1
|
Sánchez-Escudero JP, Galvis-Herrera AM, Sánchez-Trujillo D, Torres-López LC, Kennedy CJ, Aguirre-Acevedo DC, Garcia-Barrera MA, Trujillo N. Virtual Reality and Serious Videogame-Based Instruments for Assessing Spatial Navigation in Alzheimer's Disease: A Systematic Review of Psychometric Properties. Neuropsychol Rev 2024:10.1007/s11065-024-09633-7. [PMID: 38403731 DOI: 10.1007/s11065-024-09633-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
Over the past decade, research using virtual reality and serious game-based instruments for assessing spatial navigation and spatial memory in at-risk and AD populations has risen. We systematically reviewed the literature since 2012 to identify and evaluate the methodological quality and risk of bias in the analyses of the psychometric properties of VRSG-based instruments. The search was conducted primarily in July-December 2022 and updated in November 2023 in eight major databases. The quality of instrument development and study design were analyzed in all studies. Measurement properties were defined and analyzed according to COSMIN guidelines. A total of 1078 unique records were screened, and following selection criteria, thirty-seven studies were analyzed. From these studies, 30 instruments were identified. Construct and criterion validity were the most reported measurement properties, while structural validity and internal consistency evidence were the least reported. Nineteen studies were deemed very good in construct validity, whereas 11 studies reporting diagnostic accuracy were deemed very good in quality. Limitations regarding theoretical framework and research design requirements were found in most of the studies. VRSG-based instruments are valuable additions to the current diagnostic toolkit for AD. Further research is required to establish the psychometric performance and clinical utility of VRSG-based instruments, particularly the instrument development, content validity, and diagnostic accuracy for preclinical AD screening scenarios. This review provides a straightforward synthesis of the state of the art of VRSG-based instruments and suggests future directions for research.
Collapse
Affiliation(s)
| | | | | | | | - Cole J Kennedy
- Department of Psychology & Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | | | - Mauricio A Garcia-Barrera
- Department of Psychology & Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Natalia Trujillo
- National College of Public Health, University of Antioquia, Antioquia, Colombia
- Atlantic Fellowship in Equity in Brain Health, Global Brain Health Institute, University of California, San Francisco, CA, USA
- Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| |
Collapse
|
2
|
Hamza EA, Moustafa AA, Tindle R, Karki R, Nalla S, Hamid MS, El Haj M. Effect of APOE4 Allele and Gender on the Rate of Atrophy in the Hippocampus, Entorhinal Cortex, and Fusiform Gyrus in Alzheimer's Disease. Curr Alzheimer Res 2023; 19:CAR-EPUB-130079. [PMID: 36892120 DOI: 10.2174/1567205020666230309113749] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/21/2023] [Accepted: 02/25/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND The hippocampus, entorhinal cortex, and fusiform gyrus are brain areas that deteriorate during early-stage Alzheimer's disease (AD). The ApoE4 allele has been identified as a risk factor for AD development, is linked to an increase in the aggregation of amyloid ß (Aß) plaques in the brain, and is responsible for atrophy of the hippocampal area. However, to our knowledge, the rate of deterioration over time in individuals with AD, with or without the ApoE4 allele, has not been investigated. METHOD In this study, we, for the first time, analyze atrophy in these brain structures in AD patients with and without the ApoE4 using the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. RESULTS It was found that the rate of decrease in the volume of these brain areas over 12 months was related to the presence of ApoE4. Further, we found that neural atrophy was not different for female and male patients, unlike prior studies, suggesting that the presence of ApoE4 is not linked to the gender difference in AD. CONCLUSION Our results confirm and extend previous findings, showing that the ApoE4 allele gradually impacts brain regions impacted by AD.
Collapse
Affiliation(s)
- Eid Abo Hamza
- Faculty of Education, Department of Mental Health, Tanta University, Egypt
- College of Education, Humanities & Social Sciences, Al Ain University, UAE
| | - Ahmed A Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, South Africa
| | - Richard Tindle
- Department of Psychology, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Rasu Karki
- Department of Psychology, Western Sydney University, Penrith, NSW, 2214, Australia
| | - Shahed Nalla
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, South Africa
| | | | - Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ. Angers., Nantes, F-44000, France
- Clinical Gerontology Department, CHU Nantes, Bd Jacques Monod,Nantes, F44093, France
- Institut Universitaire de France, Paris, France
| |
Collapse
|
3
|
Resting state effective connectivity abnormalities of the Papez circuit and cognitive performance in multiple sclerosis. Mol Psychiatry 2022; 27:3913-3919. [PMID: 35624146 DOI: 10.1038/s41380-022-01625-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/05/2022] [Accepted: 05/11/2022] [Indexed: 02/08/2023]
Abstract
The Papez circuit is central to memory and emotional processes. However, little is known about its involvement in multiple sclerosis (MS). We aimed to investigate abnormalities of resting state (RS) effective connectivity (EC) between regions of the Papez circuit in MS and their relationship with cognitive performances. Sixty-two MS patients and 64 healthy controls (HC) underwent neuropsychological assessment, 3D T1-weighted, and RS functional MRI. RS EC analysis was performed using SPM12 and dynamic causal modeling. RS EC abnormalities were investigated using parametric empirical Bayes models and were correlated with cognitive scores. Compared to HC, MS patients showed (posterior probability > 0.95) higher EC between the right entorhinal cortex and right subiculum, and lower EC from the anterior cingulate cortex (ACC) to the posterior cingulate cortex (PCC), from left to right subiculum, from left anterior thalamus to ACC, and within ACC and PCC. Lower RS EC from the ACC to the PCC correlated with worse global cognitive scores (rho = 0.19; p = 0.03), worse visuospatial memory (rho = 0.19; p = 0.03) and worse semantic fluency (rho = 0.21; p = 0.02). Lower RS EC from the left to the right subiculum correlated with worse verbal memory (rho = 0.20; p = 0.02), lower RS EC within the ACC correlated with worse attention (rho = -0.19; p = 0.04) and more severe brain atrophy (rho = -0.26; p = 0.003). Higher EC from the right entorhinal cortex to right subiculum correlated with worse semantic fluency (rho = 0.21; p = 0.02). In conclusion, MS patients showed altered RS EC within the Papez circuit. Abnormal RS EC involving cingulate cortices and hippocampal formation contributed to explain cognitive deficits.
Collapse
|
4
|
Two Immersive Virtual Reality Tasks for the Assessment of Spatial Orientation in Older Adults with and Without Cognitive Impairment: Concurrent Validity, Group Comparison, and Accuracy Results. J Int Neuropsychol Soc 2022; 28:460-472. [PMID: 34080532 DOI: 10.1017/s1355617721000655] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Spatial disorientation is common in Alzheimer's disease (AD), Mild Cognitive Impairment (MCI), and preclinical individuals with AD biomarkers. However, traditional neuropsychological tests lack ecological validity for the assessment of spatial orientation and to date, there is still no gold standard. The current study aimed to determine the validity and accuracy of two virtual reality tasks for the assessment of spatial orientation. METHODS We adapted two spatial orientation tasks to immersive virtual environments: a "survey to route" task in which participants had to transfer information from a map to their body position within a maze [Spatial Orientation in Immersive Virtual Environment Test (SOIVET) Maze], and an allocentric-type, route learning task, with well-established topographic landmarks (SOIVET Route). A total of 19 MCI patients and 29 cognitively healthy older adults aged 61-92 participated in this study. Regular neuropsychological assessments were used for correlation analysis and participant performances were compared between groups. Receiver Operating Characteristic (ROC) curve analysis was performed for accuracy. RESULTS The SOIVET Maze correlated with measures of visuoperception, mental rotation, and planning, and was not related to age, educational level, or technology use profile. The SOIVET Route immediate correlated with measures of mental rotation, memory, and visuoconstruction, and was influenced only by education. Both tasks significantly differentiated MCI and control groups, and demonstrated moderate accuracy for the MCI diagnosis. CONCLUSION Traditional neuropsychological assessment presents limitations and immersive environments allow for the reproduction of complex cognitive processes. The two immersive virtual reality tasks are valid tools for the assessment of spatial orientation and should be considered for cognitive assessments of older adults.
Collapse
|
5
|
Application of Real and Virtual Radial Arm Maze Task in Human. Brain Sci 2022; 12:brainsci12040468. [PMID: 35447999 PMCID: PMC9027137 DOI: 10.3390/brainsci12040468] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022] Open
Abstract
Virtual Reality (VR) emerges as a promising technology capable of creating different scenarios in which the body, environment, and brain are closely related, proving enhancements in the diagnosis and treatment of several spatial memory deficits. In recent years, human spatial navigation has increasingly been studied in interactive virtual environments. However, navigational tasks are still not completely adapted in immersive 3D VR systems. We stipulate that an immersive Radial Arm Maze (RAM) is an excellent instrument, allowing the participants to be physically active within the maze exactly as in the walking RAM version in reality modality. RAM is a behavioral ecological task that allows the analyses of different facets of spatial memory, distinguishing declarative components from procedural ones. In addition to describing the characteristics of RAM, we will also analyze studies in which RAM has been used in virtual modality to provide suggestions into RAM building in immersive modality.
Collapse
|
6
|
Barclay SF, Potocki K, Burles F, Bech-Hansen NT, Iaria G. Evaluation of APOE ɛ2/ɛ3/ɛ4 Alleles in a Cohort of Individuals Affected by Developmental Topographical Disorientation. J Alzheimers Dis Rep 2021; 5:565-570. [PMID: 34514340 PMCID: PMC8385428 DOI: 10.3233/adr-210304] [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] [Accepted: 06/20/2021] [Indexed: 11/15/2022] Open
Abstract
The three common alleles of the APOE gene, ɛ2/ɛ3/ɛ4, have been linked to human spatial orientation. We investigated the genetic role of APOE in developmental topographical disorientation (DTD), a lifelong condition that results in topographical disorientation. We genotyped the APOE ɛ2/ɛ3/ɛ4 alleles in a cohort of 20 unrelated DTD probands, and found allele frequencies not statistically different from the those seen in the population as a whole. Therefore, we found no evidence that DTD occurs preferentially on a genetic background containing any particular APOE allele, making it unlikely that these APOE alleles are contributing to the development of DTD.
Collapse
Affiliation(s)
- Sarah F Barclay
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kendra Potocki
- Neurolab, Department of Psychology, Hotchkiss Brain Institute, and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Ford Burles
- Neurolab, Department of Psychology, Hotchkiss Brain Institute, and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - N Torben Bech-Hansen
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Giuseppe Iaria
- Neurolab, Department of Psychology, Hotchkiss Brain Institute, and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
7
|
Piersson AD, Mohamad M, Suppiah S, Rajab NF. Topographical patterns of whole-brain structural alterations in association with genetic risk, cerebrospinal fluid, positron emission tomography biomarkers of Alzheimer’s disease, and neuropsychological measures. Clin Transl Imaging 2021. [DOI: 10.1007/s40336-021-00440-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
Davis R. The Feasibility of Using Virtual Reality and Eye Tracking in Research With Older Adults With and Without Alzheimer's Disease. Front Aging Neurosci 2021; 13:607219. [PMID: 34248596 PMCID: PMC8267907 DOI: 10.3389/fnagi.2021.607219] [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: 09/16/2020] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Aim: To examine the feasibility of using large scale spatial, self-mobile, virtual reality, and eye tracking in older adults with and without Alzheimer's disease (AD). Methods: Older adults with early stage AD (n = 38) and a control group without AD (n = 50) were asked to find their way in a large, projected VR simulation of a retirement community repeatedly over 10 trials for each of 2 days, while wearing eye tracking glasses. Feasibility measures, including tolerance, side effects, and ability to complete the VR and eye tracking were collected. This study reports the analysis of the feasibility data for the VR and eye tracking and comparison of findings between the groups. Results: Over 80% of the subjects were able to complete the VR portion of the study. Only four subjects, all in the AD group, could not use the joystick and were excluded. Withdrawal rate (18%) was similar between the groups [X 2 (2) = 2.82, N = 88, p = 0.245] with most withdrawals occurring after the fourth trial. Simulation sickness was not significantly different between the groups. Only 60% of the subjects had completed eye tracking videos; more subjects in the AD group had complete eye tracking videos than the control group; X 2 (1) = 7.411, N = 88, p = 0.006. Eye tracking incompletion was primarily due to inability to calibration issues. Conclusion: Virtual reality testing and eye tracking can be used in older adults with and without AD in a large-scale way-finding task, but that there are some limitations.
Collapse
Affiliation(s)
- Rebecca Davis
- Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, United States
| |
Collapse
|
9
|
Genetic Alzheimer’s Disease Risk Affects the Neural Mechanisms of Pattern Separation in Hippocampal Subfields. Curr Biol 2020; 30:4201-4212.e3. [DOI: 10.1016/j.cub.2020.08.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/30/2020] [Accepted: 08/11/2020] [Indexed: 01/13/2023]
|
10
|
Yassine HN, Finch CE. APOE Alleles and Diet in Brain Aging and Alzheimer's Disease. Front Aging Neurosci 2020; 12:150. [PMID: 32587511 PMCID: PMC7297981 DOI: 10.3389/fnagi.2020.00150] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 05/04/2020] [Indexed: 12/13/2022] Open
Abstract
The APOE gene alleles modify human aging and the response to the diet at many levels with diverse pleotropic effects from gut to brain. To understand the interactions of APOE isoforms and diet, we analyze how cellular trafficking of apoE proteins affects energy metabolism, the immune system, and reproduction. The age-accelerating APOE4 allele alters the endosomal trafficking of cell surface receptors that mediate lipid and glucose metabolism. The APOE4 allele is the ancestral human allele, joined by APOE3 and then APOE2 in the human species. Under conditions of high infection, uncertain food, and shorter life expectancy, APOE4 may be adaptive for reducing mortality. As humans transitioned into modern less-infectious environments and longer life spans, APOE4 increased risks of aging-related diseases, particularly impacting arteries and the brain. The association of APOE4 with glucose dysregulation and body weight promotes many aging-associated diseases. Additionally, the APOE gene locus interacts with adjacent genes on chromosome 19 in haplotypes that modify neurodegeneration and metabolism, for which we anticipate complex gene-environment interactions. We summarize how diet and Alzheimer's disease (AD) risk are altered by APOE genotype in both animal and human studies and identify gaps. Much remains obscure in how APOE alleles modify nutritional factors in human aging. Identifying risk variant haplotypes in the APOE gene complex will clarify homeostatic adaptive responses to environmental conditions.
Collapse
Affiliation(s)
- Hussein N. Yassine
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Caleb E. Finch
- Leonard Davis School of Gerontology and Dornsife College, University of Southern California, Los Angeles, CA, United States
| |
Collapse
|
11
|
Sodums DJ, Bohbot VD. Negative correlation between grey matter in the hippocampus and caudate nucleus in healthy aging. Hippocampus 2020; 30:892-908. [PMID: 32384195 DOI: 10.1002/hipo.23210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 01/18/2023]
Abstract
Neurobiological changes that occur with aging include a reduction in function and volume of the hippocampus. These changes were associated with corresponding memory deficits in navigation tasks. However, navigation can involve different strategies that are dependent on the hippocampus and caudate nucleus. The proportion of people using hippocampus-dependent spatial strategies decreases across the lifespan. As such, the decrease in spatial strategies, and corresponding increase in caudate nucleus-dependent response strategies with age, may play a role in the observed neurobiological changes in the hippocampus. Furthermore, we previously showed a negative correlation between grey matter in the hippocampus and caudate nucleus/striatum in mice, young adults, and in individuals diagnosed with Alzheimer's disease. As such, we hypothesized that this negative relationship between the two structures would be present during normal aging. The aim of the current study was to investigate this gap in the literature by studying the relationship between grey matter in the hippocampus and caudate nucleus of the striatum, in relation to each other and to navigation strategies, during healthy aging. Healthy older adults (N = 39) were tested on the Concurrent Spatial Discrimination Learning Task (CSDLT), a virtual radial task that dissociates between spatial and response strategies. A regression of strategies against structural MRIs showed for the first time in older adults that the response strategy was associated with higher amounts of grey matter in the caudate nucleus. As expected, the spatial strategy correlated with grey matter in the hippocampus, which was negatively correlated with grey matter in the caudate nucleus. Interestingly, a sex difference emerged showing that among older adult response learners, women have the least amount of grey matter in the hippocampus, which is a known risk for Alzheimer's disease. This difference was absent among spatial learners. These results are discussed in the context of the putative protective role of spatial memory against grey matter loss in the hippocampus, especially in women.
Collapse
Affiliation(s)
- Devin J Sodums
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Véronique D Bohbot
- Department of Psychiatry, McGill University, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| |
Collapse
|
12
|
Davis R, Veltkamp A. Wayfinding Strategies and Spatial Anxiety in Older Adults With and Without Alzheimer's Disease. Res Gerontol Nurs 2020; 13:91-101. [PMID: 31697391 PMCID: PMC7294754 DOI: 10.3928/19404921-20191022-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 08/23/2019] [Indexed: 11/20/2022]
Abstract
Persons with Alzheimer's disease (AD) often experience problems finding their way (i.e., wayfinding) even in familiar locations. One possible explanation for wayfinding impairments in persons with AD is that they use different wayfinding strategies than persons without AD; and these strategies may be ineffective. The current study examined differences in wayfinding strategies and spatial anxiety in older adults with and without early-stage AD, as well as the effect gender has on both variables. Older adults with normal cognition (n = 50) and adults with early stage AD (n = 38) completed a demographic survey, cognitive tests, the Wayfinding Strategies Scale, and the Spatial Anxiety Scale. Results indicated that adults with normal cognition used significantly more orientation strategies (t [85] = 2.54, p = 0.013) than adults with AD, and men (n = 37) used significantly more orientation strategies than women (n = 51; t [85] = 2.41, p = 0.018). Participants with AD rated their spatial anxiety significantly higher than adults with normal cognition (n = 51; t [84] = -3.89, p < 0.001). Orientation strategy use was inversely related to spatial anxiety (r = -0.434, p < 0.001). These findings suggest that persons with early-stage AD may use fewer wayfinding strategies and have higher wayfinding-related anxiety compared to adults without AD. [Research in Gerontological Nursing, 13(2), 91-101.].
Collapse
|
13
|
Everyday taxi drivers: Do better navigators have larger hippocampi? Cortex 2019; 115:280-293. [PMID: 30884282 DOI: 10.1016/j.cortex.2018.12.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/14/2018] [Accepted: 12/22/2018] [Indexed: 01/11/2023]
Abstract
Work with non-human animals and human navigation experts (London taxi drivers) suggests that the size of the hippocampus, particularly the right posterior hippocampus in humans, relates to navigation expertise. Similar observations, sometimes implicating other sections of the hippocampus, have been made for aging populations and for people with neurodegenerative diseases that affect the hippocampus. These data support the hypothesis that hippocampal volume relates to navigation ability. However, the support for this hypothesis is mixed in healthy, young adults, who range widely in their navigation ability. Here, we administered a naturalistic navigation task that measures cognitive map accuracy to a sample of 90 healthy, young adults who also had MRI scans. Using a sequential analysis design with a registered analysis plan, we did not find that navigation ability related to hippocampal volume (total, right only, right posterior only). We conclude that navigation ability in a typical population does not correlate with variations in hippocampal size, and consider possible explanations for this null result.
Collapse
|