The VESPA Project: Virtual Reality Interventions for Neurocognitive and Developmental Disorders

VESPA is a financed project supported by the Sicilian Regional Research and Development funds, and it is structured by the development, research and validation of Virtual Reality (VR) based application for the diagnosis and treatment of neurocognitive conditions. In particular, this article presents its characteristics, referred to as the first (2013-2015) and second (2021-ongoing) generations of VESPA, with particular reference to literature regarding the VR technology application and development, the VR treatment of neurocognitive conditions and prior versions of this intervention. Through a comprehensive review of the research conducted over the last 5 years, evidence has emerged supporting VESPA’s aim and scopes, highlighting how the application of VR can be considered to add value to typical rehabilitation/therapeutic paths. VESPA project generations are then presented in detail, including specific session/task battery characteristics, 2.5D, 3D and 5D typologies, system usability and architecture and pathological domain-based dynamics and features. The discussion about VESPA will highlight the current advantages along with limitations and future directions

Virtual Reality to Stimulate Cognitive Behavior of Alzheimer's and Dementia Patients

Seniority and Alzheimer’s and dementia’s diseases lead to progressive cognitive impairment. The exploitation of Virtual Reality is investigated to test innovative entertainment and therapeutic activities that can provide new stimuli and interests for patients. The game approach activates mechanisms able to train memory and energize the mind through visuospatial and sound inputs. A full-immersive application has been developed to allow the patient to perform this kind of experience at home for daily training, becoming short therapeutic cycles, thanks to the affordability, the transportability and the flexibility of the infrastructure put in place. The cognitive path foresees successive levels of interaction, alternating relaxing and inspiring settings and exercises. It can improve the quality of life by learning to manage and monitor actions and feelings. In this way, these kind of experience can generate positive benefits not only for those who show fragility, but also for their families in addition to a tool to support health workers for diagnostics and training

A study of virtual reality-mediated affective state and cognitive decline in Alzheimer’s disease

NeuroscienceLa démence de type d’Alzheimer est la plus commune des démences. Elle entraîne un déclin dans les capacités cognitives et fonctionnelles, se traduisant dans des difficultés au niveau de la prise de décision, de l’accomplissement de tâches quotidiennes, de la communication ainsi qu’au niveau de la mémoire et de l’attention. On remarque également une diminution de l’état émotionnel et une apathie chez ces patients. Ce mémoire explore une nouvelle approche pour atténuer les effets psychologiques et cognitifs de la maladie. Les recherches effectuées dans ce mémoire explorent les impacts cognitifs et les effets sur le bien-être d'une intervention utilisant la réalité virtuelle sur les personnes souffrant de déclin cognitif subjectif. Deux environnements virtuels ont été testés : le premier étant un environnement dans lequel le participant voyage en train à travers différents climats, et le second étant un environnement de musicothérapie qui s’adapte en fonction de la réponse émotionnelle du participant. Pour mesurer les impacts sur l'état affectif, des lectures électroencéphalographiques ont été prises et analysées afin de déduire l'émotion ressentie par le participant avant, pendant et après l'expérience. Les résultats montrent une amélioration générale de l'état émotionnel pour les deux environnements. Quant à la mesure des effets sur les fonctions cognitives, des tâches d'attention et de mémoire ont été effectuées par les participants avant et après l'immersion. Les résultats montrent une légère amélioration des capacités d'attention et une meilleure amélioration de la mémoire. Nous approprions cet écart dans l'expérience de musicothérapie à l'activation musicale d'un réseau de structures cérébrales impliquées dans les expériences agréables : le circuit de récompense. Nous proposons que la musique facilite la rétention de la mémoire chez les personnes souffrant de démence. En effet, les résultats de l’amélioration des fonctions cognitives pour les deux expériences précédentes dépendent fortement de la précision de l'outil de mesure cognitive utilisé pour évaluer les performances d'attention et de mémoire avant et après l'intervention. Pour assurer cette précision, ce mémoire présente un outil de mesure des performances cognitives basé sur des tâches cognitives qui ont montré à plusieurs reprises leur fiabilité. Cet outil d’adresse aux personnes atteintes de la maladie d'Alzheimer pré-clinique et diagnostiquée.Alzheimer’s disease is an irreversible disease which causes progressive memory loss and cognitive decline, eventually leading to severe inability to perform basic day-to-day tasks. The urgency to find an effective cure to the disease is crucial, as the medical and economical spin-offs could be disastrous. The present thesis explores a novel approach to help attenuate the psychological and cognitive effects of the disease. The research carried out for this thesis explored cognitive effects and impacts on overall well-being of a virtual reality intervention on people suffering from subjective cognitive decline. Two virtual environments were tested: the first being an environment in which the participant travels through different climates by train, and the second being a music therapy environment modified as a function of emotional response. To measure the effects on affective state, electroencephalography readings were taken and analyzed to infer the emotion felt by the participant before, during the experiment. Results show a general improvement in emotional state. To measure the effects of the environments on cognitive functions, attention and memory tasks were carried out by the participants before and after the immersion. Results show a small improvement in attention skills and a more substantial improvement in memory skills. We appropriate this discrepancy in the music therapy experiment to the musical activation of a network of brain structures involved in rewarding and pleasurable experiences. We propose that music could facilitate memory retention in people sufferance for dementia. Importantly, the results of the previous experiments rely heavily on the accuracy of the cognitive measurement tool used to evaluate attention and memory performances before and after the intervention. To provide this accuracy, this thesis presents a cognitive performance measurement tool based on cognitive tasks which have repeatedly shown to output reliable results. This tool is created to serve for people with pre-clinical Alzheimer’s disease and diagnosed Alzheimer’s disease. Additionally, this tool is designed in such a way as to minimize the effects of repetition as well as varying levels of education and language. This thesis presents a novel and promising research in the realms of computer sciences and health care

The effectiveness of virtual reality interventions for improvement of neurocognitive performance post-traumatic brain injury: a systematic review

Objective: To evaluate current evidence for the effectiveness of virtual reality (VR) interventions in improving neurocognitive performance in individuals who have sustained a traumatic brain injury (TBI). Methods: A systematic literature search across multiple databases (PubMed, EMBASE, Web of Science) for articles of relevance. Studies were evaluated according to study design, patient cohort, VR intervention, neurocognitive parameters assessed, and outcome. VR interventions were evaluated qualitatively with respect to methodology and extent of immersion and quantitatively with respect to intervention duration. Outcomes: Our search yielded 324 articles, of which only 13 studies including 132 patients with TBI met inclusion criteria. A wide range of VR interventions and cognitive outcome measures is reported. Cognitive measures included learning and memory, attention, executive function, community skills, problem solving, route learning, and attitudes about driving. Several studies (n = 10) reported statistically significant improvements in outcome, and 2 studies demonstrated successful translation to real-life performance. Conclusions: VR interventions hold significant potential for improving neurocognitive performance in patients with TBI. While there is some evidence for translation of gains to activities of daily living, further studies are required to confirm the validity of cognitive measures and reliable translation to real-life performance

Technology and dementia: the future is now

Background: Technology has multiple potential applications to dementia from diagnosis and assessment to care delivery and supporting ageing in place. Objectives: To summarise key areas of technology development in dementia and identify future directions and implications. Method: Members of the US Alzheimer’s Association Technology Professional Interest Area involved in delivering the annual pre-conference summarised existing knowledge on current and future technology developments in dementia. Results: The main domains of technology development are as follows: (i) diagnosis, assessment and monitoring, (ii) maintenance of functioning, (iii) leisure and activity, (iv) caregiving and management. Conclusions: The pace of technology development requires urgent policy, funding and practice change, away from a narrow medical approach, to a holistic model that facilitates future risk reduction and pre- vention strategies, enables earlier detection and supports implementation at scale for a meaningful and fulfilling life with dementia

MOBEEZE. Natural Interaction Technologies, Virtual Reality and Artificial Intelligence for Gait Disorders Analysis and Rehabilitation in Patients with Parkinson's Disease

Parkinson's Disease (PD) is the most common degenerative disorder after Alzheimer's disease. Generally affecting elderly groups, it has a strong limiting effect on physical functioning and performance of roles, vitality and general perception of health. Since the disease is progressive, the patient knows he's going to get worse. The deterioration is significant not only in mobility but also in pain, social isolation, and emotional reactions. Freezing is a phenomenon associated with this disease and it is characterized by a motor disorder that leaves the patient literally stuck to the ground. Mobeeze is designed with the main objective of providing health personnel with a tool to analyse, evaluate and monitor the progress of patients’ disorders as well as the personalization and adaptation of rehabilitation sessions in patients with Parkinson's disease. Based on the characteristics measured in real time which will allow the strengthening effects of rehabilitation and help to assimilate them in the long term. The creation of Mobeeze allows the constitution of a system of analysis and evaluation of march disorders in real time, through natural interaction, virtual reality and artificial intelligence. In this project, we will analyse if these non-invasive technologies reduce the stress induced to the patient when he is feeling evaluated

Assistive technologies to address capabilities of people with dementia: from research to practice

Assistive technologies (AT) became pervasive and virtually present in all our life domains. They can be either an enabler or an obstacle leading to social exclusion. The Fondation Médéric Alzheimer gathered international experts of dementia care, with backgrounds in biomedical, human and social sciences, to analyse how AT can address the capabilities of people with dementia, on the basis of their needs. Discussion covered the unmet needs of people with dementia, the domains of daily life activities where AT can provide help to people with dementia, the enabling and empowering impact of technology to improve their safety and wellbeing, barriers and limits of use, technology assessment, ethical and legal issues. The capability approach (possible freedom) appears particularly relevant in person-centered dementia care and technology development. The focus is not on the solution, rather on what the person can do with it: seeing dementia as disability, with technology as an enabler to promote capabilities of the person, provides a useful framework for both research and practice. This article summarizes how these concepts took momentum in professional practice and public policies in the past fifteen years (2000-2015), discusses current issues in the design, development and economic model of AT for people with dementia, and covers how these technologies are being used and assessed