Visualization and Interaction Technologies in Serious and Exergames for Cognitive Assessment and Training: A Survey on Available Solutions and Their Validation

Exergames and serious games, based on standard personal computers, mobile devices and gaming consoles or on novel immersive Virtual and Augmented Reality techniques, have become popular in the last few years and are now applied in various research fields, among which cognitive assessment and training of heterogeneous target populations. Moreover, the adoption of Web based solutions together with the integration of Artificial Intelligence and Machine Learning algorithms could bring countless advantages, both for the patients and the clinical personnel, as allowing the early detection of some pathological conditions, improving the efficacy and adherence to rehabilitation processes, through the personalisation of training sessions, and optimizing the allocation of resources by the healthcare system. The current work proposes a systematic survey of existing solutions in the field of cognitive assessment and training. We evaluate the visualization and interaction technologies commonly adopted and the measures taken to fulfil the need of the pathological target populations. Moreover, we analyze how implemented solutions are validated, i.e. The chosen experimental designs, data collection and analysis. Finally, we consider the availability of the applications and raw data to the large community of researchers and medical professionals and the actual application of proposed solutions in the standard clinical practice. Despite the potential of these technologies, research is still at an early stage. Although the recent release of accessible immersive virtual reality headsets and the increasing interest on vision-based techniques for tracking body and hands movements, many studies still rely on non-immersive virtual reality (67.2%), mainly mobile and personal computers, and standard gaming tools for interactions (41.5%). Finally, we highlight that although the interest of research community in this field is increasingly higher, the sharing of dataset (10.6%) and implemented applications (3.8%) should be promoted and the number of healthcare structures which have successfully introduced the new technological approaches in the treatment of their host patients is limited (10.2%)

BRAIN COMPUTER INTERFACE (BCI) ON ATTENTION: A SCOPING REVIEW

Technological innovations are now an integral part of healthcare. Brain-computer interface (BCI) is a novel technological intervention system that is useful in restoring function to people disabled by neurological disorders such as attention deficit hyperactivity disorder (ADHD), amyotrophic lateral sclerosis (ALS), cerebral palsy, stroke, or spinal cord injury. This paper surveys the literature concerning the effectiveness of BCI on attention in subjects under various conditions. The findings of this scoping review are that studies have been made on ADHD, ALS, ASD subjects, and subjects recovering from brain and spinal cord injuries. BCI based neurofeedback training is seen to be effective in improving attention in these subjects. Some studies have also been made on healthy subjects.BCI based neurofeedback training promises neurocognitive improvement and EEG changes in the elderly. Different cognitive assessments have been tried on healthy adults.   From this review, it is evident that hardly any research has been done on using BCI for enhancing attention in post-stroke subjects. So there arises the necessity for making a study on the effects of BCI based attention training in post-stroke subjects, as attention is the key for learning motor skills that get impaired following a stroke. Currently, many researches are underway to determine the effects of a BCI based training program for the enhancement of attention in post-stroke subjects

Prefrontal cortex activation upon a demanding virtual hand-controlled task: A new frontier for neuroergonomics

open9noFunctional near-infrared spectroscopy (fNIRS) is a non-invasive vascular-based functional neuroimaging technology that can assess, simultaneously from multiple cortical areas, concentration changes in oxygenated-deoxygenated hemoglobin at the level of the cortical microcirculation blood vessels. fNIRS, with its high degree of ecological validity and its very limited requirement of physical constraints to subjects, could represent a valid tool for monitoring cortical responses in the research field of neuroergonomics. In virtual reality (VR) real situations can be replicated with greater control than those obtainable in the real world. Therefore, VR is the ideal setting where studies about neuroergonomics applications can be performed. The aim of the present study was to investigate, by a 20-channel fNIRS system, the dorsolateral/ventrolateral prefrontal cortex (DLPFC/VLPFC) in subjects while performing a demanding VR hand-controlled task (HCT). Considering the complexity of the HCT, its execution should require the attentional resources allocation and the integration of different executive functions. The HCT simulates the interaction with a real, remotely-driven, system operating in a critical environment. The hand movements were captured by a high spatial and temporal resolution 3-dimensional (3D) hand-sensing device, the LEAP motion controller, a gesture-based control interface that could be used in VR for tele-operated applications. Fifteen University students were asked to guide, with their right hand/forearm, a virtual ball (VB) over a virtual route (VROU) reproducing a 42 m narrow road including some critical points. The subjects tried to travel as long as possible without making VB fall. The distance traveled by the guided VB was 70.2 ± 37.2 m. The less skilled subjects failed several times in guiding the VB over the VROU. Nevertheless, a bilateral VLPFC activation, in response to the HCT execution, was observed in all the subjects. No correlation was found between the distance traveled by the guided VB and the corresponding cortical activation. These results confirm the suitability of fNIRS technology to objectively evaluate cortical hemodynamic changes occurring in VR environments. Future studies could give a contribution to a better understanding of the cognitive mechanisms underlying human performance either in expert or non-expert operators during the simulation of different demanding/fatiguing activities.openCarrieri, Marika; Petracca, Andrea; Lancia, Stefania; Basso Moro, Sara; Brigadoi, Sabrina; Spezialetti, Matteo; Ferrari, Marco; Placidi, Giuseppe; Quaresima, ValentinaCarrieri, Marika; Petracca, Andrea; Lancia, Stefania; BASSO MORO, Sara; Brigadoi, Sabrina; Spezialetti, Matteo; Ferrari, Marco; Placidi, Giuseppe; Quaresima, Valentin

The Effect of Volitional Fatigue on Reaction Time and Neural Activity in Concussed Individuals: A Study of Cognitive Changes Post-mTBI

Mild traumatic brain injury (mTBI) presents as an important public health concern in the United States, with an estimated 1.7 million people diagnosed annually (Diaz-Arrastia & Vos, 2014) and approximately 50% of all concussions that occur in the United States are unreported or misdiagnosed each year. The purpose of this project was to determine the extent that voluntary exhaustion exacerbates declined cognitive functioning known to exist in concussed individuals compared to non-concussed controls, additionally understanding the extent to which musculoskeletal fatigue can decrease cognition and further delay in reaction time in individuals with mild traumatic brain injuries. Twenty (N-20) participants were recruited to complete two trials of a virtual reality response time task before and after exercise to volitional fatigue. Fifteen(n=15) individuals were non-concussed with no history of concussion, and five(n=5) individuals had a history of concussion in the past year. After a 60s go/no-go task in Virtual Reality, each completed a fatiguing exercise protocol outside of virtual reality, and then repeated the VR task. Theta wave activity heatmaps revealed a significant decrease (p 0.5) in theta activity following exercise across all regions. Alpha wave activity heatmaps revealed a significant increase (p 0.1) in alpha activity following exercise across all regions was observed in the non-concussed group. A two-way repeated measures ANOVA was completed for all measures collected (Mean Score, Mean Score Accuracy[ScA], Linger Time[LT], Motor Reaction Time[MRT], and Visual Reaction Time[VRT]) across group (C=Concussed/H=Non-Concussed) and condition (Pre/Post-Exercise). Although averages among groups for Score (F(1,18) = 1.43, p > 0.05), ScA (F(1,18) = 0.633, p > 0.05), and MRT (F(1,11) = 4.59, p > 0.05) appeared to possibly be related, none of them yielded significant results. VRT (F(1,18) = 2.36, p > 0.05) and LT (F(1,18) = 0.033, p > 0.05) averages for both groups across both tasks did not yield significant effects. Despite this, a small within-subjects MRT * Group effect was found (η2 = 0.294, p = 0.055) indicating potentially practical significance. The findings of this project point to the understanding of a drastic increase in cognitive workload following fatigue in concussed individuals, indicating that those suffering from concussion experience increased utilization of cognitive resources to accurately perform the same visual and motor reaction tasks that they completed prior to exercise, while non-concussed participants experience little-to-no change following fatigue. The results demonstrate that following exercise to volitional fatigue, concussed individuals have significantly increased cognitive activity over the regions of the brain predominately involved in decision-making and reasoning skills

Cognitive Decay And Memory Recall During Long Duration Spaceflight

This dissertation aims to advance the efficacy of Long-Duration Space Flight (LDSF) pre-flight and in-flight training programs, acknowledging existing knowledge gaps in NASA\u27s methodologies. The research\u27s objective is to optimize the cognitive workload of LDSF crew members, enhance their neurocognitive functionality, and provide more meaningful work experiences, particularly for Mars missions.The study addresses identified shortcomings in current training and learning strategies and simulation-based training systems, focusing on areas requiring quantitative measures for astronaut proficiency and training effectiveness assessment. The project centers on understanding cognitive decay and memory loss under LDSF-related stressors, seeking to establish when such cognitive decline exceeds acceptable performance levels throughout mission phases. The research acknowledges the limitations of creating a near-orbit environment due to resource constraints and the need to develop engaging tasks for test subjects. Nevertheless, it underscores the potential impact on future space mission training and other high-risk professions. The study further explores astronaut training complexities, the challenges encountered in LDSF missions, and the cognitive processes involved in such demanding environments. The research employs various cognitive and memory testing events, integrating neuroimaging techniques to understand cognition\u27s neural mechanisms and memory. It also explores Rasmussen\u27s S-R-K behaviors and Brain Network Theory’s (BNT) potential for measuring forgetting, cognition, and predicting training needs. The multidisciplinary approach of the study reinforces the importance of integrating insights from cognitive psychology, behavior analysis, and brain connectivity research. Research experiments were conducted at the University of North Dakota\u27s Integrated Lunar Mars Analog Habitat (ILMAH), gathering data from selected subjects via cognitive neuroscience tools and Electroencephalography (EEG) recordings to evaluate neurocognitive performance. The data analysis aimed to assess brain network activations during mentally demanding activities and compare EEG power spectra across various frequencies, latencies, and scalp locations. Despite facing certain challenges, including inadequacies of the current adapter boards leading to analysis failure, the study provides crucial lessons for future research endeavors. It highlights the need for swift adaptation, continual process refinement, and innovative solutions, like the redesign of adapter boards for high radio frequency noise environments, for the collection of high-quality EEG data. In conclusion, while the research did not reveal statistically significant differences between the experimental and control groups, it furnished valuable insights and underscored the need to optimize astronaut performance, well-being, and mission success. The study contributes to the ongoing evolution of training methodologies, with implications for future space exploration endeavors

Cognitive Resilience to Psychological Stress in Military Personnel

Military personnel often perform complex cognitive operations under unique conditions of intense stress. This requirement to perform diverse physical and mental tasks under stress, often with high stakes, has led to recognition of the term ‘tactical athlete’ for these performers. Impaired cognitive performance as a result of this stress may have serious implications for the success of military operations and the well-being of military service men and women, particularly in combat scenarios. Therefore, understanding the nature of the stress experienced by military personnel and the resilience of cognitive functioning to this stress is of great importance. This review synthesises the current state of the literature regarding cognitive resilience to psychological stress in tactical athletes. The experience of psychological stress in military personnel is considered through the lens of the Transactional Theory of stress, while offering contemporary updates and new insights. Models of the effects of stress on cognitive performance are then reviewed to highlight the complexity of this interaction before considering recent advancements in the preparation of military personnel for the enhancement of cognitive resilience. Several areas for future research are identified throughout the review, emphasising the need for the wider use of self-report measures and mixed methods approaches to better reflect the subjective experience of stress and its impact on the performance of cognitive operations

Neuroadaptive mobile geographic information displays: an emerging cartographic research frontier

Mobility, including navigation and wayfinding, is a basic human requirement for survival. For thousands of years maps have played a significant role for human mobility and survival. Increasing reliance on digital GNSS-enabled navigation assistance, however, is impacting human attentional resources and is limiting our innate cognitive spatial abilities. To mitigate human de-skilling, a neuroadaptive (mobile) cartographic research frontier is proposed and first steps towards creating well-designed mobile geographic information displays (mGIDs) that not only respond to navigators’ cognitive load and visuo-spatial attentional resources during navigation in real-time but are also able to scaffold spatial learning while still maintaining navigation efficiency. This in turn, will help humans to remain as independent from geoinformation technology, as desired. La mobilité, dont la navigation et l'orientation, est un besoin humain fondamental pour la survie. Pendant des milliers d'années, les cartes analogiques ont joué un rôle significatif pour la mobilité humaine et sa survie. Pourtant, la dépendance grandissante vis-à-vis de l'assistance à la navigation à l'aide de données numériques GNSS, impacte les ressources de l'attention humaine et limite nos capacités innées de cognition spatiale. Pour atténuer la perte de compétence humaine, un front de recherche sur la cartographie (mobile) neuroadaptative est proposé ainsi que des premières étapes pour la création d'écrans d'informations géographiques mobile (mGID) bien conçus, qui non seulement répondent à la charge cognitive et aux ressources de l'attention visio-spatiale des utilisateurs navigateurs pendant la navigation temps-réel mais aussi qui soient capables d'élaborer un apprentissage spatial tout en assurant l'efficacité de la navigation. Cela aidera les humains à rester aussi indépendant de la technologie de l'information géographique qu'ils le souhaitent