed. CONCLUSION We conclude that our VRCT program helps improve cognition in both the MCI group and cognitively normal elderly group. Therefore, the VRCT is expected to help improve cognitive function in elderly populations with and without MCI.
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Affiliation(s)
- Seri Maeng
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Hyeyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Seo-Eun Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jae Myeong Kang
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kyoung-Sae Na
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Seok-Hee Oh
- Department of Computer Engineering, Gachon University, Seongnam, Republic of Korea
| | - Jung Woon Park
- Department of IT Convergence Engineering, Gachon University Graduate School, Seongnam, Republic of Korea
| | - Jae Nam Bae
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Seong-Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Republic of Korea
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23
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Kim JH, Park S, Lim H. Developing a virtual reality for people with dementia in nursing homes based on their psychological needs: a feasibility study. BMC Geriatr 2021; 21:167. [PMID: 33678160 PMCID: PMC7938563 DOI: 10.1186/s12877-021-02125-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 03/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background The purpose of this study was (1) to develop a virtual reality (VR) intervention program based on the psychological needs of patients residing in nursing facilities in South Korea to alleviate their behavioral and psychological symptoms and (2) to confirm the possibility of utilizing VR in patients with dementia. Methods In the first phase, patients with dementia residing in nursing homes and experiencing behavioral and psychological symptoms were recruited. Surveys and questionnaires were used to identify activities that alleviated the behavioral and psychological symptoms of dementia (BPSD) among the patients. These activities were classified into five types of psychological needs. In the second phase, a fully immersive, interactive, easy-to-use VR platform was developed that reflected these psychological needs. Patients with dementia experienced the VR content. The researchers assessed the level of the participants’ immersion, preference, and interaction with the VR using a 5-point Likert scale. Results In the feasibility test, 10 nursing home residents were recruited. The mean immersion score was 4.93 ± 0.16 points, the mean preference score was 4.35 ± 0.41 points, and the mean interaction score was 3.84 ± 0.43 points using a 5-point Likert scale. Higher mean scores indicated a more positive outcome. Six of the 10 participants required assistance while using the VR. The mean VR experience duration was 10.00 ± 3.46 min. Conclusions The VR-based intervention program that was developed to reduce BPSD was feasible for the participants and provided them with a high degree of satisfaction and immersion. Furthermore, this study also confirmed the convenience and safety of the program. These findings support the potential use of VR-based BPSD intervention programs to treat patients with dementia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02125-w.
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Affiliation(s)
- Jung-Hee Kim
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 06591, Korea.
| | - Seonmin Park
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 06591, Korea
| | - Hyeongji Lim
- College of Nursing, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 06591, Korea
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Hassanin HI, Tawfik HM, Zygouris S, Tsatali M, Sweed HS, Tsolaki M. Setting Up a Cognitive Training Service for Egyptian Older Adults. J Alzheimers Dis 2021; 79:1673-1682. [PMID: 33459648 DOI: 10.3233/jad-201278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND With greying of nations, dementia becomes a public health priority. The rising dementia prevalence escalates both health care expenses and burden, placing the entire healthcare system and caregivers under huge stress. Cognition-oriented interventions have been shown to enhance the overall cognitive performance among healthy and cognitively impaired older adults. OBJECTIVE This article is assumed to be a steppingstone for the introduction and establishment of cognition- oriented interventions in Egypt. In addition, it aims to offer provisional guidance for health care providers in Arab speaking countries in a stepwise approach in order to establish cognition-oriented intervention services and help them to evaluate and monitor their efficacy. METHODS Aconsortium of Egyptian and Greek specialists developed a protocol for the operations of the Ain Shams Cognitive Training Lab and the provision of cognition-oriented interventions. This protocol is based on a previous successful protocol that has been implemented in Greece for more than 10 years and is co-designed to fit the needs of older adults in Arabic speaking countries. RESULTS The types of services offered, their objectives, recruitment of participants, delivery of interventions, measurement of outcomes and privacy policy are all outlined in the policy. CONCLUSION Establishing the appropriate framework in which cognitive training strategies can be adapted and implemented in Arabic population, constitutes an inevitable achievement in healthy ageing and can be also assumed as a dementia prevention strategy. Moreover, setting up the first cognitive laboratory in Egypt older adults, can be a model of good practice across the Arabic countries.
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Affiliation(s)
- Hany I Hassanin
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Egypt.,Ain Shams Ageing Research Center, Ain Shams Cognitive Training Lab, Cairo, Egypt.,Global Brain Health Institute, Trinity College Dublin, Ireland & University of California San Francisco, San Francisco, CA, USA
| | - Heba M Tawfik
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Egypt.,Ain Shams Ageing Research Center, Ain Shams Cognitive Training Lab, Cairo, Egypt
| | - Stelios Zygouris
- Global Brain Health Institute, Trinity College Dublin, Ireland & University of California San Francisco, San Francisco, CA, USA.,School of Medicine, Aristotle University of Thessaloniki, Greece.,Network Aging Research, Heidelberg University, Germany
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece.,The University of Sheffield International Faculty, City College, Thessaloniki, Greece
| | - Hala S Sweed
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Egypt.,Ain Shams Ageing Research Center, Ain Shams Cognitive Training Lab, Cairo, Egypt
| | - Magda Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
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25
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Iliadou P, Paliokas I, Zygouris S, Lazarou E, Votis K, Tzovaras D, Tsolaki M. A Comparison of Traditional and Serious Game-Based Digital Markers of Cognition in Older Adults with Mild Cognitive Impairment and Healthy Controls. J Alzheimers Dis 2021; 79:1747-1759. [PMID: 33459650 PMCID: PMC7990420 DOI: 10.3233/jad-201300] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Electroencephalography (EEG) has been used to assess brain activity while users are playing an immersive serious game. Objective: To assess differences in brain activation as measured with a non-intrusive wearable EEG device, differences in game performance and correlations between EEG power, game performance and global cognition, between cognitively impaired and non-impaired older adults, during the administration of a novel self-administered serious game-based test, the Virtual Supermarket Test (VST). Methods: 43 older adults with subjective cognitive decline (SCD) and 33 older adults with mild cognitive impairment (MCI) were recruited from day centers for cognitive disorders. Global cognition was assessed with the Montreal Cognitive Assessment (MoCA). Brain activity was measured with a non-intrusive wearable EEG device in a resting state condition and while they were administered the VST. Results: During resting state condition, the MCI group showed increased alpha, beta, delta, and theta band power compared to the SCD group. During the administration of the VST, the MCI group showed increased beta and theta band power compared to the SCD group. Regarding game performance, alpha, beta, delta, and theta rhythms were positively correlated with average duration, while delta rhythm was positively correlated with mean errors. MoCA correlated with alpha, beta, delta, and theta rhythms and with average game duration and mean game errors indicating that elevated EEG rhythms in MCI may be associated with an overall cognitive decline. Conclusion: VST performance can be used as a digital biomarker. Cheap commercially available wearable EEG devices can be used for obtaining brain activity biomarkers.
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Affiliation(s)
| | - Ioannis Paliokas
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Stelios Zygouris
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Network Aging Research, Heidelberg University, Germany
| | - Eftychia Lazarou
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Magdalini Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
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Lim JE, Wong WT, Teh TA, Lim SH, Allen JC, Quah JHM, Malhotra R, Tan NC. A Fully-Immersive and Automated Virtual Reality System to Assess the Six Domains of Cognition: Protocol for a Feasibility Study. Front Aging Neurosci 2021; 12:604670. [PMID: 33488382 PMCID: PMC7817896 DOI: 10.3389/fnagi.2020.604670] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction: Dementia is increasing in prevalence in aging populations. Current questionnaire-based cognitive assessments may not comprehensively assess cognitive function and real-time task-performance. Virtual reality (VR) technology has been used in cognitive assessments but existing systems have limited scope in evaluating all cognitive domains. We have developed a novel, fully-immersive VR system (CAVIRE: Cognitive Assessment by VIrtual REality), which incorporates automated audio-visual instructions. An automated scoring matrix to assess the six cognitive domains—perceptual-motor function, executive function, complex attention, social cognition, learning and memory, and language—is embedded in the CAVIRE system. Aims: The primary aim is to evaluate the feasibility of using the CAVIRE system to assess cognitive function of participants across different age groups from 35 to 84 years old. The secondary aims are to determine the CAVIRE performance-indices (completion time and scores) of the participants and to assess their acceptability toward the use of CAVIRE as a modality for cognitive assessment. Methods: One hundred and seventy-five participants will be assessed by CAVIRE at a primary care clinic in Singapore. They will be first assessed using questionnaires: Montreal Cognitive Assessment (MoCA), Abbreviated Mental Test (AMT), Mini-Mental State Examination (MMSE), Basic Activities of Daily Living (BADLs), Instrumental Activities of Daily Living (IADLs). Those aged 65–84 years will be grouped into cognitively intact (n = 50, MoCA score ≥ 26) and cognitively impaired (n = 50, MoCA < 26). The CAVIRE performance-indices of cognitively healthy younger participants aged 35–64 years (n = 75) will serve as benchmark references. CAVIRE auto-computes the participant's performance-indices in 13 different segments. The tasks include domestic chores, memory, shopping, and social interactions. The proportion of participants who complete the entire VR assessment in each age group will be evaluated as feasibility indicators. The CAVIRE performance-indices will be compared across the different age groups. Feedback on the acceptability of the CAVIRE system will be collated and compared among the participants across the age groups. Significance: CAVIRE is designed to assess the six domains of cognitive function using VR. The results of this feasibility study will provide insights for the implementation of the CAVIRE system as an alternative modality of cognitive assessment in the community.
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Affiliation(s)
- Jie En Lim
- Duke-NUS Medical School, Singapore, Singapore
| | - Wei Teen Wong
- SingHealth Polyclinics-Outram, SingHealth Polyclinics, Singapore, Singapore
| | - Tuan Ann Teh
- Technology Development Centre, Institute of Technical Education College West, Singapore, Singapore
| | - Soon Huat Lim
- Technology Development Centre, Institute of Technical Education College West, Singapore, Singapore
| | - John Carson Allen
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Joanne Hui Min Quah
- Head Office, SingHealth Polyclinics, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Ngiap Chuan Tan
- Duke-NUS Medical School, Singapore, Singapore.,Head Office, SingHealth Polyclinics, Singapore, Singapore.,SingHealth Duke-NUS Family Medicine Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Giannopoulou P. Cognitive Tasks of an Information System for Memory Training and Cognitive Enhancement Using Mobile Devices. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1338:217-223. [DOI: 10.1007/978-3-030-78775-2_26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Jin R, Pilozzi A, Huang X. Current Cognition Tests, Potential Virtual Reality Applications, and Serious Games in Cognitive Assessment and Non-Pharmacological Therapy for Neurocognitive Disorders. J Clin Med 2020; 9:E3287. [PMID: 33066242 PMCID: PMC7602094 DOI: 10.3390/jcm9103287] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/09/2020] [Accepted: 10/10/2020] [Indexed: 12/13/2022] Open
Abstract
As the global population ages, the incidence of major neurocognitive disorders (major NCDs), such as the most common geriatric major NCD, Alzheimer's disease (AD), has grown. Thus, the need for more definitive cognitive assessment or even effective non-pharmacological intervention for age-related NCDs is becoming more and more pressing given that no definitive diagnostics or efficacious therapeutics are currently unavailable for them. We evaluate the current state of the art of cognitive assessment for major NCDs, and then briefly glance ahead at potential application of virtual reality (VR) technologies in major NCD assessment and in cognition training of visuospatial reasoning in a 3D environment, as well as in the alleviation of depression and other symptoms of cognitive disorders. We believe that VR-based technologies have tremendous potentials in cognitive assessment and non-pharmacological therapy for major NCDs.
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Affiliation(s)
| | | | - Xudong Huang
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA; (R.J.); (A.P.)
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29
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From repeating routes to planning novel routes: the impact of landmarks and ageing on route integration and cognitive mapping. PSYCHOLOGICAL RESEARCH 2020; 85:2164-2176. [PMID: 32929584 PMCID: PMC8357655 DOI: 10.1007/s00426-020-01401-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/04/2020] [Indexed: 12/02/2022]
Abstract
The integration of intersecting routes is an important process for the formation of cognitive maps and thus successful navigation. Here we present a novel task to study route integration and the effects that landmark information and cognitive ageing have on this process. We created two virtual environments, each comprising five places and one central intersection but with different landmark settings: in the Identical Landmark environment, the intersection contained visually monotonic features whereas the intersection contained visually distinctive features in the Different Landmarks environment. In both environments young and older participants were presented with two short routes that both traversed through the shared intersection. To test route integration, participants were asked to either repeat the learning routes, to navigate the routes from the destination to the starting place or to plan novel routes. As expected, results demonstrate better performance when repeating or retracing routes than when planning novel routes. Performance was better in younger than older participants and in the Different Landmark environment which does not require detailed knowledge of the spatial configuration of all places in the environment. A subgroup of the older participants who performed lower on a screening test for cognitive impairments could not successfully complete the experiment or did not reach the required performance criterion. These results demonstrate that strategically placed landmarks support the integration of route knowledge into spatial representations that allow for goal-dependent flexible navigation behaviour and that earliest signs of atypical cognitive ageing affect this process of route integration.
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30
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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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31
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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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32
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Using a Virtual Reality Serious Game to Assess the Performance of Older Adults with Frailty. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1196:127-139. [PMID: 32468314 DOI: 10.1007/978-3-030-32637-1_13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The comparison of cognitive performance of older adults with frailty and non-frail ones (according to Fried's criteria) was investigated. METHODS/DESIGN The differences in performance between people with frailty and individuals without frailty according to Fried were tested using a Virtual Reality (VR) application. The Fried criteria for frailty were used to categorize users into study groups, while standardized batteries were used for a Comprehensive Geriatric Assessment, including Activities of Daily Living (ADL), lifestyle, cognition, and depression screening. A group of 80 elders (78.08 years old in average) played the VR game entitled Virtual Supermarket (VSM). From those, 39 were healthy controls and 30 were categorized as pre-frail and 11 as frail. The VSM application presented users with a virtual shopping experience where users had to locate and purchase items displayed in a shopping list. This application was designed to test player's ability to reproduce a typical customer behavior in a simulated environment which requires spatial orientation, short-term memory, selective attention, and cognition speed. The performance, duration, and error rate were used as measurements. RESULTS The analysis showed that there was a statistically significant difference in game performance between the different user groups with X2 (2) = 9.929, p = 0.007. Moreover, the multinomial logistic regression model generated, which based on game performance metrics, was found to be statistically significant with X2 (4) = 15.662, p = 0.004. CONCLUSIONS Results shed more light toward the possible use of VR for distant self-administered evaluation of the frail status.
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Owens AP, Ballard C, Beigi M, Kalafatis C, Brooker H, Lavelle G, Brønnick KK, Sauer J, Boddington S, Velayudhan L, Aarsland D. Implementing Remote Memory Clinics to Enhance Clinical Care During and After COVID-19. Front Psychiatry 2020; 11:579934. [PMID: 33061927 PMCID: PMC7530252 DOI: 10.3389/fpsyt.2020.579934] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/31/2020] [Indexed: 12/15/2022] Open
Abstract
Social isolation is likely to be recommended for older adults due to COVID-19, with ongoing reduced clinical contact suggested for this population. This has increased the need for remote memory clinics, we therefore review the literature, current practices and guidelines on organizing such remote memory clinics, focusing on assessment of cognition, function and other relevant measurements, proposing a novel pathway based on three levels of complexity: simple telephone or video-based interviews and testing using available tests (Level 1), digitized and validated methods based on standard pen-and-paper tests and scales (Level 2), and finally fully digitized cognitive batteries and remote measurement technologies (RMTs, Level 3). Pros and cons of these strategies are discussed. Remotely collected data negates the need for frail patients or carers to commute to clinic and offers valuable insights into progression over time, as well as treatment responses to therapeutic interventions, providing a more realistic and contextualized environment for data-collection. Notwithstanding several challenges related to internet access, computer skills, limited evidence base and regulatory and data protection issues, digital biomarkers collected remotely have significant potential for diagnosis and symptom management in older adults and we propose a framework and pathway for how technologies can be implemented to support remote memory clinics. These platforms are also well-placed for administration of digital cognitive training and other interventions. The individual, societal and public/private costs of COVID-19 are high and will continue to rise for some time but the challenges the pandemic has placed on memory services also provides an opportunity to embrace novel approaches. Remote memory clinics' financial, logistical, clinical and practical benefits have been highlighted by COVID-19, supporting their use to not only be maintained when social distancing legislation is lifted but to be devoted extra resources and attention to fully potentiate this valuable arm of clinical assessment and care.
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Affiliation(s)
- Andrew P Owens
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Clive Ballard
- The University of Exeter Medical School, The University of Exeter, Exeter, United Kingdom
| | - Mazda Beigi
- Psychological Medicine and Older Adults, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Chris Kalafatis
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Psychological Medicine and Older Adults, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Helen Brooker
- The University of Exeter Medical School, The University of Exeter, Exeter, United Kingdom.,Ecog Pro Ltd, Bristol, United Kingdom
| | - Grace Lavelle
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Kolbjørn K Brønnick
- SESAM-Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Justin Sauer
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Psychological Medicine and Older Adults, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Steve Boddington
- Psychological Medicine and Older Adults, South London & Maudsley NHS Foundation Trust, London, United Kingdom
| | - Latha Velayudhan
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Psychological Medicine and Older Adults, South London & Maudsley NHS Foundation Trust, London, United Kingdom.,SESAM-Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
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Zając-Lamparska L, Wiłkość-Dębczyńska M, Wojciechowski A, Podhorecka M, Polak-Szabela A, Warchoł Ł, Kędziora-Kornatowska K, Araszkiewicz A, Izdebski P. Effects of virtual reality-based cognitive training in older adults living without and with mild dementia: a pretest-posttest design pilot study. BMC Res Notes 2019; 12:776. [PMID: 31775849 PMCID: PMC6882084 DOI: 10.1186/s13104-019-4810-2] [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: 08/28/2019] [Accepted: 11/14/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Modern technologies are increasingly used in the development of cognitive interventions for older adults. Research into possible applications of virtual reality in such interventions has begun only recently. The aim of present study was to evaluate the effects of 8 sessions of VR-based cognitive training using the GRADYS game in healthy older adults (n = 72; aged 60-88) and older adults living with mild dementia (n = 27; aged 60-89). RESULTS Older adults with mild dementia demonstrated worse baseline cognitive performance than participants without dementia. Both groups showed progress in training, which was greater in healthy older adults. There were also significant differences in cognitive functioning before and after the training. However, positive changes were revealed almost exclusively in the group of older adults without dementia. Based on the findings, we can recommend the GRADYS game for cognitive enhancement and as a possible counter-measure for cognitive decline experienced in normal cognitive ageing. Our results provide also support for the usefulness of VR technology in cognitive interventions in older adults. The use of the GRADYS game in persons living with dementia, however, would require several of the hardware and software modifications. Trial registration ISRCTN17613444, date of registration: 10.09.2019. Retrospectively registered.
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Affiliation(s)
| | | | - Adam Wojciechowski
- Institute of Information Technology, Lodz University of Technology, Lodz, Poland
| | - Marta Podhorecka
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Anna Polak-Szabela
- Department of Geriatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Łukasz Warchoł
- Faculty of Psychology, Kazimierz Wielki University, Staffa 1, 85-867, Bydgoszcz, Poland
| | | | - Aleksander Araszkiewicz
- Department of Psychiatrics, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Paweł Izdebski
- Faculty of Psychology, Kazimierz Wielki University, Staffa 1, 85-867, Bydgoszcz, Poland
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Eraslan Boz H, Limoncu H, Zygouris S, Tsolaki M, Giakoumis D, Votis K, Tzovaras D, Öztürk V, Yener GG. A new tool to assess amnestic mild cognitive impairment in Turkish older adults: virtual supermarket (VSM). AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:639-653. [PMID: 31482749 DOI: 10.1080/13825585.2019.1663146] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to investigate cognitive functioning by administering the Virtual Supermarket (VSM) test in patients with amnestic mild cognitive impairment (aMCI, N = 37) and age and education-matched healthy controls (HCs, N = 52). An extensive neuropsychological test battery and the VSM were administered to all participants. The aMCI group exhibited lower performance and required more time to complete the VSM compared to HCs. Also, aMCI-Multiple Domain (aMCI-MD) patients performed worse in the "Correct Types", "Correct Quantities", "Bought Unlisted", "Correct Money" variables compared to HCs. Moreover, aMCI-SD patients displayed lower performance in "Bought Unlisted" and "Correct Money" variables compared to HCs. The VSM variables correlated with established neuropsychological test scores. The VSM test was found to discriminate between aMCI and HCs with a correct classification rate (CCR) of 81%. This is a preliminary study showing that the VSM is a valid, brief and user-friendly test. .
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Affiliation(s)
- Hatice Eraslan Boz
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University , Izmir, Turkey
| | - Hatice Limoncu
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey
| | - Stelios Zygouris
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki , Greece, Greece.,Network Aging Research, Heidelberg University , Heidelberg, Germany
| | - Magda Tsolaki
- Department of Neurology, School of Medicine, Aristotle University of Thessaloniki , Greece, Greece.,Greek Association of Alzheimer's Disease and Related Disorders , Thessaloniki, Greece
| | - Dimitrios Giakoumis
- Centre for Research & Technology Hellas/Information Technologies Institute (CERTH/ITI) , Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research & Technology Hellas/Information Technologies Institute (CERTH/ITI) , Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research & Technology Hellas/Information Technologies Institute (CERTH/ITI) , Thessaloniki, Greece
| | - Vesile Öztürk
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University , Izmir, Turkey
| | - Görsev G Yener
- Department of Neurology, School of Medicine, Dokuz Eylul University , Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University , Izmir, Turkey
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Piau A, Wild K, Mattek N, Kaye J. Current State of Digital Biomarker Technologies for Real-Life, Home-Based Monitoring of Cognitive Function for Mild Cognitive Impairment to Mild Alzheimer Disease and Implications for Clinical Care: Systematic Review. J Med Internet Res 2019; 21:e12785. [PMID: 31471958 PMCID: PMC6743264 DOI: 10.2196/12785] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 05/22/2019] [Accepted: 06/29/2019] [Indexed: 12/16/2022] Open
Abstract
Background Among areas that have challenged the progress of dementia care has been the assessment of change in symptoms over time. Digital biomarkers are defined as objective, quantifiable, physiological, and behavioral data that are collected and measured by means of digital devices, such as embedded environmental sensors or wearables. Digital biomarkers provide an alternative assessment approach, as they allow objective, ecologically valid, and long-term follow-up with continuous assessment. Despite the promise of a multitude of sensors and devices that can be applied, there are no agreed-upon standards for digital biomarkers, nor are there comprehensive evidence-based results for which digital biomarkers may be demonstrated to be most effective. Objective In this review, we seek to answer the following questions: (1) What is the evidence for real-life, home-based use of technologies for early detection and follow-up of mild cognitive impairment (MCI) or dementia? And (2) What transformation might clinicians expect in their everyday practices? Methods A systematic search was conducted in PubMed, Cochrane, and Scopus databases for papers published from inception to July 2018. We searched for studies examining the implementation of digital biomarker technologies for mild cognitive impairment or mild Alzheimer disease follow-up and detection in nonclinic, home-based settings. All studies that included the following were examined: community-dwelling older adults (aged 65 years or older); cognitively healthy participants or those presenting with cognitive decline, from subjective cognitive complaints to early Alzheimer disease; a focus on home-based evaluation for noninterventional follow-up; and remote diagnosis of cognitive deterioration. Results An initial sample of 4811 English-language papers were retrieved. After screening and review, 26 studies were eligible for inclusion in the review. These studies ranged from 12 to 279 participants and lasted between 3 days to 3.6 years. Most common reasons for exclusion were as follows: inappropriate setting (eg, hospital setting), intervention (eg, drugs and rehabilitation), or population (eg, psychiatry and Parkinson disease). We summarized these studies into four groups, accounting for overlap and based on the proposed technological solutions, to extract relevant data: (1) data from dedicated embedded or passive sensors, (2) data from dedicated wearable sensors, (3) data from dedicated or purposive technological solutions (eg, games or surveys), and (4) data derived from use of nondedicated technological solutions (eg, computer mouse movements). Conclusions Few publications dealt with home-based, real-life evaluations. Most technologies were far removed from everyday life experiences and were not mature enough for use under nonoptimal or uncontrolled conditions. Evidence available from embedded passive sensors represents the most relatively mature research area, suggesting that some of these solutions could be proposed to larger populations in the coming decade. The clinical and research communities would benefit from increasing attention to these technologies going forward.
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Affiliation(s)
- Antoine Piau
- Gerontopole, University Hospital of Toulouse, Université Paul Sabatier, Toulouse, France.,Oregon Center for Aging and Technology, Oregon Health and Science University, Portland, OR, United States
| | - Katherine Wild
- Oregon Center for Aging and Technology, Oregon Health and Science University, Portland, OR, United States
| | - Nora Mattek
- Oregon Center for Aging and Technology, Oregon Health and Science University, Portland, OR, United States
| | - Jeffrey Kaye
- Oregon Center for Aging and Technology, Oregon Health and Science University, Portland, OR, United States
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La Corte V, Sperduti M, Abichou K, Piolino P. Episodic Memory Assessment and Remediation in Normal and Pathological Aging Using Virtual Reality: A Mini Review. Front Psychol 2019; 10:173. [PMID: 30787898 PMCID: PMC6372520 DOI: 10.3389/fpsyg.2019.00173] [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: 09/08/2018] [Accepted: 01/18/2019] [Indexed: 11/18/2022] Open
Abstract
Life expectancy is constantly increasing in developed countries. Unfortunately, a longer life does not always correspond to a healthier life, as even normal aging is associated with cognitive decline and increased risk factors for neurodegenerative diseases. Episodic memory (EM) is one of the most vulnerable cognitive functions in aging, and its decline is the hallmark of typical Alzheimer's disease. This memory system is defined as the ability to acquire and recollect personally experienced episodes associated with a specific affective, spatial, and temporal context. However, most of the neuropsychological and experimental tasks currently employed to assess EM consist in learning simple material (e.g., list of words) in highly stereotyped contexts. In the same vein, classical paper-and-pencil or numeric remediation tools have shown their limitations in the transfer of acquired skills to daily life. Virtual reality (VR), thanks to its immersive properties, and the possibility of delivering realistic and complex scenarios, seems a promising tool to address the limitations of the assessment and remediation of EM. Here, we review existing studies employing VR in normal and pathological aging to assess and reeducate EM. Overall, we show that VR has been mainly used via non-immersive systems. Further studies should, therefore, test the impact of different degrees of immersion. Moreover, there is a lack of VR remediation tools specifically targeting EM. We propose that future studies should fill this gap, addressing in particular the adaptivity of VR remediation protocols.
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Affiliation(s)
- Valentina La Corte
- Memory and Cognition Laboratory, Institute of Psychology, Paris Descartes University, Paris, France
- Center for Psychiatry and Neuroscience, INSERM U894, Paris, France
- Institute of Memory and Alzheimer’s Disease, Department of Neurology, Pitié-Salpêtrière Hospital, Paris, France
| | - Marco Sperduti
- Memory and Cognition Laboratory, Institute of Psychology, Paris Descartes University, Paris, France
- Center for Psychiatry and Neuroscience, INSERM U894, Paris, France
| | - Kouloud Abichou
- Memory and Cognition Laboratory, Institute of Psychology, Paris Descartes University, Paris, France
- Center for Psychiatry and Neuroscience, INSERM U894, Paris, France
| | - Pascale Piolino
- Memory and Cognition Laboratory, Institute of Psychology, Paris Descartes University, Paris, France
- Center for Psychiatry and Neuroscience, INSERM U894, Paris, France
- University Institute of France, Paris, France
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38
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Li BY, He NY, Qiao Y, Xu HM, Lu YZ, Cui PJ, Ling HW, Yan FH, Tang HD, Chen SD. Computerized cognitive training for Chinese mild cognitive impairment patients: A neuropsychological and fMRI study. Neuroimage Clin 2019; 22:101691. [PMID: 30708349 PMCID: PMC6354286 DOI: 10.1016/j.nicl.2019.101691] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/19/2019] [Accepted: 01/25/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND Computerized multi-model training has been widely studied for its effect on delaying cognitive decline. In this study, we designed the first Chinese-version computer-based multi-model cognitive training for mild cognitive impairment (MCI) patients. Neuropsychological effects and neural activity changes assessed by functional MRI were both evaluated. METHOD MCI patients in the training group were asked to take training 3-4 times per week for 6 months. Neuropsychological and resting-state fMRI assessment were performed at baseline and at 6 months. Patients in both groups were continuously followed up for another 12 months and assessed by neuropsychological tests again. RESULTS 78 patients in the training group and 63 patients in the control group accomplished 6-month follow-up. Training group improved 0.23 standard deviation (SD) of mini-mental state examination, while control group had 0.5 SD decline. Addenbrooke's cognitive examination-revised scores in attention (p = 0.002) and memory (p = 0.006), as well as stroop color-word test interference index (p = 0.038) and complex figure test-copy score (p = 0.035) were also in favor of the training effect. Difference between the changes of two groups after training was not statistically significant. The fMRI showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus. However, difference between the changes of two groups after another 12 months was not statistically significant. CONCLUSIONS Multi-model cognitive training help MCI patients to gained cognition benefit, especially in memory, attention and executive function. Functional neuroimaging provided consistent neural activation evidence. Nevertheless, after one-year follow up after last training, training effects were not significant. The study provided new evidence of beneficial effect of multi-model cognitive training.
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Affiliation(s)
- Bin-Yin Li
- Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Na-Ying He
- Department of Radiology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yuan Qiao
- Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hong-Min Xu
- Department of Radiology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Yi-Zhou Lu
- Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Pei-Jing Cui
- Department of Geriatrics, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Hua-Wei Ling
- Department of Radiology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| | - Fu-Hua Yan
- Department of Radiology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Hui-Dong Tang
- Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
| | - Sheng-Di Chen
- Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
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Park MJ, Kim DJ, Lee U, Na EJ, Jeon HJ. A Literature Overview of Virtual Reality (VR) in Treatment of Psychiatric Disorders: Recent Advances and Limitations. Front Psychiatry 2019; 10:505. [PMID: 31379623 PMCID: PMC6659125 DOI: 10.3389/fpsyt.2019.00505] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/27/2019] [Indexed: 11/13/2022] Open
Abstract
In this paper, we conduct a literature survey on various virtual reality (VR) treatments in psychiatry. We collected 36 studies that used VR to provide clinical trials or therapies for patients with psychiatric disorders. In order to gain a better understanding of the management of pain and stress, we first investigate VR applications for patients to alleviate pain and stress during immersive activities in a virtual environment. VR exposure therapies are particularly effective for anxiety, provoking realistic reactions to feared stimuli. On top of that, exposure therapies with simulated images are beneficial for patients with psychiatric disorders such as phobia and posttraumatic stress disorder (PTSD). Moreover, VR environments have shown the possibility of changing depression, cognition, even social functions. We review empirical evidence from VR-based treatments on psychiatric illnesses such as dementia, mild cognitive impairment (MCI), schizophrenia and autism. Through cognitive training and social skill training, rehabilitation through VR therapies helps patients to improve their quality of life. Recent advances in VR technology also demonstrate potential abilities to address cognitive and functional impairments in dementia. In terms of the different types of VR systems, we discuss the feasibility of the technology within different stages of dementia as well as the methodological limitations. Although there is room for improvement, its widespread adoption in psychiatry is yet to occur due to technical drawbacks such as motion sickness and dry eyes, as well as user issues such as preoccupation and addiction. However, it is worth mentioning that VR systems relatively easily deliver virtual environments with well-controlled sensory stimuli. In the future, VR systems may become an innovative clinical tool for patients with specific psychiatric symptoms.
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Affiliation(s)
- Mi Jin Park
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong Jun Kim
- Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Unjoo Lee
- Department of Electronic Engineering, Hallym University, Kangwon, South Korea
| | - Eun Jin Na
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
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40
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Koo BM, Vizer LM. Mobile Technology for Cognitive Assessment of Older Adults: A Scoping Review. Innov Aging 2019; 3:igy038. [PMID: 30619948 PMCID: PMC6312550 DOI: 10.1093/geroni/igy038] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The number of people diagnosed with dementia is rising appreciably as the population ages. In an effort to improve outcomes, many have called for facilitating early detection of cognitive decline. Increased use of mobile technology by older adults provides the opportunity to deliver convenient, cost-effective assessments for earlier detection of cognitive impairment. This article presents a review of the literature on how mobile platforms-smartphones and tablets-are being used for cognitive assessment of older adults along with benefits and opportunities associated with using mobile platforms for cognitive assessment. RESEARCH DESIGN AND METHODS We searched MEDLINE, Web of Science, PsycInfo, CINAHL, EMBASE, and Cochrane Central Register of Controlled Trials in October 2018. This search returned 7,024 articles. After removing 1,464 duplicates, we screened titles and abstracts then screened full-text for those articles meeting inclusion and exclusion criteria. RESULTS Twenty-nine articles met our inclusion criteria and were categorized into 3 groups as follows: (a) mobile versions of existing article or computerized neuropsychological tests; (b) new cognitive tests developed specifically for mobile platforms; and (c) the use of new types of data for cognitive assessment. This scoping review confirms the considerable potential of mobile assessment. DISCUSSION AND IMPLICATIONS Mobile technologies facilitate repeated and continuous assessment and support unobtrusive collection of auxiliary behavioral markers of cognitive impairment, thus allowing users to view trends and detect acute changes that have traditionally been difficult to identify. Opportunities include using new mobile sensors and wearable devices, improving reliability and validity of mobile assessments, determining appropriate clinical use of mobile assessment information, and incorporating person-centered assessment principles and digital phenotyping.
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Affiliation(s)
- Bon Mi Koo
- School of Medicine, University of North Carolina at Chapel Hill
| | - Lisa M Vizer
- School of Medicine, University of North Carolina at Chapel Hill
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41
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Oagaz H, Schoun B, Pooji M, Choi MH. Neurocognitive Assessment in Virtual Reality Through Behavioral Response Analysis. IEEE J Biomed Health Inform 2018; 23:1899-1910. [PMID: 30442624 DOI: 10.1109/jbhi.2018.2881455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ability to detect and diagnose neurocognitive disorders at the earliest possible moment is key to a better prognosis for the patient. Two of the earliest indicators of potential neurocognitive problems are motor and visual dysfunction. Motor disorders and problems in visual cognition can be seen in many neurocognitive disorders, resulting in abnormal physical reactions to visual stimuli. Analyzing physical behaviors when presented with such stimuli can provide insights into the visual perception and motor abilities of an individual, yet there is currently no unbiased, objective, general-purpose tool that analyzes attention and motor behavior to assess neurocognitive function. We propose a novel method of neurocognitive function assessment that tests the patient's cognition using virtual reality with eye tracking and motion analysis. By placing the patient in a controlled virtual environment and analyzing their movements, we can evoke certain physical responses from subjects for neurocognitive assessment. We have developed a prototype system that places the subject in a virtual baseball field and captures their full body motion as they try to catch baseballs. This scenario tests the subject's ability to determine the landing time and position of the ball, as well as the test subject's balance, motor skills, attention, and memory. Preliminary tests with 20 healthy normal individuals demonstrate the ability of this tool to assess the test subject's balance, memory, attention, and reaction to visual stimuli. This platform has a twofold contribution: it is used to assess several neurocognitive constructs that affect visual and motor capability neutrally and objectively based on controlled stimuli, and it enables objective comparison between different neurocognitive disorders research in this field.
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42
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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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43
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Balsam P, Borodzicz S, Malesa K, Puchta D, Tymińska A, Ozierański K, Kołtowski Ł, Peller M, Grabowski M, Filipiak KJ, Opolski G. OCULUS study: Virtual reality-based education in daily clinical practice. Cardiol J 2018; 26:260-264. [PMID: 29297178 PMCID: PMC8086674 DOI: 10.5603/cj.a2017.0154] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 12/14/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Atrial fibrillation (AF) is associated with high risk of stroke and other thromboembolic complications. The OCULUS study aimed to evaluate the effectiveness of the three-dimensional (3D) movie in teaching patients about the consequences of AF and pharmacological stroke prevention. METHODS The study was based on a questionnaire and included 100 consecutive patients (38% women, 62% with AF history). Using the oculus glasses and a smartphone, a 3D movie describing the risk of stroke in AF was shown. Similar questions were asked immediately after, 1 week and 1 year after the projection. RESULTS Before the projection 22/100 (22.0%) declared stroke a consequence of AF, while immediately after 83/100 (83.0%) (p < 0.0001) patients declared this consequence. Seven days after, stroke as AF consequence was chosen by 74/94 (78.7%) vs. 22/94 (23.4%) when compared to the baseline knowledge; p < 0.0001, a similar trend was also observed in 1-year follow-up (64/90 [71.1%] vs. 21/90 [23.3%]; p < 0.0001). Before the projection 88.3% (83/94) patients responded, that drugs may reduce the risk of stroke, and after 1 week the number of patients increased to (94/94 [100%]; p = 0.001). After 1 year 87/90 (96.7%) answered that drugs may diminish the risk of stroke (p = 0.02 in comparison to the baseline survey 78/90 [86.7%]). Use of oral anticoagulation to reduce the risk of stroke was initially chosen by 66/94 (70.2%), by 90/94 (95.7%; p < 0.0001) 7 days after and by 83/90 (92.2%; p < 0.0001) 1 year after. CONCLUSIONS 3D movie is an effective tool in transferring knowledge about the consequences of AF and the pivotal role of oral anticoagulation in stroke prevention. TRIAL REGISTRATION ClinicalTrials.gov, NCT03104231. Registered on 28 March 2017.
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Affiliation(s)
- Paweł Balsam
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Sonia Borodzicz
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland.
| | - Karolina Malesa
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Dominika Puchta
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Agata Tymińska
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | | | - Łukasz Kołtowski
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Michał Peller
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Marcin Grabowski
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | | | - Grzegorz Opolski
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
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Pourmand A, Davis S, Lee D, Barber S, Sikka N. Emerging Utility of Virtual Reality as a Multidisciplinary Tool in Clinical Medicine. Games Health J 2017; 6:263-270. [PMID: 28759254 DOI: 10.1089/g4h.2017.0046] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Among the more recent products borne of the evolution of digital technology, virtual reality (VR) is gaining a foothold in clinical medicine as an adjunct to traditional therapies. Early studies suggest a growing role for VR applications in pain management, clinical skills training, cognitive assessment and cognitive therapy, and physical rehabilitation. MATERIALS AND METHODS To complete a review of the literature, we searched PubMed and MEDLINE databases with the following search terms: "virtual reality," "procedural medicine," "oncology," "physical therapy," and "burn." We further limited our search to publications in the English language. Boolean operators were used to combine search terms. RESULTS The included search terms yielded 97 potential articles, of which 45 were identified as meeting study criteria, and are included in this review. These articles provide data, which strongly support the hypothesis that VR simulations can enhance pain management (by reducing patient perception of pain and anxiety), can augment clinical training curricula and physical rehabilitation protocols (through immersive audiovisual environments), and can improve clinical assessment of cognitive function (through improved ecological validity). CONCLUSION Through computer-generated, life-like digital landscapes, VR stands to change the current approach to pain management, medical training, neurocognitive diagnosis, and physical rehabilitation. Additional studies are needed to help define best practices in VR utilization, and to explore new therapeutic uses for VR in clinical practice.
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Affiliation(s)
- Ali Pourmand
- Department of Emergency Medicine, George Washington University , Washington, District of Columbia
| | - Steven Davis
- Department of Emergency Medicine, George Washington University , Washington, District of Columbia
| | - Danny Lee
- Department of Emergency Medicine, George Washington University , Washington, District of Columbia
| | - Scott Barber
- Department of Emergency Medicine, George Washington University , Washington, District of Columbia
| | - Neal Sikka
- Department of Emergency Medicine, George Washington University , Washington, District of Columbia
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Manera V, Ben-Sadoun G, Aalbers T, Agopyan H, Askenazy F, Benoit M, Bensamoun D, Bourgeois J, Bredin J, Bremond F, Crispim-Junior C, David R, De Schutter B, Ettore E, Fairchild J, Foulon P, Gazzaley A, Gros A, Hun S, Knoefel F, Olde Rikkert M, Phan Tran MK, Politis A, Rigaud AS, Sacco G, Serret S, Thümmler S, Welter ML, Robert P. Recommendations for the Use of Serious Games in Neurodegenerative Disorders: 2016 Delphi Panel. Front Psychol 2017; 8:1243. [PMID: 28790945 PMCID: PMC5524915 DOI: 10.3389/fpsyg.2017.01243] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 07/07/2017] [Indexed: 11/21/2022] Open
Abstract
The use of Serious Games (SG) in the health domain is expanding. In the field of neurodegenerative disorders (ND) such as Alzheimer’s disease, SG are currently employed both to support and improve the assessment of different functional and cognitive abilities, and to provide alternative solutions for patients’ treatment, stimulation, and rehabilitation. As the field is quite young, recommendations on the use of SG in people with ND are still rare. In 2014 we proposed some initial recommendations (Robert et al., 2014). The aim of the present work was to update them, thanks to opinions gathered by experts in the field during an expert Delphi panel. Results confirmed that SG are adapted to elderly people with mild cognitive impairment (MCI) and dementia, and can be employed for several purposes, including assessment, stimulation, and improving wellbeing, with some differences depending on the population (e.g., physical stimulation may be better suited for people with MCI). SG are more adapted for use with trained caregivers (both at home and in clinical settings), with a frequency ranging from 2 to 4 times a week. Importantly, the target of SG, their frequency of use and the context in which they are played depend on the SG typology (e.g., Exergame, cognitive game), and should be personalized with the help of a clinician.
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Affiliation(s)
- Valeria Manera
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Université Côte d'Azur, INRIA, STARSSophia Antipolis, France
| | - Grégory Ben-Sadoun
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France
| | - Teun Aalbers
- Radboudumc Alzheimer Center, Donders Institute for Medical NeuroSciences, RadboudumcNijmegen, Netherlands
| | | | - Florence Askenazy
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Centre Ressources Autisme, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Children's Hospitals of Nice CHU-LenvalNice, France.,IA AssociationNice, France
| | - Michel Benoit
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,IA AssociationNice, France.,Université Côte d'Azur, Centre Hospitalier Universitaire, Hôpital PasteurNice, France
| | - David Bensamoun
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Université Côte d'Azur, Centre Hospitalier Universitaire, Hôpital PasteurNice, France
| | - Jérémy Bourgeois
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Centre Ressources Autisme, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Children's Hospitals of Nice CHU-LenvalNice, France
| | | | | | | | - Renaud David
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,IA AssociationNice, France.,Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressource et de RechercheNice, France
| | - Bob De Schutter
- College for Education, Health and Society, Miami University, OxfordOH, United States
| | - Eric Ettore
- Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressource et de RechercheNice, France
| | - Jennifer Fairchild
- Department of Veterans Affairs, VA Palo Alto Health Care System, LivermoreCA, United States.,Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, StanfordCA, United States
| | | | - Adam Gazzaley
- Departments of Neurology and Psychiatry and Department of Physiology, University of California, San Francisco, San FranciscoCA, United States
| | - Auriane Gros
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressource et de RechercheNice, France
| | - Stéphanie Hun
- Centre Ressources Autisme, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Children's Hospitals of Nice CHU-LenvalNice, France
| | - Frank Knoefel
- Bruyère Memory Program, Bruyère Research InstituteOttawa, ON, Canada.,Department of Family Medicine, University of OttawaOttawa, ON, Canada.,Department of Systems and Computer Engineering, Carleton UniversityOttawa, ON, Canada
| | - Marcel Olde Rikkert
- Department of Geriatrics and Radboudumc Alzheimer Center, Radboud University Medical CenterNijmegen, Netherlands
| | | | - Antonios Politis
- 1st Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of AthensAthens, Greece
| | - Anne S Rigaud
- Hopital Broca, Assistance Publique-Hôpitaux de ParisParis, France.,Faculty of Medicine, Université Paris DescartesParis, France
| | - Guillaume Sacco
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressource et de RechercheNice, France
| | - Sylvie Serret
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,Centre Ressources Autisme, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Children's Hospitals of Nice CHU-LenvalNice, France
| | - Susanne Thümmler
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,IEM Rossetti des PEP 06Nice, France.,Centre Ressources Autisme, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Children's Hospitals of Nice CHU-LenvalNice, France
| | - Marie L Welter
- UMR-S975, Institut du Cerveau et de la Moelle épiniere, Université Pierre et Marie CurieParis, France.,U975, INSERMParis, France.,UMR 7225, CNRSParis, France.,Département de Neurologie, Hôpitaux Universitaires Pitié-Salpêtrière, Assistance Publique-Hôpitaux de ParisParis, France
| | - Philippe Robert
- Université Côte d'Azur, Cognition, Behaviour, Technology - CoBTeKNice, France.,IA AssociationNice, France.,Université Côte d'Azur, Centre Hospitalier Universitaire de Nice, Centre Mémoire de Ressource et de RechercheNice, France
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