What is the future for immersive virtual reality in memory rehabilitation? A systematic review

Towards an ecologically valid naturalistic cognitive neuroscience of memory and event cognition

The landscape of human memory and event cognition research has witnessed a transformative journey toward the use of naturalistic contexts and tasks. In this review, we track this progression from abrupt, artificial stimuli used in extensively controlled laboratory experiments to more naturalistic tasks and stimuli that present a more faithful representation of the real world. We argue that in order to improve ecological validity, naturalistic study designs must consider the complexity of the cognitive phenomenon being studied. Then, we review the current state of "naturalistic" event segmentation studies and critically assess frequently employed movie stimuli. We evaluate recently developed tools like lifelogging and other extended reality technologies to help address the challenges we identified with existing naturalistic approaches. We conclude by offering some guidelines that can be used to design ecologically valid cognitive neuroscience studies of memory and event cognition.

Brain Neuroplasticity Leveraging Virtual Reality and Brain-Computer Interface Technologies

This study explores neuroplasticity through the use of virtual reality (VR) and brain-computer interfaces (BCIs). Neuroplasticity is the brain's ability to reorganize itself by forming new neural connections in response to learning, experience, and injury. VR offers a controlled environment to manipulate sensory inputs, while BCIs facilitate real-time monitoring and modulation of neural activity. By combining VR and BCI, researchers can stimulate specific brain regions, trigger neurochemical changes, and influence cognitive functions such as memory, perception, and motor skills. Key findings indicate that VR and BCI interventions are promising for rehabilitation therapies, treatment of phobias and anxiety disorders, and cognitive enhancement. Personalized VR experiences, adapted based on BCI feedback, enhance the efficacy of these interventions. This study underscores the potential for integrating VR and BCI technologies to understand and harness neuroplasticity for cognitive and therapeutic applications. The researchers utilized the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) method to conduct a comprehensive and systematic review of the existing literature on neuroplasticity, VR, and BCI. This involved identifying relevant studies through database searches, screening for eligibility, and assessing the quality of the included studies. Data extraction focused on the effects of VR and BCI on neuroplasticity and cognitive functions. The PRISMA method ensured a rigorous and transparent approach to synthesizing evidence, allowing the researchers to draw robust conclusions about the potential of VR and BCI technologies in promoting neuroplasticity and cognitive enhancement.

An exploratory study of the effect of age and gender on face scanning during affect recognition in immersive virtual reality

A person with impaired emotion recognition is not able to correctly identify facial expressions represented by other individuals. The aim of the present study is to assess eyes gaze and facial emotion recognition in a healthy population using dynamic avatars in immersive virtual reality (IVR). For the first time, the viewing of each area of interest of the face in IVR is studied by gender and age. This work in healthy people is conducted to assess the future usefulness of IVR in patients with deficits in the recognition of facial expressions. Seventy-four healthy volunteers participated in the study. The materials used were a laptop computer, a game controller, and a head-mounted display. Dynamic virtual faces randomly representing the six basic emotions plus neutral expression were used as stimuli. After the virtual human represented an emotion, a response panel was displayed with the seven possible options. Besides storing the hits and misses, the software program internally divided the faces into different areas of interest (AOIs) and recorded how long participants looked at each AOI. As regards the overall accuracy of the participants' responses, hits decreased from the youngest to the middle-aged and older adults. Also, all three groups spent the highest percentage of time looking at the eyes, but younger adults had the highest percentage. It is also noteworthy that attention to the face compared to the background decreased with age. Moreover, the hits between women and men were remarkably similar and, in fact, there were no statistically significant differences between them. In general, men paid more attention to the eyes than women, but women paid more attention to the forehead and mouth. In contrast to previous work, our study indicates that there are no differences between men and women in facial emotion recognition. Moreover, in line with previous work, the percentage of face viewing time for younger adults is higher than for older adults. However, contrary to earlier studies, older adults look more at the eyes than at the mouth.Consistent with other studies, the eyes are the AOI with the highest percentage of viewing time. For men the most viewed AOI is the eyes for all emotions in both hits and misses. Women look more at the eyes for all emotions, except for joy, fear, and anger on hits. On misses, they look more into the eyes for almost all emotions except surprise and fear.

Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment

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.

Negami: An Augmented Reality App for the Treatment of Spatial Neglect After Stroke

BACKGROUND

A widely applied and effective rehabilitation method for patients experiencing spatial neglect after a stroke is "visual exploration training." Patients improve their ipsilesional bias of attention and orientation by training exploration movements and search strategies toward the contralesional side of space. In this context, gamification can have a positive influence on motivation for treatment and thus on the success of treatment. In contrast to virtual reality applications, treatment enhancements through augmented reality (AR) have not yet been investigated, although they offer some advantages over virtual reality.

OBJECTIVE

This study aimed to develop an AR-based app (Negami) for the treatment of spatial neglect that combines visual exploration training with active, contralesionally oriented rotation of the eyes, head, and trunk.

METHODS

The app inserts a virtual element (origami bird) into the real space surrounding the patient, which the patient explores with the camera of a tablet. Subjective reports from healthy elderly participants (n=10) and patients with spatial neglect after stroke (n=10) who trained with the new Negami app were analyzed. Usability, side effects, and game experience were assessed by various questionnaires.

RESULTS

Training at the highest defined difficulty level was perceived as differently challenging but not as frustrating by the group of healthy elderly participants. The app was rated with high usability, hardly any side effects, high motivation, and entertainment. The group of patients with spatial neglect after stroke consistently evaluated the app positively on the dimensions of motivation, satisfaction, and fun.

CONCLUSIONS

The Negami app represents a promising extension by adding AR to traditional exploration training for spatial neglect. Through participants' natural interaction with the physical surrounding environment during playful tasks, side effects as symptoms of cybersickness are minimized and patients' motivation appeared to markedly increase. The use of AR in cognitive rehabilitation programs and the treatment of spatial neglect seems promising and should receive further investigation.