Virtual Kitchen Test. Assessing frontal lobe functions in patients with alcohol dependence syndrome

Virtual Reality-Based Cognitive Stimulation on People with Mild to Moderate Dementia due to Alzheimer's Disease: A Pilot Randomized Controlled Trial

The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.

Eye Movement Analysis and Cognitive Assessment. The Use of Comparative Visual Search Tasks in a Non-immersive VR Application

BACKGROUND

An adequate behavioral response depends on attentional and mnesic processes. When these basic cognitive functions are impaired, the use of non-immersive Virtual Reality Applications (VRAs) can be a reliable technique for assessing the level of impairment. However, most non-immersive VRAs use indirect measures to make inferences about visual attention and mnesic processes (e.g., time to task completion, error rate).

OBJECTIVES

To examine whether the eye movement analysis through eye tracking (ET) can be a reliable method to probe more effectively where and how attention is deployed and how it is linked with visual working memory during comparative visual search tasks (CVSTs) in non-immersive VRAs.

METHODS

The eye movements of 50 healthy participants were continuously recorded while CVSTs, selected from a set of cognitive tasks in the Systemic Lisbon Battery (SLB). Then a VRA designed to assess of cognitive impairments were randomly presented.

RESULTS

The total fixation duration, the number of visits in the areas of interest and in the interstimulus space, along with the total execution time was significantly different as a function of the Mini Mental State Examination (MMSE) scores.

CONCLUSIONS

The present study demonstrates that CVSTs in SLB, when combined with ET, can be a reliable and unobtrusive method for assessing cognitive abilities in healthy individuals, opening it to potential use in clinical samples.

When life gives you lemons: The effectiveness of culinary group intervention among cancer patients

RATIONALE

Previous studies have shown that the dietary habits of cancer patients and survivors have significant implications for their recovery and quality of life. The current study examined the effectiveness of an innovative culinary group intervention on cancer patients' quality of life through changes in their eating behaviors, as manifested by an increase in their tendency towards intuitive eating and healthy food choices.

METHODS

In total, 190 cancer patients participated in this study, and were allocated to an intervention or a wait-list control group. A battery of self-report questionnaires assessing food choices, intuitive eating, health-related quality of life, and subjective well-being was administered at two time points: Before the intervention (T1) and at the end of the three month intervention (T2).

RESULTS

Analyses revealed an increase in health-related quality of life and well-being among the intervention group. Intuitive eating and healthy food choices also increased among the intervention but not wait-list control group. Finally, results indicated that participation in the culinary group intervention and improvements in health-related quality of life and well-being were mediated by changes in eating behaviors.

CONCLUSIONS

Our findings demonstrate that nutrition and eating behaviors have a significant effect on cancer patients' physical and emotional adjustment. A culinary group intervention seems to target patients' physical and emotional needs and promote their adjustment.

Systemic Lisbon Battery: Normative Data for Memory and Attention Assessments

Background

Memory and attention are two cognitive domains pivotal for the performance of instrumental activities of daily living (IADLs). The assessment of these functions is still widely carried out with pencil-and-paper tests, which lack ecological validity. The evaluation of cognitive and memory functions while the patients are performing IADLs should contribute to the ecological validity of the evaluation process.

Objective

The objective of this study is to establish normative data from virtual reality (VR) IADLs designed to activate memory and attention functions.

Methods

A total of 243 non-clinical participants carried out a paper-and-pencil Mini-Mental State Examination (MMSE) and performed 3 VR activities: art gallery visual matching task, supermarket shopping task, and memory fruit matching game. The data (execution time and errors, and money spent in the case of the supermarket activity) was automatically generated from the app.

Results

Outcomes were computed using non-parametric statistics, due to non-normality of distributions. Age, academic qualifications, and computer experience all had significant effects on most measures. Normative values for different levels of these measures were defined.

Conclusions

Age, academic qualifications, and computer experience should be taken into account while using our VR-based platform for cognitive assessment purposes.

Evaluation of Cognitive Functions through the Systemic Lisbon Battery: Normative Data

INTRODUCTION

This article is part of the Focus Theme of Methods of Information in Medicine on "Methodologies, Models and Algorithms for Patients Rehabilitation".

BACKGROUND

ICT is an emerging alternative to paper-and-pencil tests for the assessment of cognitive functions, allowing for the monitoring of participants' behavior while they perform simulations of instrumental activities of daily life (IADLs) in a virtual reality (VR) scenario. This requires normative values for each VR task, so that deviations to normality can be identified as indicators of cognitive impairment.

OBJECTIVES

To identify normative data for several IADL tasks that are available on the Systemic Lisbon Battery (SLB).

METHODS

Fifty-nine participants performed a series of VR tasks that require the use of the memory and executive function dimensions of cognitive functionality.

RESULTS

Normative data for the different subsets and total score of the SLB, based on proportion of correct hits per execution time, were identified. Age and experience with video games affect (respectively, negatively and positively) performance on the SLB and should be taken into account in assessment; on the other hand, gender and education do not.

CONCLUSIONS

Overall results suggest that the SLB may be useful to assess cognitive functioning during the execution of activities of daily living, but larger studies and with clinical samples are needed.

Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury

BACKGROUND

Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine.

OBJECTIVES

To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments.

METHODS

The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation.

RESULTS

An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures.

CONCLUSIONS

The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current work is devoted to designing more experiments in order to present more evidence about its values.

New methodologies for patients rehabilitation

OBJECTIVE

The present editorial is part of the focus theme of Methods of Information in Medicine titled "New Methodologies for Patients Rehabilitation", with a specific focus on technologies and human factors related to the use of Information and Communication Technologies (ICT) for improving patient rehabilitation.

METHODS

The focus theme explores different dimensions of empowerment methodologies for disabled people in terms of rehabilitation and health care, and to explores the extent to which ICT is a useful tool in this process.

RESULTS

The focus theme lists a set of research papers that present different ways of using ICT to develop advanced systems that help disabled people in their rehabilitation process.