Effect of Cognitive Training in Fully Immersive Virtual Reality on Visuospatial Function and Frontal-Occipital Functional Connectivity in Predementia: Randomized Controlled Trial
| Autor: | Jae Myeong Kang, Jung Hae Youn, Nambeom Kim, Sook Young Lee, Seungho Ryu, Jung Woon Park, Jun-Young Lee, Geumjin Park, Soo Kyun Woo, Byeong Kil Yeon, Seong Jin Cho |
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| Rok vydání: | 2020 |
| Předmět: |
visual network
medicine.medical_specialty Computer applications to medicine. Medical informatics R858-859.7 Health Informatics Neuropsychological Tests Affect (psychology) cognitive training 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Cognition mild cognitive impairment medicine Humans Apathy Cognitive Dysfunction 030212 general & internal medicine Cognitive decline Aged Original Paper Memory clinic fMRI Neuropsychology Virtual Reality Middle Aged Cognitive training visuospatial function Quality of Life Verbal memory medicine.symptom Public aspects of medicine RA1-1270 Psychology 030217 neurology & neurosurgery |
| Zdroj: | Journal of Medical Internet Research Journal of Medical Internet Research, Vol 23, Iss 5, p e24526 (2021) |
| ISSN: | 1438-8871 |
| Popis: | Background Cognitive training can potentially prevent cognitive decline. However, the results of recent studies using semi-immersive virtual reality (VR)-assisted cognitive training are inconsistent. Objective We aimed to examine the hypothesis that cognitive training using fully immersive VR, which may facilitate visuospatial processes, could improve visuospatial functioning, comprehensive neuropsychological functioning, psychiatric symptoms, and functional connectivity in the visual brain network in predementia. Methods Participants over 60 years old with subjective cognitive decline or mild cognitive impairment from a memory clinic were randomly allocated to the VR (n=23) or the control (n=18) group. The VR group participants received multidomain and neuropsychologist-assisted cognitive training in a fully immersive VR environment twice a week for 1 month. The control group participants did not undergo any additional intervention except for their usual therapy such as pharmacotherapy. Participants of both groups were evaluated for cognitive function using face-to-face comprehensive neuropsychological tests, including the Rey-Osterrieth Complex Figure Test (RCFT) copy task; for psychiatric symptoms such as depression, apathy, affect, and quality of life; as well as resting-state functional magnetic resonance imaging (rsfMRI) at baseline and after training. Repeated-measures analysis of variance was used to compare the effect of cognitive training between groups. Seed-to-voxel–based analyses were used to identify the cognitive improvement–related functional connectivity in the visual network of the brain. Results After VR cognitive training, significant improvement was found in the total score (F1,39=14.69, P=.001) and basic components score of the RCFT copy task (F1,39=9.27, P=.005) compared with those of the control group. The VR group also showed improvements, albeit not significant, in naming ability (F1,39=3.55, P=.07), verbal memory delayed recall (F1,39=3.03, P=.09), and phonemic fluency (F1,39=3.08, P=.09). Improvements in psychiatric symptoms such as apathy (F1,39=7.02, P=.01), affect (F1,39=14.40, P=.001 for positive affect; F1,39=4.23, P=.047 for negative affect), and quality of life (F1,39=4.49, P=.04) were found in the VR group compared to the control group. Improvement in the RCFT copy task was associated with a frontal-occipital functional connectivity increase revealed by rsfMRI in the VR group compared to the control group. Conclusions Fully immersive VR cognitive training had positive effects on the visuospatial function, apathy, affect, quality of life, and increased frontal-occipital functional connectivity in older people in a predementia state. Future trials using VR cognitive training with larger sample sizes and more sophisticated designs over a longer duration may reveal greater improvements in cognition, psychiatric symptoms, and brain functional connectivity. Trial Registration Clinical Research Information Service KCT0005243; https://tinyurl.com/2a4kfasa |
| Databáze: | OpenAIRE |
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