Immersive virtual reality methods in cognitive neuroscience and neuropsychology: the Virtual Reality Everyday Assessment Lab (VR-EAL).an immersive neuropsychological test battery of everyday cognitive functions

In cognitive neuroscience and neuropsychology, the collection of cognitive and behavioural data is predominantly achieved by implementing paper-and-pencil and computerized (i.e., 2D and 3D applications) assessments. However, these psychometric tools in clinics and/or laboratories display several limitations and discrepancies between the observed performance in the laboratory/clinic and the actual performance of individuals in everyday life. The functional and predictive association between an individual's performance on a set of neuropsychological tests and the individual's performance in various everyday life settings is called ecological validity. Ecological validity is considered an important issue that cannot be resolved by the currently available assessment tools. Virtual reality head-mounted displays (HMD) appear to be effective research tools, which may address the problem of ecological validity in neuropsychological testing. However, their widespread implementation is hindered by virtual reality induced symptoms and effects (VRISE) and the lack of skills in virtual reality software development. In this PhD, a technological systematic literature review of the reasons for adverse symptomatology was conducted and suggestions and technological knowledge for the implementation of virtual reality HMD systems in cognitive neuroscience provided. The review indicated features pertinent to display, sound, motion tracking, navigation, ergonomic interactions, user experience, and computer hardware that should be considered by researchers. Subsequently, a meta-analysis of 44 neuroscientific or neuropsychological studies involving virtual reality HMD systems was performed. The meta-analysis of the virtual reality studies demonstrated that new generation HMDs induce significantly less VRISE and marginally fewer dropouts. Importantly, the commercial versions of the new generation HMDs with ergonomic interactions had zero incidents of adverse symptomatology and dropouts. HMDs equivalent to or greater than the commercial versions of contemporary HMDs accompanied with ergonomic interactions are suitable for implementation in cognitive neuroscience. Another aim of this PhD was to devise a brief tool to appraise and report both the quality of software features and VRISE intensity quantitatively; such a tool does not currently exist. The Virtual Reality Neuroscience Questionnaire (VRNQ; Kourtesis et al., 2019) was developed to assess the quality of virtual reality software in terms of user experience, game mechanics, in-game assistance, and VRISE. Forty participants aged between 28 and 43 years were recruited (18 gamers and 22 non-gamers) for the study. They participated in 3 different virtual reality sessions until they felt weary or discomfort and subsequently filled in the VRNQ. The results demonstrated that VRNQ is a valid tool for assessing virtual reality software as it has good convergent, discriminant, and construct validity. The maximum duration of virtual reality sessions should be between 55 and 70 min when the virtual reality software meets or exceeds the parsimonious cut-offs of the VRNQ, and the users are familiarized with the virtual reality system. Also, gaming experience does not affect how long virtual reality sessions should last. Furthermore, while the quality of virtual reality software substantially modulates the maximum duration of virtual reality sessions, age and education do not. Finally, deeper immersion, better quality of graphics and sound, and more helpful in-game instructions and prompts were found to reduce VRISE intensity. The VRNQ facilitates the brief assessment and reporting of the quality of virtual reality software features and/or the intensity of VRISE, while its minimum and parsimonious cut-offs may appraise the suitability of virtual reality software for implementation in research and clinical settings. However, the development of virtual reality software is predominantly dependent on third parties (e.g., freelancers or companies) with programming and software development skills. A solution that will promote the adoption of immersive virtual reality as a research and clinical tool might be the in-house development of virtual reality research/clinical software by computer science literate cognitive scientists or research software engineers. In Chapter 4, guidelines are offered for the development of virtual reality software in cognitive neuroscience and neuropsychology, by describing and discussing the stages of the development of Virtual Reality Everyday Assessment Lab (VR-EAL), the first neuropsychological battery in immersive virtual reality. Techniques for evaluating cognitive functions within a realistic storyline are discussed. The utility of various assets in Unity, software development kits, and other software are described so that cognitive scientists can overcome challenges pertinent to VRISE and the quality of the virtual reality software. In addition, VR-EAL is evaluated in accordance with the necessary criteria for virtual reality software for research purposes. The virtual reality neuroscience questionnaire (VRNQ) was implemented to appraise the quality of the three versions of VR-EAL in terms of user experience, game mechanics, in-game assistance, and VRISE. Twenty-five participants aged between 20 and 45 years with 12–16 years of full-time education evaluated various versions of VR-EAL. The final version of VR-EAL achieved high scores in every sub-score of the VRNQ and exceeded its parsimonious cut-offs. It also appeared to have better in-game assistance and game mechanics, while its improved graphics substantially increased the quality of the user experience and almost eradicated VRISE. The results substantially support the feasibility of the development of effective virtual reality research and clinical software without the presence of VRISE during a 60-min virtual reality session. In Chapter 5, validation of VR-EAL as an assessment of prospective memory, episodic memory, attention, and executive functions using an ecologically valid approach is examined. Performance on the VR-EAL, an immersive virtual reality neuropsychological battery, is examined against an extensive paper-and-pencil neuropsychological battery. Forty-one participants (21 females) were recruited: 18 gamers and 23 non-gamers who attended both an immersive virtual reality and a paper-and-pencil testing session. Bayesian Pearson correlation analyses were conducted to assess construct and convergent validity of the VR-EAL. Bayesian t-tests were performed to compare virtual reality and paper-and-pencil testing in terms of administration time, similarity to real life tasks (i.e., ecological validity), and pleasantness. VR-EAL scores were significantly correlated with their equivalent scores on the paper-and-pencil tests. The participants’ reports indicated that the VR-EAL tasks were considered significantly more ecologically valid and pleasant than the paper-and-pencil neuropsychological battery. The VR-EAL battery also had a shorter administration time. The VR-EAL appears to be an effective neuropsychological tool for the assessment of everyday cognitive functions, and has enhanced ecological validity, a highly pleasant testing experience, and does not induce cybersickness. In the final part of this thesis, the preparatory attentional and memory (PAM) and the multiprocess theories of prospective memory are examined by attempting to identify the cognitive functions which may predict the individual’s performance on ecologically valid prospective memory tasks in the same group of participants described in Chapter 5. Bayesian t-tests were conducted to explore the differences among different prospective memory tasks (e.g., event-based and time-based) and prospective memory tasks with varying delays between encoding and the recall of the intended action (e.g., short-delay versus long-delay). Bayesian linear regression analyses were performed to examine the predictors of VR-EAL scores. The results revealed that the type of prospective memory task does not play a significant role in everyday prospective memory functioning, but instead the length of delay between encoding and retrieving the prospective memory intention plays a central role. Support for the PAM and MP frameworks was found in non-focal and focal event-based tasks respectively. However, the findings, inferring a dynamic interplay between automatic and intentional monitoring and retrieval processes, agree with the inclusive approach of the multiprocess framework. Also, the role of executive functions appears crucial in everyday PM. Finally, everyday PM is predominantly facilitated by episodic memory, visuospatial attention, auditory attention, and executive functions. In conclusion, this PhD thesis attempted to show how immersive virtual reality research methods may be implemented efficiently without the confounding effect of cybersickness symptomatology in order to enhance the ecological validity of neuropsychological testing and contribute to our understanding of everyday cognitive ability

How immersive virtual reality methods may meet the criteria of the National Academy of Neuropsychology and American Academy of Clinical Neuropsychology:A software review of the Virtual Reality Everyday Assessment Lab (VR-EAL)

International audienceClinical tools involving immersive virtual reality (VR) may bring several advantages to cognitive neuroscience and neuropsychology. However, there are some technical and methodological pitfalls. The American Academy of Clinical Neuropsychology (AACN) and the National Academy of Neuropsychology (NAN) raised 8 key issues pertaining to Computerized Neuropsychological Assessment Devices. These issues pertain to: (1) the safety and effectivity; (2) the identity of the end-user; (3) the technical hardware and software features; (4) privacy and data security; (5) the psychometric properties; (6) examinee issues; (7) the use of reporting services; and (8) the reliability of the responses and results. The VR Everyday Assessment Lab (VR-EAL) is the first immersive VR neuropsychological battery with enhanced ecological validity for the assessment of everyday cognitive functions by offering a pleasant testing experience without inducing cybersickness. The VR-EAL meets the criteria of the NAN and AACN, addresses the methodological pitfalls, and brings advantages for neuropsychological testing. However, there are still shortcomings of the VR-EAL, which should be addressed. Future iterations should strive to improve the embodiment illusion in VR-EAL and the creation of an open access VR software library should be attempted. The discussed studies demonstrate the utility of VR methods in cognitive neuroscience and neuropsychology

Virtual reality for the assessment of everyday cognitive functions in older adults: an evaluation of the virtual reality action test and two interaction devices in a 91-year-old woman

Performance-based functional tests for the evaluation of daily living activities demonstrate strong psychometric properties and solve many of the limitations associated with self- and informant-report questionnaires. Virtual reality (VR) technology, which has gained interest as an effective medium for administering interventions in the context of healthcare, has the potential to minimize the time-demands associated with the administration and scoring of performance-based assessments. To date, efforts to develop VR systems for assessment of everyday function in older adults generally have relied on non-immersive systems. The aim of the present study was to evaluate the feasibility of an immersive VR environment for the assessment of everyday function in older adults. We present a detailed case report of an elderly woman who performed an everyday activity in an immersive VR context (Virtual Reality Action Test) with two different types of interaction devices (controller vs. sensor). VR performance was compared to performance of the same task with real objects outside of the VR system (Real Action Test). Comparisons were made on several dimensions, including (1) quality of task performance (e.g., order of task steps, errors, use and speed of hand movements); (2) subjective impression (e.g., attitudes), and (3) physiological markers of stress. Subjective impressions of performance with the different controllers also were compared for presence, cybersickness, and usability. Results showed that the participant was capable of using controllers and sensors to manipulate objects in a purposeful and goal-directed manner in the immersive VR paradigm. She performed the everyday task similarly across all conditions. She reported no cybersickness and even indicated that interactions in the VR environment were pleasant and relaxing. Thus, immersive VR is a feasible approach for function assessment even with older adults who might have very limited computer experience, no prior VR exposure, average educational experiences, and mild cognitive difficulties. Because of inherent limitations of single case reports (e.g., unknown generalizability, potential practice effects, etc.), group studies are needed to establish the full psychometric properties of the Virtual Reality Action Test

The assessment and rehabilitation of prospective memory problems in people with neurological disorders: A review

People with neurological disorders often report difficulty with prospective memory (PM), that is, remembering to do things they had intended to do. This paper briefly reviews the literature regarding the neuropsychology of PM function, concluding that from the clinical perspective, PM is best considered in terms of its separable but interacting mnemonic and executive components. Next, the strengths and limitations in the current clinical assessment of PM, including the assessment of component processes, desktop analogues of PM tasks, and naturalistic PM tasks, are outlined. The evidence base for the rehabilitation of PM is then considered, focusing on retraining PM, using retrospective memory strategies, problem-solving training, and finally, electronic memory aids. It is proposed that further research should focus on establishing the predictive validity of PM assessment, and refining promising rehabilitation techniques

Novel supports to the assessment of cognitive functions through the combined use of technologies and subjective and objective measurements

Tesis por compendio[ES] Las funciones cognitivas incluyen todos los procesos a través de los cuales un individuo percibe, registra, mantiene, manipula, usa y expresa información que está involucrada en cualquier actividad cotidiana. Las principales herramientas estandarizadas se pueden dividir en tres grupos principales: escalas cortas de pruebas de seguimiento cognitivo: cuestionarios, baterías neuropsicológicas generales y pruebas específicas. Estas herramientas están bien validadas y son confiables, pero, en la última década, varias investigaciones han demostrado que algunos pacientes pueden realizar bien estas pruebas neuropsicológicas, incluso cuando tienen dificultades significativas para adaptar sus comportamientos a las actividades de la vida diaria. De acuerdo con esto, más recientemente, un nuevo enfoque ha aumentado sustancialmente, lo que podría proporcionar una mayor validez ecológica en la evaluación de las capacidades cognitivas funcionales que el enfoque estandarizado: el uso de sistemas tecnológicos avanzados para la evaluación neuropsicológica (STAEN). STAEN se refiere a un conjunto de dispositivos y aplicaciones de software tales como pruebas computarizadas, juegos divertidos e interactivos de fantasía (JS) y / o sistemas de realidad virtual simulada (RV) y / o aumentada (RA) que van más allá de las pruebas de evaluación tradicionales y que Brindar la posibilidad de entregar estímulos controlados y dinámicos, en entornos ecológicamente válidos y seguros. Partiendo de estas premisas, el objetivo principal de la tesis era diseñar, desarrollar y validar un SG 2D no inmersivo versus un JS 3D inmersivo y una actividad de la vida diaria en un entorno 3D RV inmersivo versus un RA para la evaluación de funciones cognitivas, comparando la eficacia y efectividad de ellos. El primer estudio 2D incluyó 354 sujetos sanos y se encontraron correlaciones entre el juego y los métodos tradicionales, lo que sugiere que el juego podría ser una herramienta válida para evaluar las funciones cognitivas en adultos. El segundo estudio, comparó la versión 2D versus una versión 3D STAEN, involucró a 94 sujetos sanos y mostró que la versión 3D fue capaz de generar tiempos más bajos y respuestas correctas más altas que la 2D, lo que sugiere evidencia inicial de la eficacia de un sistema más inmersivo en comparación con un sistema no-inmersivo. Aunque este resultado destaca una posible limitación en el uso de diferentes sistemas tecnológicos debido a las diferencias en los dos métodos de interacción (el sistema 2D aplicó el mouse y el teclado; los controladores de dos manos virtuales 3D) y el registro de datos de latencia de hardware y software. Con respecto a la variabilidad individual en edad, género y educación, los hallazgos mostraron consistencia con la literatura de referencia. Específicamente, los más jóvenes mostraron un mayor rendimiento que los mayores; niveles educativos más altos reflejados en una mejor puntuación y sobre género, los resultados mostraron un panorama más compuesto. Además, para mejorar la validez ecológica de la evaluación, el último estudio de esta tesis comparó el rendimiento conductual y las respuestas fisiológicas, durante una tarea de cocina ecológica, entre un sistema virtual y un sistema aumentado en 50 sujetos sanos. La tarea de cocinar consistió en 4 niveles que aumentaron en dificultad. A medida que el nivel aumentó, aparecieron actividades adicionales. Los resultados de comportamiento mostraron que los tiempos son siempre más bajos en realidad virtual que en RA, aumentando constantemente de acuerdo con la dificultad de las tareas. Con respecto a las respuestas fisiológicas, los hallazgos mostraron que la condición RA produjo más excitación y activación individual que la realidad virtual. Para concluir, STAEN está demostrando ser herramientas confiables y efectivas para la evaluación de las funciones cognitivas en adultos, proporcionando más validez ec[CA] Les funcions cognitives inclouen tots els processos a través dels quals un individu percep, registra, manté, manipula, usa i expressa informació que està involucrada en qualsevol activitat quotidiana. Les principals ferramentes estandarditzades es poden dividir en tres grups principals: escales curtes de proves de seguiment cognitiu: qüestionaris, bateries neuropsicológiques generals i proves específiques. Estes ferramentes estan ben validades i són confiables, però, en l'última dècada, diverses investigacions han demostrat que alguns pacients poden realitzar bé estes proves neuropsicológiques, inclús quan tenen dificultats significatives per a adaptar els seus comportaments a les activitats de la vida diària. D'acord amb açò, més recentment, un nou enfocament ha augmentat substancialment, la qual cosa podria proporcionar una major validesa ecològica en l'avaluació de les capacitats cognitives funcionals que l'enfocament estandarditzat: l'ús de sistemes tecnològics avançats per a l'avaluació neuropsicológica (STAEN). STAEN es referix a un conjunt de dispositius i aplicacions de software com ara proves computaritzades, jocs divertits i interactius de fantasia (JS) i / o sistemes de realitat virtual simulada (RV) i / o augmentada (RA) que van més enllà de les proves d'avaluació tradicionals i que brinden la possibilitat de presentar estímuls controlats i dinàmics, en entorns ecològicament vàlids i segurs. Partint d'estes premisses, l'objectiu principal de la tesi era dissenyar, desenrotllar i validar un SG 2D no inmersiu versus un JS 3D inmersiu i una activitat de la vida diària en un entorn 3D RV inmersiu versus un RA per a l'avaluació de funcions cognitives, comparant l'eficàcia i efectivitat d'ells. El primer estudi 2D va incloure 354 subjectes sans i es van trobar correlacions entre el joc i els mètodes tradicionals, la qual cosa suggerix que el joc podria ser una ferramenta vàlida per a avaluar les funcions cognitives en adults. El segon estudi, va comparar la versió 2D versus una versió 3D STAEN, va involucrar a 94 subjectes sans i va mostrar que la versió 3D va ser capaç de generar temps més baixos i respostes correctes més altes que la 2D, la qual cosa suggerix evidència inicial de l'eficàcia d'un sistema més inmersiu en comparació amb un sistema no-inmersiu. Encara que este resultat destaca una possible limitació en l'ús de diferents sistemes tecnològics a causa de les diferències en els dos mètodes d'interacció (el sistema 2D va aplicar el ratolí i el teclat; els controladors de dos mans virtuals 3D) i el registre de dades de latència de hardware i software. Respecte a la variabilitat individual en edat, gènere i educació, les troballes van mostrar consistència amb la literatura de referència. Específicament, els més jóvens van mostrar un major rendiment que els majors; nivells educatius més alts reflectits en una millor puntuació i sobre gènere, els resultats van mostrar un panorama més compost. A més, per a millorar la validesa ecològica de l'avaluació, l'últim estudi d'esta tesi va comparar el rendiment conductual i les respostes fisiològiques, durant una tasca de cuina ecològica, entre un sistema virtual i un sistema augmentat en 50 subjectes sans. La tasca de cuinar va consistir en 4 nivells que van augmentar en dificultat. A mesura que el nivell va augmentar, van aparéixer activitats addicionals. Els resultats de comportament van mostrar que els temps són sempre més baixos en realitat virtual que en RA, augmentant constantment d'acord amb la dificultat de les tasques. Respecte a les respostes fisiològiques, les troballes van mostrar que la condició RA va produir més excitació i activació individual que la realitat virtual. Per a concloure, STAEN està demostrant ser ferramentes confiables i efectives per a l'avaluació de les funcions cognitives en adults, proporcionant més validesa ecològica i objectivitat que els mètodes tradicio[EN] Cognitive functions include all the processes through which an individual perceives, records, maintains, manipulates, uses and expresses information that are involved in any everyday activity. The main standardized tools can be divided in three main groups: short scales of cognitive tracking tests - questionnaires, general neuropsychological batteries, and specific tests. These tools are well-validated and reliable but, in the last decade, several research have shown that some patients can perform these neuropsychological tests well, even when they have significant difficulties in adapting their behaviours to daily life activities. According to this, more recently, a new approach has substantially increased, potentially providing a higher ecological validity in functional cognitive abilities assessment than standardized approach: the use of advanced technological systems for neuropsychological assessment (ATSNA). ATSNA refer to a set of devices and software applications such as computerized tests, fun and interactive fantasy serious games (SG), and/or simulated virtual (VR) and/or augmented (AR) reality systems that go beyond traditional assessment tests and that supply the possibility to deliver controlled and dynamic stimuli, in ecologically valid, and secure environments. Starting from these premises, the main objective of the thesis was to design, develop, and validate a non-immersive 2D SG versus an immersive 3D SG and a daily life activity in an immersive 3D VR environment versus an AR for the assessment of cognitive functions, comparing the efficacy and effectiveness of them. The first 2D study involved 354 healthy subjects and correlations were found between the game and traditional methods, suggesting that the game could be a valid tool for assessing cognitive functions in adults. The second study, compared 2D versus a 3D ATSNA version, it involved 94 healthy subjects and showed that 3D version was able to generate lower times and higher correct answers that the 2D, suggesting initial evidence of efficacy of a more immersive system compared to a non-immersive system. Although this result highlights a potential limitation on using different technological systems due to the differences on the two interaction methods (the 2D system applied mouse and keyboard; the 3D two virtual hands' controllers) and hardware and software latency data recording. Regarding individual variability on age, gender, and education, the findings showed consistency with the reference literature. Specifically, younger showed higher performance that older; higher educational levels reflected on a better score and about gender, results showed a more composite panorama. Furthermore, to enhance the ecological validity of assessment, the last study of this thesis compared the behavioural performance and physiological responses, during an ecological cooking task, between a virtual and an augmented system on 50 healthy subjects. The cooking task consisted of 4 levels that increased in difficulty. As the level increased, additional activities appeared. The behavioural results showed that times are always lower in VR than in AR, increasing constantly in accordance with the difficulty of the tasks. Regarding physiological responses, the findings showed that AR condition produced more individual excitement and activation than VR. To conclude, ATSNA are proving to be reliable and effective tools for the assessment of cognitive functions in adults, providing more ecological validity and objectivity than traditional methods of assessment.Chicchi Giglioli, IAM. (2020). Novel supports to the assessment of cognitive functions through the combined use of technologies and subjective and objective measurements [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/139075TESISCompendi

Brain Drain Or Brain Gain? Cognitive Skill Training With Novice Video Game Players With Casual Video Games

Video game playing (vgp) has become a popular and widespread form of entertainment over the past two decades. This form of media is now popular with children, adolescents, and adults alike. While most early research on the effects of vgp focused on the relation of violence in video games and expressions of aggression, more recent research has begun to explore possible beneficial effects of vgp. Study results have been inconsistent, with some suggesting that vgp may improve various cognitive skills such as spatial skills, attentional skills, executive control, and problem solving. Other studies refute or qualify these findings. Additionally, different types of games have been related to improvements in differing cognitive skills. A lack of consistency in vgp training programs and an abundance of correlational rather than causational studies have made interpretation of vgp training results murky at best. The current study aimed to clarify possible causal relationships between vgp and changes in cognitive skill. Novice game players were trained on two different vgp genres (strategy and action-shooter) and administered pre- and post-test batteries of cognitive skill. Forty-nine female participants played 20 hours of a randomly assigned video-game over the course of ten weeks and completed multiple cognitive skills tests pre- and post-study. Individuals who played the first-person shooter-style game exhibited significant improvements in attention, working memory, visuospatial skills, processing speed, and problem-solving. Individuals playing the strategy style game demonstrated significant improvements in working memory, problem-solving, and visuospatial skills as well. Both groups exhibited a decline in self-reported willingness to engage in social conversation following the training paradigm but no cognitive skill declines were observed. These findings have implications for the utility of commercial video-games as a cognitive skill building tool. They also support the potential efficacy of electronic media as a potentially useful means of addressing cognitive deficits while also remaining highly engaging and motivating for individuals to utilize

Évaluer la réalisation d’une intention avec le Virtual Multitasking Test 3e édition : une étude de validité du construit

Essai doctoral présenté à la Faculté des arts et des sciences en vue de l'obtention du grade de Doctorat en Psychologie, option neuropsychologie clinique (D. Psy)Problématique : La mémoire prospective (MP) est un processus cognitif complexe qui implique de se souvenir de réaliser une intention dans le futur (Ellis, 1996). La MP est reconnue pour sa contribution à l’autonomie et à la sécurité de la personne dans la vie quotidienne. Ainsi, dans plusieurs contextes cliniques, dépister les troubles de la MP pourrait avoir une utilité pronostique et thérapeutique. Or, les tests neuropsychologiques traditionnels ne reflètent pas assez bien la complexité des tâches quotidiennes. La réalité virtuelle (RV) apparaît être une alternative intéressante, étant donné les protocoles d'évaluation écologiquement valides qu’elle permet d’élaborer. Dans cette foulée, le Virtual Multitasking Test-3 (VMT-3), un appartement tridimensionnel, permet d’évaluer la MP grâce à plusieurs types de tâches similaires au quotidien. Objectif : L’objectif de cette recherche était de valider le VMT-3 sur plan du construit en le comparant avec deux outils standardisés, et reconnus comme étant écologiques, soit le Rivermead Behavioural Memory Test-3 (RBMT-3) et le Cambridge Prospective Memory Test (CAMPROMPT). Méthode : L’échantillon final comprenait 102 participants sains, dont 48 femmes et 54 hommes d’une moyenne d’âge de 41 ans. Nous avons comparé les performances des sujets à des épreuves traditionnelles de MP et de mémoire épisodique (ME), ainsi que dans le VMT-3. Résultats : Les corrélations issues de la présente étude ont principalement révélé des liens significatifs entre les indices du VMT-3 et les indices de ME et de MP du RBMT-3. Le CAMPROMPT est quant à lui seulement corrélé avec les tâches event-based du VMT-3. Conclusion : Ces résultats suggèrent que le VMT-3 propose des indices valides de MP de type EB. Des recherches supplémentaires sont nécessaires afin de poursuivre cette étude de validation. L’interprétation des résultats suggère que la réalisation du VMT-3 est possible grâce à un amalgame de fonctions cognitives, dont la MP, les fonctions exécutives et le multitasking. Nous suggérons que le VMT-3 soit maintenant comparé à des tests neuropsychologiques écologiques qui évaluent le multitasking.Background: Prospective memory (PM) is a complex cognitive process which involves remembering realizing an intention in the future (Ellis, 1996). PM is recognized for its implication on autonomy and safety of the person in everyday life. In several clinical contexts, detecting PM disorders could have a therapeutic utility. Yet, the traditional neuropsychological tests do not represent well enough the complexity of daily tasks. However, virtual reality represents an interesting alternative given its good ecological validity. Virtual Multitasking Test-3 (VMT-3), a three-dimensional apartment, helps to estimate PM thanks to several everyday life tasks. Objective: The objective of this research is to validate the VMT-3 on a theoretical plan by comparing it with two standardized neuropsychological tests that are recognized as being ecological (RBMT-3 and CAMPROMPT). Method: The final sample involves 102 healthy participants, among whom 48 women and 54 men with an average age of 41. We compared the subjects’ performance using traditional tests of PM and episodic memory (EM) as well as the VMT-3. Results: The correlations of this present study found significant links between index of the VMT-3 and index of ME and MP part of the RBMT-3. The CAMPROMPT was only correlated with event-based index of the VMT-3. Conclusion: The VMT-3 proposes valid indications of PM (event-based type). Future research is necessary to continue this validation study. The results’ interpretation suggests that the realization of the VMT-3 is possible thanks to some cognitive functions, among which the PM, the executive functions and the multitasking. We suggest that the VMT-3 should be compared with ecological neuropsychological tests which evaluate multitasking abilities

Editorial: Executive function(s): Conductor, Orchestra or Symphony? Towards a Trans-Disciplinary Unification of Theory and Practice Across Development, in Normal and Atypical Groups

There are several theories of executive function(s) that tend to share some theoretical overlap yet are also conceptually distinct, each bolstered by empirical data (Norman and Shallice, 1986; Shallice & Burgess, 1991; Stuss and Alexander, 2007; Burgess, Gilbert, & Dumentheil, 2007; Burgess & Shallice, 1996; Miyake et al., 2000). The notion that executive processes are supervisory, and most in demand in novel situations was an early conceptualization of executive function that has been adapted and refined over time (Norman & Shallice, 1986; Shallice, 2001; Burgess, Gilbert & Dumentheil, 2007). Presently there is general consensus that executive functions are multi-componential (Shallice, 2001), and are supervisory only in the sense that attention in one form or another is key to the co-ordination of other hierarchically organized ‘lower’ cognitive processes. Attention in this sense is defined as (i) independent but interrelated attentional control processes (Stuss & Alexander, 2007); (ii) automatic orientation towards stimuli in the environment or internally–driven thought (Burgess, Gilbert & Dumontheil, 2007); (iii) the automatically generated interface between tacit processes and strategic conscious thought (Barker, Andrade, Romanowski, Morton and Wasti, 2006; Morton and Barker, 2010); and (iv) distinct but interrelated executive processes that maintain, update and switch across different sources of information (Miyake et al., 2000). One problem is that executive dysfunction or dysexecutive syndrome (Baddeley & Wilson, 1988) after brain injury typically produces a constellation of deficits across social, cognate, emotional and motivational domains that rarely map neatly onto theoretical frameworks (Barker, Andrade & Romanowski, 2004). As a consequence there is debate that conceptual theories of executive function do not always correspond well to the clinical picture (Manchester, Priestley & Jackson, 2004). Several studies have reported cases of individuals with frontal lobe pathology and impaired daily functioning despite having little detectable impairment on traditional tests of executive function (Shallice & Burgess, 1991; Eslinger & Damasio, 1985; Barker, Andrade & Romanowski, 2004; Andrés & Van der Linden, 2002; Chevignard et al., 2000; Cripe, 1998; Fortin, Godbout & Braun, 2003). There is also some suggestion that weak ecological validity limits predictive and clinical utility of many traditional measures of executive function (Burgess et al, 2006; Lamberts, Evans & Spikman, 2010; Barker, Morton, Morrison, McGuire, 2011). Complete elimination of environmental confounds runs the risk of generating results that cannot be generalized beyond constrained circumstances of the test environment (Barker, Andrade & Romanowski, 2004). Several researchers have concluded that a new approach is needed that is mindful of the needs of the clinician yet also informed by the academic debate and progress within the discipline (McFarquhar & Barker, 2012; Burgess et al., 2006). Finally, translational issues also confound executive function research across different disciplines (psychiatry, cognitive science, and developmental psychology) and across typically developing and clinical populations (including Autism Spectrum Disorders, Head Injury and Schizophrenia – Blakemore & Choudhury, 2006; Taylor, Barker, Heavey & McHale, 2013). Consequently, there is a need for unification of executive function approaches across disciplines and populations and narrowing of the conceptual gap between theoretical positions, clinical symptoms and measurement

A Novel Ecological Approach Reveals Early Executive Function Impairments in Huntington’s Disease

Introduction: Impairments in executive functions are common in neurogenetic disorders such as Huntington’s disease (HD) and are thought to significantly influence the patient’s functional status. Reliable tools with higher ecological validity that can assess and predict the impact of executive dysfunction in daily-life performance are needed. This study aimed to develop and validate a novel non-immersive virtual reality task (“EcoKitchen”) created with the purpose of capturing cognitive and functional changes shown by HD carriers without clinical manifestations of the disease (Premanifest HD), in a more realistic setting.Materials and Methods: We designed a virtual reality task with three blocks of increasing executive load. The performance of three groups (Controls, CTRL; Premanifest HD individuals, HP; Early Manifest HD patients, HD) was compared in four main components of the study protocol: the EcoKitchen; a subjective (self-report) measure – “The Adults and Older Adults Functional Assessment Inventory (IAFAI)”; the “Behavioural Assessment of Dysexecutive Syndrome battery (BADS)”; and a conventional neuropsychological test battery. We also examined statistical associations between EcoKitchen and the other executive, functional and clinical measures used.Results: The HD group showed deficits in all the assessment methods used. In contrast, the HP group was only found to be impaired in the EcoKitchen task, particularly in the most cognitively demanding blocks, where they showed a higher number of errors compared to the CTRL group. Statistically significant correlations were identified between the EcoKitchen, measures of the other assessment tools, and HD clinical features.Discussion: The EcoKitchen task, developed as an ecological executive function assessment tool, was found to be sensitive to early deficits in this domain. Critically, in premanifest HD individuals, it identifies dysfunction prior to symptom onset. Further it adds a potential tool for diagnosis and management of the patients’ real-life problems