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Perez V, Duque A, Hidalgo V, Salvador A. EEG frequency bands in subjective cognitive decline: A systematic review of resting state studies. Biol Psychol 2024; 191:108823. [PMID: 38815895 DOI: 10.1016/j.biopsycho.2024.108823] [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: 03/05/2024] [Revised: 05/14/2024] [Accepted: 05/27/2024] [Indexed: 06/01/2024]
Abstract
As the older population continues to expand, there is a growing prevalence of individuals who experience subjective cognitive decline (SCD), characterized by self-reported failures in cognitive function and an increased risk of cognitive impairment. Recognizing that preventive interventions are typically more effective in preclinical stages, current research endeavors to focus on identifying early biological markers of SCD using resting-state electroencephalogram (rsEEG) methods. To do so, a systematic literature review covering the past 20 years was conducted following PRISMA guidelines, in order to consolidate findings on rsEEG frequency bands in individuals with SCD. Pubmed and Web of Science databases were searched for rsEEG studies of people with SCD. Quality assessments were completed using a modified Newcastle-Ottawa scale. A total of 564 articles published from December 2003 to December 2023 were reviewed, and significant aspects of these papers were analyzed to provide a general overview of the research on this technique. After removing unrelated articles, nine articles were selected for the present study. The review emphasizes patterns in frequency band activity, revealing that individuals classified as SCD exhibited increased theta power than healthy controls, but decreased than MCI. However, findings for the alpha, delta, and beta bands were inconsistent, demonstrating variability across studies and highlighting the need for further research. Although the rsEEG of frequency bands emerges as a promising early biomarker, there is a noteworthy need to establish uniform standards and consistent measurement approaches in order to ensure the reliability and comparability of the results obtained in the research.
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Affiliation(s)
- Vanesa Perez
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, Valencia, Spain; Valencian International University, Valencia, Spain
| | | | - Vanesa Hidalgo
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, Valencia, Spain; Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain.
| | - Alicia Salvador
- Laboratory of Social Cognitive Neuroscience, IDOCAL, Department of Psychobiology, University of Valencia, Valencia, Spain; Spanish National Network for Research in Mental Health CIBERSAM, 28029, Spain
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Chudzik A, Śledzianowski A, Przybyszewski AW. Machine Learning and Digital Biomarkers Can Detect Early Stages of Neurodegenerative Diseases. SENSORS (BASEL, SWITZERLAND) 2024; 24:1572. [PMID: 38475108 DOI: 10.3390/s24051572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Neurodegenerative diseases (NDs) such as Alzheimer's Disease (AD) and Parkinson's Disease (PD) are devastating conditions that can develop without noticeable symptoms, causing irreversible damage to neurons before any signs become clinically evident. NDs are a major cause of disability and mortality worldwide. Currently, there are no cures or treatments to halt their progression. Therefore, the development of early detection methods is urgently needed to delay neuronal loss as soon as possible. Despite advancements in Medtech, the early diagnosis of NDs remains a challenge at the intersection of medical, IT, and regulatory fields. Thus, this review explores "digital biomarkers" (tools designed for remote neurocognitive data collection and AI analysis) as a potential solution. The review summarizes that recent studies combining AI with digital biomarkers suggest the possibility of identifying pre-symptomatic indicators of NDs. For instance, research utilizing convolutional neural networks for eye tracking has achieved significant diagnostic accuracies. ROC-AUC scores reached up to 0.88, indicating high model performance in differentiating between PD patients and healthy controls. Similarly, advancements in facial expression analysis through tools have demonstrated significant potential in detecting emotional changes in ND patients, with some models reaching an accuracy of 0.89 and a precision of 0.85. This review follows a structured approach to article selection, starting with a comprehensive database search and culminating in a rigorous quality assessment and meaning for NDs of the different methods. The process is visualized in 10 tables with 54 parameters describing different approaches and their consequences for understanding various mechanisms in ND changes. However, these methods also face challenges related to data accuracy and privacy concerns. To address these issues, this review proposes strategies that emphasize the need for rigorous validation and rapid integration into clinical practice. Such integration could transform ND diagnostics, making early detection tools more cost-effective and globally accessible. In conclusion, this review underscores the urgent need to incorporate validated digital health tools into mainstream medical practice. This integration could indicate a new era in the early diagnosis of neurodegenerative diseases, potentially altering the trajectory of these conditions for millions worldwide. Thus, by highlighting specific and statistically significant findings, this review demonstrates the current progress in this field and the potential impact of these advancements on the global management of NDs.
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Affiliation(s)
- Artur Chudzik
- Polish-Japanese Academy of Information Technology, Faculty of Computer Science, 86 Koszykowa Street, 02-008 Warsaw, Poland
| | - Albert Śledzianowski
- Polish-Japanese Academy of Information Technology, Faculty of Computer Science, 86 Koszykowa Street, 02-008 Warsaw, Poland
| | - Andrzej W Przybyszewski
- Polish-Japanese Academy of Information Technology, Faculty of Computer Science, 86 Koszykowa Street, 02-008 Warsaw, Poland
- UMass Chan Medical School, Department of Neurology, 65 Lake Avenue, Worcester, MA 01655, USA
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Kirkham R, Kooijman L, Albertella L, Myles D, Yücel M, Rotaru K. Immersive Virtual Reality-Based Methods for Assessing Executive Functioning: Systematic Review. JMIR Serious Games 2024; 12:e50282. [PMID: 38407958 DOI: 10.2196/50282] [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: 07/03/2023] [Revised: 11/26/2023] [Accepted: 12/29/2023] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Neuropsychological assessments traditionally include tests of executive functioning (EF) because of its critical role in daily activities and link to mental disorders. Established traditional EF assessments, although robust, lack ecological validity and are limited to single cognitive processes. These methods, which are suitable for clinical populations, are less informative regarding EF in healthy individuals. With these limitations in mind, immersive virtual reality (VR)-based assessments of EF have garnered interest because of their potential to increase test sensitivity, ecological validity, and neuropsychological assessment accessibility. OBJECTIVE This systematic review aims to explore the literature on immersive VR assessments of EF focusing on (1) EF components being assessed, (2) how these assessments are validated, and (3) strategies for monitoring potential adverse (cybersickness) and beneficial (immersion) effects. METHODS EBSCOhost, Scopus, and Web of Science were searched in July 2022 using keywords that reflected the main themes of VR, neuropsychological tests, and EF. Articles had to be peer-reviewed manuscripts written in English and published after 2013 that detailed empirical, clinical, or proof-of-concept studies in which a virtual environment using a head-mounted display was used to assess EF in an adult population. A tabular synthesis method was used in which validation details from each study, including comparative assessments and scores, were systematically organized in a table. The results were summed and qualitatively analyzed to provide a comprehensive overview of the findings. RESULTS The search retrieved 555 unique articles, of which 19 (3.4%) met the inclusion criteria. The reviewed studies encompassed EF and associated higher-order cognitive functions such as inhibitory control, cognitive flexibility, working memory, planning, and attention. VR assessments commonly underwent validation against gold-standard traditional tasks. However, discrepancies were observed, with some studies lacking reported a priori planned correlations, omitting detailed descriptions of the EF constructs evaluated using the VR paradigms, and frequently reporting incomplete results. Notably, only 4 of the 19 (21%) studies evaluated cybersickness, and 5 of the 19 (26%) studies included user experience assessments. CONCLUSIONS Although it acknowledges the potential of VR paradigms for assessing EF, the evidence has limitations. The methodological and psychometric properties of the included studies were inconsistently addressed, raising concerns about their validity and reliability. Infrequent monitoring of adverse effects such as cybersickness and considerable variability in sample sizes may limit interpretation and hinder psychometric evaluation. Several recommendations are proposed to improve the theory and practice of immersive VR assessments of EF. Future studies should explore the integration of biosensors with VR systems and the capabilities of VR in the context of spatial navigation assessments. Despite considerable promise, the systematic and validated implementation of VR assessments is essential for ensuring their practical utility in real-world applications.
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Affiliation(s)
- Rebecca Kirkham
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Lars Kooijman
- Institute for Intelligent Systems Research and Innovation, Deakin University, Geelong, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Dan Myles
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
| | - Murat Yücel
- Queensland Institute of Medical Research Berghofer Medical Research Institute, Herston, Australia
- Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Kristian Rotaru
- Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Clayton, Australia
- Monash Business School, Monash University, Caufield, Australia
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Kim SY, Park J, Choi H, Loeser M, Ryu H, Seo K. Digital Marker for Early Screening of Mild Cognitive Impairment Through Hand and Eye Movement Analysis in Virtual Reality Using Machine Learning: First Validation Study. J Med Internet Res 2023; 25:e48093. [PMID: 37862101 PMCID: PMC10625097 DOI: 10.2196/48093] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/07/2023] [Accepted: 09/22/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND With the global rise in Alzheimer disease (AD), early screening for mild cognitive impairment (MCI), which is a preclinical stage of AD, is of paramount importance. Although biomarkers such as cerebrospinal fluid amyloid level and magnetic resonance imaging have been studied, they have limitations, such as high cost and invasiveness. Digital markers to assess cognitive impairment by analyzing behavioral data collected from digital devices in daily life can be a new alternative. In this context, we developed a "virtual kiosk test" for early screening of MCI by analyzing behavioral data collected when using a kiosk in a virtual environment. OBJECTIVE We aimed to investigate key behavioral features collected from a virtual kiosk test that could distinguish patients with MCI from healthy controls with high statistical significance. Also, we focused on developing a machine learning model capable of early screening of MCI based on these behavioral features. METHODS A total of 51 participants comprising 20 healthy controls and 31 patients with MCI were recruited by 2 neurologists from a university hospital. The participants performed a virtual kiosk test-developed by our group-where we recorded various behavioral data such as hand and eye movements. Based on these time series data, we computed the following 4 behavioral features: hand movement speed, proportion of fixation duration, time to completion, and the number of errors. To compare these behavioral features between healthy controls and patients with MCI, independent-samples 2-tailed t tests were used. Additionally, we used these behavioral features to train and validate a machine learning model for early screening of patients with MCI from healthy controls. RESULTS In the virtual kiosk test, all 4 behavioral features showed statistically significant differences between patients with MCI and healthy controls. Compared with healthy controls, patients with MCI had slower hand movement speed (t49=3.45; P=.004), lower proportion of fixation duration (t49=2.69; P=.04), longer time to completion (t49=-3.44; P=.004), and a greater number of errors (t49=-3.77; P=.001). All 4 features were then used to train a support vector machine to distinguish between healthy controls and patients with MCI. Our machine learning model achieved 93.3% accuracy, 100% sensitivity, 83.3% specificity, 90% precision, and 94.7% F1-score. CONCLUSIONS Our research preliminarily suggests that analyzing hand and eye movements in the virtual kiosk test holds potential as a digital marker for early screening of MCI. In contrast to conventional biomarkers, this digital marker in virtual reality is advantageous as it can collect ecologically valid data at an affordable cost and in a short period (5-15 minutes), making it a suitable means for early screening of MCI. We call for further studies to confirm the reliability and validity of this approach.
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Affiliation(s)
- Se Young Kim
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
| | - Jinseok Park
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hojin Choi
- Department of Neurology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Martin Loeser
- Department of Computer Science, Electrical Engineering and Mechatronics, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Hokyoung Ryu
- Graduate School of Technology and Innovation Management, Hanyang University, Seoul, Republic of Korea
| | - Kyoungwon Seo
- Department of Applied Artificial Intelligence, Seoul National University of Science and Technology, Seoul, Republic of Korea
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Wu R, Li A, Xue C, Chai J, Qiang Y, Zhao J, Wang L. Screening for Mild Cognitive Impairment with Speech Interaction Based on Virtual Reality and Wearable Devices. Brain Sci 2023; 13:1222. [PMID: 37626578 PMCID: PMC10452416 DOI: 10.3390/brainsci13081222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Significant advances in sensor technology and virtual reality (VR) offer new possibilities for early and effective detection of mild cognitive impairment (MCI), and this wealth of data can improve the early detection and monitoring of patients. In this study, we proposed a non-invasive and effective MCI detection protocol based on electroencephalogram (EEG), speech, and digitized cognitive parameters. The EEG data, speech data, and digitized cognitive parameters of 86 participants (44 MCI patients and 42 healthy individuals) were monitored using a wearable EEG device and a VR device during the resting state and task (the VR-based language task we designed). Regarding the features selected under different modality combinations for all language tasks, we performed leave-one-out cross-validation for them using four different classifiers. We then compared the classification performance under multimodal data fusion using features from a single language task, features from all tasks, and using a weighted voting strategy, respectively. The experimental results showed that the collaborative screening of multimodal data yielded the highest classification performance compared to single-modal features. Among them, the SVM classifier using the RBF kernel obtained the best classification results with an accuracy of 87%. The overall classification performance was further improved using a weighted voting strategy with an accuracy of 89.8%, indicating that our proposed method can tap into the cognitive changes of MCI patients. The MCI detection scheme based on EEG, speech, and digital cognitive parameters proposed in this study provides a new direction and support for effective MCI detection, and suggests that VR and wearable devices will be a promising direction for easy-to-perform and effective MCI detection, offering new possibilities for the exploration of VR technology in the field of language cognition.
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Affiliation(s)
- Ruixuan Wu
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan 030024, China
| | - Aoyu Li
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan 030024, China
| | - Chen Xue
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan 030024, China
| | - Jiali Chai
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan 030024, China
| | - Yan Qiang
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan 030024, China
| | - Juanjuan Zhao
- College of Computer Science and Technology (College of Data Science), Taiyuan University of Technology, Taiyuan 030024, China
- College of Information, Jinzhong College of Information, Jinzhong 030600, China
| | - Long Wang
- College of Information, Jinzhong College of Information, Jinzhong 030600, China
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Abd-Alrazaq A, Abuelezz I, Al-Jafar E, Denecke K, Househ M, Aziz S, Ahmed A, Aljaafreh A, AlSaad R, Sheikh J. The performance of serious games for enhancing attention in cognitively impaired older adults. NPJ Digit Med 2023; 6:122. [PMID: 37422507 PMCID: PMC10329640 DOI: 10.1038/s41746-023-00863-2] [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: 09/25/2022] [Accepted: 06/15/2023] [Indexed: 07/10/2023] Open
Abstract
Attention, which is the process of noticing the surrounding environment and processing information, is one of the cognitive functions that deteriorate gradually as people grow older. Games that are used for other than entertainment, such as improving attention, are often referred to as serious games. This study examined the effectiveness of serious games on attention among elderly individuals suffering from cognitive impairment. A systematic review and meta-analyses of randomized controlled trials were carried out. A total of 10 trials ultimately met all eligibility criteria of the 559 records retrieved. The synthesis of very low-quality evidence from three trials, as analyzed in a meta-study, indicated that serious games outperform no/passive interventions in enhancing attention in cognitively impaired older adults (P < 0.001). Additionally, findings from two other studies demonstrated that serious games are more effective than traditional cognitive training in boosting attention among cognitively impaired older adults. One study also concluded that serious games are better than traditional exercises in enhancing attention. Serious games can enhance attention in cognitively impaired older adults. However, given the low quality of the evidence, the limited number of participants in most studies, the absence of some comparative studies, and the dearth of studies included in the meta-analyses, the results remain inconclusive. Thus, until the aforementioned limitations are rectified in future research, serious games should serve as a supplement, rather than a replacement, to current interventions.
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Affiliation(s)
- Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Israa Abuelezz
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | | | - Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Science, Bern, Switzerland
| | - Mowafa Househ
- Division of Information and Computing Technology, College of Science and Engineering, Hamad Bin Khalifa University, Qatar Foundation, Doha, Qatar
| | - Sarah Aziz
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Arfan Ahmed
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Ali Aljaafreh
- Department of Management Information Systems, School of Business, Mutah University, Karak, Jordan
| | - Rawan AlSaad
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Javaid Sheikh
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
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Ulbl J, Rakusa M. The Importance of Subjective Cognitive Decline Recognition and the Potential of Molecular and Neurophysiological Biomarkers-A Systematic Review. Int J Mol Sci 2023; 24:10158. [PMID: 37373304 DOI: 10.3390/ijms241210158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/01/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early stages of Alzheimer's disease (AD). Neurophysiological markers such as electroencephalography (EEG) and event-related potential (ERP) are emerging as alternatives to traditional molecular and imaging markers. This paper aimed to review the literature on EEG and ERP markers in individuals with SCD. We analysed 30 studies that met our criteria, with 17 focusing on resting-state or cognitive task EEG, 11 on ERPs, and two on both EEG and ERP parameters. Typical spectral changes were indicative of EEG rhythm slowing and were associated with faster clinical progression, lower education levels, and abnormal cerebrospinal fluid biomarkers profiles. Some studies found no difference in ERP components between SCD subjects, controls, or MCI, while others reported lower amplitudes in the SCD group compared to controls. Further research is needed to explore the prognostic value of EEG and ERP in relation to molecular markers in individuals with SCD.
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Affiliation(s)
- Janina Ulbl
- Division of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
| | - Martin Rakusa
- Division of Neurology, University Medical Centre Maribor, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
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Stasolla F, Di Gioia M. Combining reinforcement learning and virtual reality in mild neurocognitive impairment: a new usability assessment on patients and caregivers. Front Aging Neurosci 2023; 15:1189498. [PMID: 37293666 PMCID: PMC10244593 DOI: 10.3389/fnagi.2023.1189498] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 04/26/2023] [Indexed: 06/10/2023] Open
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Vacca RA, Augello A, Gallo L, Caggianese G, Malizia V, La Grutta S, Murero M, Valenti D, Tullo A, Balech B, Marzano F, Ghezzo A, Tancredi G, Turchetta A, Riccio MP, Bravaccio C, Scala I. Serious Games in the new era of digital-health interventions: A narrative review of their therapeutic applications to manage neurobehavior in neurodevelopmental disorders. Neurosci Biobehav Rev 2023; 149:105156. [PMID: 37019246 DOI: 10.1016/j.neubiorev.2023.105156] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/10/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
Children and adolescents with neurodevelopmental disorders generally show adaptive, cognitive and motor skills impairments associated with behavioral problems, i.e., alterations in attention, anxiety and stress regulation, emotional and social relationships, which strongly limit their quality of life. This narrative review aims at providing a critical overview of the current knowledge in the field of serious games (SGs), known as digital instructional interactive videogames, applied to neurodevelopmental disorders. Indeed, a growing number of studies is drawing attention to SGs as innovative and promising interventions in managing neurobehavioral and cognitive disturbs in children with neurodevelopmental disorders. Accordingly, we provide a literature overview of the current evidence regarding the actions and the effects of SGs. In addition, we describe neurobehavioral alterations occurring in some specific neurodevelopmental disorders for which a possible therapeutic use of SGs has been suggested. Finally, we discuss findings obtained in clinical trials using SGs as digital therapeutics in neurodevelopment disorders and suggest new directions and hypotheses for future studies to bridge the gaps between clinical research and clinical practice.
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Varela-Aldás J, Buele J, López I, Palacios-Navarro G. Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4609. [PMID: 36901618 PMCID: PMC10002257 DOI: 10.3390/ijerph20054609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Few works analyze the parameters inherent to immersive virtual reality (IVR) in applications for memory evaluation. Specifically, hand tracking adds to the immersion of the system, placing the user in the first person with full awareness of the position of their hands. Thus, this work addresses the influence of hand tracking in memory assessment with IVR systems. For this, an application based on activities of daily living was developed, where the user must remember the location of the elements. The data collected by the application are the accuracy of the answers and the response time; the participants are 20 healthy subjects who pass the MoCA test with an age range between 18 to 60 years of age; the application was evaluated with classic controllers and with the hand tracking of the Oculus Quest 2. After the experimentation, the participants carried out presence (PQ), usability (UMUX), and satisfaction (USEQ) tests. The results indicate no difference with statistical significance between both experiments; controller experiments have 7.08% higher accuracy and 0.27 ys. faster response time. Contrary to expectations, presence was 1.3% lower for hand tracking, and usability (0.18%) and satisfaction (1.43%) had similar results. The findings indicate no evidence to determine better conditions in the evaluation of memory in this case of IVR with hand tracking.
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Affiliation(s)
- José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
| | - Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, 44003 Teruel, Spain
| | - Irene López
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
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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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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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13
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Lee B, Lee T, Jeon H, Lee S, Kim K, Cho W, Hwang J, Chae YW, Jung JM, Kang HJ, Kim NH, Shin C, Jang J. Synergy through Integration of Wearable EEG and Virtual Reality for Mild Cognitive Impairment and Mild Dementia Screening. IEEE J Biomed Health Inform 2022; 26:2909-2919. [PMID: 35104235 DOI: 10.1109/jbhi.2022.3147847] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Virtual reality (VR) technologies have shown promising potential in the early diagnosis of dementia by enabling accessible and regular assessment. However, previous VR studies were restricted to the analysis of behavioral responses, so information about degenerated brain dynamics could not be directly acquired. To address this issue, we provide a cognitive impairment (CI) screening tool based on a wearable EEG device integrated into a VR platform. Subjects were asked to use a hardware setup consisting of a frontal six-channel EEG device mounted on a VR device and to perform four cognitive tasks in VR. Behavioral response profiles and EEG features were extracted during the tasks, and classifiers were trained on extracted features to differentiate subjects with CI from healthy controls (HCs). Notably, the performance of the patient classification consistently improved when EEG characteristics measured during cognitive tasks were additionally included in feature attributes than when only the task scores or resting-state EEG features were used, suggesting that our protocol provides discriminative information for screening. These results propose that the integration of EEG devices into a VR framework could emerge as a powerful and synergistic strategy for constructing an easily accessible EEG-based dementia screening tool.
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14
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Jeong H, Jeong YW, Park Y, Kim K, Park J, Kang DR. Applications of deep learning methods in digital biomarker research using noninvasive sensing data. Digit Health 2022; 8:20552076221136642. [PMID: 36353696 PMCID: PMC9638529 DOI: 10.1177/20552076221136642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 10/04/2022] [Indexed: 07/02/2024] Open
Abstract
Introduction: Noninvasive digital biomarkers are critical elements in digital healthcare in terms of not only the ease of measurement but also their use of raw data. In recent years, deep learning methods have been put to use to analyze these diverse heterogeneous data; these methods include representation learning for feature extraction and supervised learning for the prediction of these biomarkers. Methods: We introduce clinical cases of digital biomarkers and various deep-learning methods applied according to each data type. In addition, deep learning methods for the integrated analysis of multidimensional heterogeneous data are introduced, and the utility of these data as an integrated digital biomarker is presented. The current status of digital biomarker research is examined by surveying research cases applied to various types of data as well as modeling methods. Results: We present a future research direction for using data from heterogeneous sources together by introducing deep learning methods for dimensionality reduction and mode integration from multimodal digital biomarker studies covering related domains. The integration of multimodality has led to advances in research through the improvement of performance and complementarity between modes. Discussion: The integrative digital biomarker will be more useful for research on diseases that require data from multiple sources to be treated together. Since delicate signals from patients are not missed and the interaction effects between signals are also considered, it will be helpful for immediate detection and more accurate prediction of symptoms.
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Affiliation(s)
- Hoyeon Jeong
- Department of Biostatistics, Yonsei University Wonju College of
Medicine, Wonju, Republic of Korea
| | - Yong W Jeong
- Department of Biostatistics, Yonsei University Wonju College of
Medicine, Wonju, Republic of Korea
| | - Yeonjae Park
- Department of Biostatistics, Yonsei University Wonju College of
Medicine, Wonju, Republic of Korea
| | - Kise Kim
- School of Health and Environmental Science, Korea University, Seoul, Republic of Korea
| | | | - Dae R Kang
- Department of Biostatistics, Yonsei University Wonju College of
Medicine, Wonju, Republic of Korea
- Department of Precision Medicine, Yonsei University Wonju College of
Medicine, Wonju, Republic of Korea
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15
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Lin CW, Mao TY, Huang CF. A Novel Game-Based Intelligent Test for Detecting Elderly Cognitive Function Impairment. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:1698406. [PMID: 34880929 PMCID: PMC8648469 DOI: 10.1155/2021/1698406] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022]
Abstract
PURPOSES This research explores the game-based intelligent test (GBIT), predicts the possibilities of Mini-Mental State Examination (MMSE) scores and the risk of cognitive impairment, and then verifies GBIT as one of the reliable and valid cognitive assessment tools. METHODS This study recruited 117 elderly subjects in Taiwan (average age is 79.92 ± 8.68, average height is 156.91 ± 8.01, average weight is 59.14 ± 9.67, and average MMSE score is 23.33 ± 6.16). A multiple regression model was used to analyze the GBIT parameters of the elderly's reaction, attention, coordination, and memory to predict their MMSE performance. The binary logistic regression was then utilized to predict their risk of cognitive impairment. The statistical significance level was set as α = 0.05. RESULTS Multiple regression analysis showed that gender, the correct number of reactions, and the correct number of memory have a significantly positive predictive power on MMSE of the elderly (F = 37.60, R 2 = 0.69, and p < 0.05). Binary logistic regression analysis noted that the correct average number of reactions falls by one question, and the ratio of cognitive dysfunction risk increases 1.09 times (p < 0.05); the correct average number of memory drops by one question, the ratio of cognitive dysfunction risk increases 3.76 times (p < 0.05), and the overall model predictive power is 88.20% (sensitivity: 84.00%; specificity: 92.30%). CONCLUSIONS This study verifies that GBIT is reliable and can effectively predict the cognitive function and risk of cognitive impairment in the elderly. Therefore, GBIT can be used as one of the feasible tools for evaluating older people's cognitive function.
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Affiliation(s)
- Chih-Wei Lin
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Tso-Yen Mao
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Chun-Feng Huang
- Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
- Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
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16
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Lee B, Lee T, Jeon H, Lee S, Kim K, Cho W, Hwang J, Chae YW, Jung JM, Kang HJ, Kim NH, Shin C, Jang J. Synergy through Integration of Wearable EEG and Virtual Reality for Mild Cognitive Impairment and Mild Dementia Screening: Protocol Design and Feasibility Study (Preprint). JMIR Form Res 2021. [DOI: 10.2196/30028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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