Abstract
In recent years, Virtual Reality technologies have emerged as assessment and treatment tools in neuropsychology. In this chapter, we will explore the possibility of using Virtual Reality to improve the traditional neuropsychological assessment of executive functions. First, we will discuss the advantages offered by Virtual Reality to more traditional approaches. Then, the chapter details the characteristics of the Virtual Multiple Errands Test (VMET), a virtual reality tool developed using NeuroVR (http://www.neurovr.org)—a free virtual reality platform useful for the assessment and neurorehabilitation. Specifically, the VMET is an assessment protocol of executive functions, where participants are invited to navigate a virtual supermarket, completing tasks that require certain rules. In the chapter, we will present the detailed description of its clinical rationale and its different phases. Furthermore, a systematic analysis of the results obtained in different studies using the VMET will be outlined. Finally, we will discuss the potentiality of the VMET for integrating the traditional neuropsychological evaluation of patients with Parkinson’s disease. Detection of early executive deficits in Parkinson’s disease could facilitate the identification of patients at risk to develop dementia, and could give the chance to develop early neurorehabilitation interventions.
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Abbreviations
- VR:
-
Virtual reality
- VE:
-
Virtual environment
- MET:
-
Multiple errands test
- VMET:
-
Virtual multiple errands test
- 3D:
-
Three-dimensional
- PD:
-
Parkinson’s disease
- OCD:
-
Obsessive-compulsive disorder
References
Aarsland, D., Andersen, K., Larsen, J.P., Lolk, A., Kragh-Sorensen, P.: Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch. Neurol. 60(3), 387–392 (2003). doi:10.1001/archneur.60.3.387
Aarsland, D., Larsen, J.P., Karlsen, K., Lim, N.G., Tandberg, E.: Mental symptoms in Parkinson’s disease are important contributors to caregiver distress. Int. J. Geriatr. Psychiatry 14(10), 866–874 (1999). doi:10.1002/(Sici)1099-1166(199910)14:10<866:Aid-Gps38>3.0.Co;2-Z
Aarsland, D., Larsen, J.P., Tandberg, E., Laake, K.: Predictors of nursing home placement in Parkinson’s disease: a population-based, prospective study. J. Am. Geriatr. Soc. 48(8), 938–942 (2000)
Albani, G., Raspelli, S., Carelli, L., Priano, L., Pignatti, R., Morganti, F., Riva, G.: Sleep dysfunctions influence decision making in undemented Parkinson’s disease patients: a study in a virtual supermarket. Stud. Health. Technol. Inform. 163, 8–10 (2011)
Alderman, N., Burgess, P.W., Knight, C., Henman, C.: Ecological validity of a simplified version of the multiple errands shopping test. J. Int. Neuropsychol. Soc. 9(1), 31–44 (2003). doi:10.1017/S1355617703910046
Azuma, T., Cruz, R.F., Bayles, K.A., Tomoeda, C.K., Montgomery, E.B.: A longitudinal study of neuropsychological change in individuals with Parkinson’s disease. Int. J. Geriatr. Psychiatry 18(11), 1043–1049 (2003). doi:10.1002/Gps.1015
Bechara, A., Damasio, A.R., Damasio, H., Anderson, S.W.: Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50(1–3), 7–15 (1994). doi:10.1016/0010-0277(94)90018-3
Bohil, C.J., Alicea, B., Biocca, F.A.: Virtual reality in neuroscience research and therapy. Nat. Rev. Neurosci. 12(12), 752–762 (2011). doi:10.1038/Nrn3122
Bosboom, J.L.W., Stoffers, D., Wolters, E.C.: Cognitive dysfunction and dementia in Parkinson’s disease. J. Neural Transm. 111(10–11), 1303–1315 (2004). doi:10.1007/s00702-004-0168-1
Brooke, J.: SUS: A “quick and dirty” usability scale. In: Jordan, P.W., Thomas, B., Weerdmeester, B.A., McClelland, I.L. (eds.) Usability Evaluation in Industry, pp. 189–194. Taylor & Francis, London (1996)
Brooks, B.M., Rose, F.D.: The use of virtual reality in memory rehabilitation: current findings and future directions. Neurorehabilitation 18(2), 147–157 (2003)
Burgess, P.W., Alderman, N., Forbes, C., Costello, A., Coates, L.M.A., Dawson, D.R., Channon, S.: The case for the development and use of “ecologically valid” measures of executive function in experimental and clinical neuropsychology. J. Int. Neuropsychol. Soc. 12(2), 194–209 (2006). doi:10.1017/S135561770606310
Burgess, P.W., Shallice, T.: Bizarre responses, rule detection and frontal lobe lesions. Cortex 32(2), 241–259 (1996)
Burgess, P.W., Shallice, T.: Response suppression, initiation and strategy use following frontal lobe lesions. Neuropsychologia 34(4), 263–272 (1996). doi:10.1016/0028-3932(95)00104-2
Burgess, P.W., Veitch, E., Costello, A.D., Shallice, T.: The cognitive and neuroanatomical correlates of multitasking. Neuropsychologia 38(6), 848–863 (2000). doi:10.1016/S0028-3932(99)00134-7
Ceravolo, R., Pagni, C., Tognoni, G., Bonuccelli, U.: The epidemiology and clinical manifestations of dysexecutive syndrome in Parkinson’s disease. Front. Neurol. 3, 159 (2012). doi:10.3389/fneur.2012.00159
Chan, R.C., Shum, D., Toulopoulou, T., Chen, E.Y.: Assessment of executive functions: review of instruments and identification of critical issues. Arch. Clin. Neuropsychol. 23(2), 201–216 (2008). doi:10.1016/j.acn.2007.08.010
Chaytor, N., Schmitter-Edgecombe, M.: The ecological validity of neuropsychological tests: a review of the literature on everyday cognitive skills. Neuropsychol. Rev. 13(4), 181–197 (2003)
Chen, E.Y., Shapleske, J., Luque, R., McKenna, P.J., Hodges, J.R., Calloway, S.P., Berrios, G.E.: The Cambridge neurological inventory: a clinical instrument for assessment of soft neurological signs in psychiatric patients. Psychiatry Res. 56(2), 183–204 (1995)
Cipresso, P., Paglia, F.L., Cascia, C.L., Riva, G., Albani, G., La Barbera, D.: Break in volition: a virtual reality study in patients with obsessive-compulsive disorder. Exp. Brain Res. (2013). doi:10.1007/s00221-013-3471-y
Cipresso, P., Serino, S., Pedroli, E., Albani, G., Riva, G.: Psychometric reliability of the NeuroVR-based virtual version of the multiple errands test. Paper presented at the 7th international conference on pervasive computing technologies for healthcare, Venice (2013)
Dubois, B., Burn, D., Goetz, C., Aarsland, D., Brown, R.G., Broe, G.A., Emre, M.: Diagnostic procedures for Parkinson’s disease dementia: recommendations from the movement disorder society task force. Mov. Disord. 22(16), 2314–2324 (2007). doi:10.1002/Mds.21844
Foltynie, T., Brayne, C.E., Robbins, T.W., Barker, R.A.: The cognitive ability of an incident cohort of Parkinson’s patients in the UK. The CamPaIGN study. Brain 127(Pt 3), 550–560 (2004). doi:10.1093/brain/awh067
Goel, V., Grafman, J., Tajik, J., Gana, S., Danto, D.: A study of the performance of patients with frontal lobe lesions in a financial planning task. Brain 120, 1805–1822 (1997). doi:10.1093/brain/120.10.1805
Goldstein, G.: Functional considerations in neuropsychology. In: Sbordone, R.J., Long, C.J. (eds.) Ecological validity of neuropsychological testing, pp. 75–89. GR Press/St. Lucie Press, Delray Beach, FL (1996)
Grafman, J., Litvan, I.: Importance of deficits in executive functions. Lancet 354(9194), 1921–1923 (1999). doi:10.1016/S0140-6736(99)90438-5
Hely, M.A., Reid, W.G.J., Adena, M.A., Halliday, G.A., Morris, J.G.L.: The Sydney multicenter study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov. Disord. 23(6), 837–844 (2008). doi:10.1002/Mds.21956
Humes, G.E., Welsh, M.C., Retzlaff, P., Cookson, N.: Towers of Hanoi and London: reliability and validity of two executive function tasks. Assessment 4(3), 249–257 (1997)
Janvin, C.C., Aarsland, D., Larsen, J.P.: Cognitive predictors of dementia in Parkinson’s disease: a community-based, 4-year longitudinal study. J. Geriatr. Psychiatry Neurol. 18(3), 149–154 (2005). doi:10.1177/0891988705277540
Janvin, C.C., Larsen, J.P., Aarsland, D., Hugdahl, K.: Subtypes of mild cognitive impairment in Parkinson’s disease: progression to dementia. Mov. Disord. 21(9), 1343–1349 (2006). doi:10.1002/Mds.20974
Jones-Gotman, M., Milner, B.: Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia 15(4–5), 653–674 (1977)
Kehagia, A.A., Barker, R.A., Robbins, T.W.: Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson’s disease. Lancet Neurol. 9(12), 1200–1213 (2010). doi:10.1016/S1474-4422(10)70212-X
Knight, C., Alderman, N., Burgess, P.W.: Development of a simplified version of the multiple errands test for use in hospital settings. Neuropsychol. Rehabil. 12(3), 231–255 (2002). doi:10.1080/09602010244000039
Lange, B., Chang, C.Y., Suma, E., Newman, B., Rizzo, A.S., Bolas, M.: Development and evaluation of low cost game-based balance rehabilitation tool using the Microsoft Kinect sensor. In: Conference proceedings of IEEE engineering medical biology society, Aug 30–Sep 3, pp. 1831–1834 (2011)
La Paglia, F., La Cascia, C., Rizzo, R., Riva, G., La Barbera, D.: Assessment of executive functions in patients with obsessive compulsive disorder by NeuroVR. Stud. Health Technol. Inform. 181, 98–102 (2012)
Levy, G., Jacobs, D.M., Tang, M.X., Cote, L.J., Louis, E.D., Alfaro, B., Marder, K.: Memory and executive function impairment predict dementia in Parkinson’s disease. Mov. Disord. 17(6), 1221–1226 (2002). doi:10.1002/mds.10280
Litvan, I., Aarsland, D., Adler, C.H., Goldman, J.G., Kulisevsky, J., Mollenhauer, B., Weintraub, D.: MDS task force on mild cognitive impairment in Parkinson’s Disease: critical review of PD-MCI. Mov. Disord. 26(10), 1814–1824 (2011). doi:10.1002/Mds.23823
Litvan, I., Goldman, J.G., Troster, A.I., Schmand, B.A., Weintraub, D., Petersen, R.C., Emre, M.: Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement disorder society task force guidelines. Mov. Disord. 27(3), 349–356 (2012). doi:10.1002/Mds.24893
McKinlay, A., Grace, R.C., Dalrymple-Alford, J.C., Roger, D.: Characteristics of executive function impairment in Parkinson’s disease patients without dementia. J. Int. Neuropsychol. Soc. 16(2), 268–277 (2010). doi:10.1017/S1355617709991299
Muslimovic, D., Post, B., Speelman, J.D., Schmand, B.: Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 65(8), 1239–1245 (2005). doi:10.1212/01.wnl.0000180516.69442.95
Parkinson, J.: An essay on the Shaking Palsy. Whittingham and Rowland, London (1817)
Pedroli, E., Cipresso, P., Serino, S., Albani G., Riva, G.: A virtual reality test for the assessment of cognitive deficits: usability and perspectives. Paper presented at the 7th international conference on pervasive computing technologies for healthcare, Venice (2013)
Rand, D., Katz, N., Kizony, R., Shahar, M., Weiss, P.L.: The virtual mall: a functional virtual environment for stroke rehabilitation. Cyberpsychology Behav. 8(4), 369–370 (2005)
Rand, D., Katz, N., Weiss, P.L.: Evaluation of virtual shopping in the VMall: comparison of post-stroke participants to healthy control groups. Disabil. Rehabil. 29(22), 1710–1719 (2007). doi:10.1080/09638280601107450
Rand, D., Rukan, S.B.A., Weiss, P.L., Katz, N.: Validation of the Virtual MET as an assessment tool for executive functions. Neuropsychol. Rehabil. 19(4), 583–602 (2009). doi:10.1080/09602010802469074
Raspelli, S., Pallavicini, F., Carelli, L., Morganti, F., Poletti, B., Corra, B., Riva, G.: Validation of a neuro virtual reality-based version of the multiple errands test for the assessment of executive functions. Stud. Health Technol. Inform. 167, 92–97 (2011)
Riva, G.: Applications of virtual environments in medicine. Methods Inf. Med. 42(5), 524–534 (2003)
Riva, G.: Virtual reality: an experiential tool for clinical psychology. British J. Guidance Counselling 37(3), 337–345 (2009). doi:10.1080/03069880902957056
Riva, G., Castelnuovo, G., Mantovani, F.: Transformation of flow in rehabilitation: the role of advanced communication technologies. Behav. Res. Methods 38(2), 237–244 (2006)
Riva, G., Gaggioli, A.: Rehabilitation as empowerment: the role of advanced technologies. In: Gaggioli, A., Keshner, E.A., Weiss, P.L., Riva, G. (eds.) Technologies in Rehabilitation: Empowering Cognitive, Physical, Social and Communicative Skills through Virtual Reality, Robots, Wearable Systems and Brain-Computer Interfaces Advanced, vol. 145, pp. 3–22. IOS Press, Amsterdam (2009)
Riva, G., Gaggioli, A.: Rehabilitation as empowerment: the role of advanced technologies. In: Advanced Technologies in Rehabilitation: Empowering Cognitive, Physical, Social and Communicative Skills through Virtual Reality, Robots, Wearable Systems and Brain-Computer Interfaces, vol. 145, pp. 3–22 (2009b). doi: 10.3233/978-1-60750-018-6-3
Riva, G., Gaggioli, A., Grassi, A., Raspelli, S., Cipresso, P., Pallavicini, F., Donvito, G.: NeuroVR 2–a free virtual reality platform for the assessment and treatment in behavioral health care. Stud. Health Technol. Inform. 163, 493–495 (2011)
Riva, G., Mantovani, F., Gaggioli, A.: Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology. J. Neuroeng. Rehabil. 1(1), 9 (2004). doi:10.1186/1743-0003-1-9
Riva, G., Vigna, C., Grassi, A., Raspelli, S., Cipresso, P., Pallavicini, F., Serino, S., Gaggioli, A.: Learning Island: the development of a virtual reality system for the experiential training of stress management. Stud. Health Technol. Inform. 173, 369–371 (2012)
Robertson, I.H., Manly, T., Andrade, J., Baddeley, B.T., Yiend, J.: ‘Oops!’: performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia 35(6), 747–758 (1997). doi:10.1016/S0028-3932(97)00015-8
Rogers, R.D., Sahakian, B.J., Hodges, J.R., Polkey, C.E., Kennard, C., Robbins, T.W.: Dissociating executive mechanisms of task control following frontal lobe damage and Parkinson’s disease. Brain 121, 815–842 (1998). doi:10.1093/brain/121.5.815
Rose, F.D., Brooks, B.M., Rizzo, A.A.: Virtual reality in brain damage rehabilitation: review. Cyberpsychology Behav. 8(3), 241–262 (2005). doi:10.1089/cpb.2005.8.241
Rowe, J., Stephan, K.E., Friston, K., Frackowiak, R., Lees, A., Passingham, R.: Attention to action in Parkinson’s disease—impaired effective connectivity among frontal cortical regions. Brain 125, 276–289 (2002). doi:10.1093/Brain/Awf036
Schrag, A., Jahanshahi, M., Quinn, N.: What contributes to quality of life in patients with Parkinson’s disease? J. Neurol. Neurosurg. Psychiatry 69(3), 308–312 (2000). doi:10.1136/jnnp.69.3.308
Schultheis, M.T., Rizzo, A.A.: The application of virtual reality technology in rehabilitation. Rehabil. Psychol. 46(3), 296–311 (2001). doi:10.1037/0090-5550.46.3.296
Shallice, T.: Specific impairments of planning. Philos. Trans. R. Soc. Lond. B Biol. Sci. 298(1089), 199–209 (1982). doi:10.1098/rstb.1982.0082
Shallice, T.: From Neuropsychology to Mental Structure. Cambridge University Press, Cambridge (1988)
Shallice, T., Burgess, P.W.: Deficits in strategy application following frontal-lobe damage in man. Brain 114, 727–741 (1991). doi:10.1093/brain/114.2.727
Stuss, D.T., Benson, D.F.: The frontal lobes. Raven Press, New York (1986)
Stuss, D.T., Shallice, T., Alexander, M.P., Picton, T.W.: A multidisciplinary approach to anterior attentional functions. Ann. N. Y. Acad. Sci. 769, 191–211 (1995)
Troster, A.I.: Neuropsychological characteristics of dementia with Lewy bodies and Parkinson’s disease with dementia: differentiation, early detection, and implications for “mild cognitive impairment” and biomarkers. Neuropsychol. Rev. 18(1), 103–119 (2008). doi:10.1007/s11065-008-9055-0
Verleden, S., Vingerhoets, G., Santens, P.: Heterogeneity of cognitive dysfunction in Parkinson’s disease: a cohort study. Eur. Neurol. 58(1), 34–40 (2007). doi:10.1159/000102164
Vingerhoets, G., Verleden, S., Santens, P., Miatton, M., De Reuck, J.: Predictors of cognitive impairment in advanced Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry 74(6), 793–796 (2003)
Williams-Gray, C.H., Evans, J.R., Goris, A., Foltynie, T., Ban, M., Robbins, T.W., Barker, R.A.: The distinct cognitive syndromes of Parkinson’s disease: 5 year follow-up of the CamPaIGN cohort. (Research Support, Non-U.S. Gov’t). Brain 132(Pt 11), 2958–2969 (2009). doi: 10.1093/brain/awp245
Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., Evans, J.J.: Behavioural assessment of the dysexecutive syndrome (1996)
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This work was supported by the Italian funded project “VRehab. Virtual Reality in the Assessment and TeleRehabilitation of Parkinson’s Disease and Post-Stroke Disabilities” - RF-2009-1472190.
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Serino, S. et al. (2014). The Role of Virtual Reality in Neuropsychology: The Virtual Multiple Errands Test for the Assessment of Executive Functions in Parkinson’s Disease. In: Ma, M., Jain, L., Anderson, P. (eds) Virtual, Augmented Reality and Serious Games for Healthcare 1. Intelligent Systems Reference Library, vol 68. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54816-1_14
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