Age and sex impact on visuospatial working memory (VSWM), mental rotation, and cognitive strategies during navigation

Advancing Gait Analysis: Integrating Multimodal Neuroimaging and Extended Reality Technologies

The analysis of human gait is a cornerstone in diagnosing and monitoring a variety of neuromuscular and orthopedic conditions. Recent technological advancements have paved the way for innovative methodologies that combine multimodal neuroimaging and eXtended Reality (XR) technologies to enhance the precision and applicability of gait analysis. This review explores the state-of-the-art solutions of an advanced gait analysis approach, a multidisciplinary concept that integrates neuroimaging, extended reality technologies, and sensor-based methods to study human locomotion. Several wearable neuroimaging modalities such as functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), commonly used to monitor and analyze brain activity during walking and to explore the neural mechanisms underlying motor control, balance, and gait adaptation, were considered. XR technologies, including virtual, augmented, and mixed reality, enable the creation of immersive environments for gait analysis, real-time simulation, and movement visualization, facilitating a comprehensive assessment of locomotion and its neural and biomechanical dynamics. This advanced gait analysis approach enhances the understanding of gait by examining both cerebral and biomechanical aspects, offering insights into brain-musculoskeletal coordination. We highlight its potential to provide real-time, high-resolution data and immersive visualization, facilitating improved clinical decision-making and rehabilitation strategies. Additionally, we address the challenges of integrating these technologies, such as data fusion, computational demands, and scalability. The review concludes by proposing future research directions that leverage artificial intelligence to further optimize multimodal imaging and XR applications in gait analysis, ultimately driving their translation from laboratory settings to clinical practice. This synthesis underscores the transformative potential of these approaches for personalized medicine and patient outcomes.

Augmented Reality Exergames for Upcoming Cognitive-Motor Rehabilitation: User-Centered Design Approach and User Experience of Healthy Children

BACKGROUND

Traditional rehabilitation programs for children with cerebral palsy and acquired brain injuries aim to enhance motor and cognitive abilities through repetitive exercises, which are often perceived as tedious and demotivating. Extended reality technologies, including augmented reality (AR) and virtual reality, offer more engaging methods through exergames. However, to date, no AR exergames simultaneously integrate cognitive and motor aspects within navigational tasks. Developing these exergames necessitates rigorous methodological steps, especially when using emerging technologies such as AR. The MIDE (Multidisciplinary Iterative Design of Exergames) framework advocates a participatory design approach, involving users from the outset, the objective being to optimize the interface and validate game mechanics through user experience (UX) assessment. Some researchers initially test these mechanisms on healthy children before applying them to clinical populations.

OBJECTIVE

This study aims to evaluate the UX of our AR exergames, consisting of two games (AR Corsi and AR Zoo), in typically developing children.

METHODS

Typically developing children participated in two 1.5-hour sessions. During each session, they played one of two AR games using the Microsoft HoloLens 2 headset: AR Corsi and AR Zoo, both of which are designed to engage executive functions and motor skills through navigational capabilities. UX was assessed after each session using the following measures: System Usability Scale scores for usability, AttrakDiff for attractiveness and game quality, MeCue for emotional experience, and Rating scale of Perceived Exertion for Children for pre- and postsession mental and physical fatigue.

RESULTS

A total of 27 participants (mean age 11.9, SD 1.2 years) were included in the study. Mean System Usability Scale scores were 79.9 (SD 11.4) for AR Corsi and 76.3 (SD 12.1) for AR Zoo, indicating good usability. The AttrakDiff questionnaire yielded favorable results, with scores between 1 and 3 for overall attractiveness, pragmatic quality, and stimulation for both AR games. However, the hedonic quality "identity" received neutral scores (mean 0.6, SD 0.5 for AR Corsi and mean 0.7, SD 0.8 for AR Zoo). The MeCue emotions module yielded average scores of 5.2 (SD 0.7) for AR Corsi and 5.3 (SD 0.8) for AR Zoo, significantly exceeding the theoretical mean of 4 (P<.001). We observed a significant effect of physical fatigue (P=.02) and mental fatigue (P=.002) after exposure to both games. A comparative analysis of UX between the two games showed no significant differences.

CONCLUSIONS

This study demonstrates that our exergame, comprising two AR games, is user-friendly and well-received by typically developing children, eliciting positive emotions and overall appeal. Although some children reported fatigue, favorable UX evaluation confirms the validity of the game's content and mechanisms, suggesting its suitability for use among children with cerebral palsy and acquired brain injuries.

Towards a comprehensive framework for complex walking tasks: Characterization, behavioral adaptations, and clinical implications in ageing and neurological populations

Complex walking tasks, including change of direction, patterns and rhythms, require more attentional resources than simple walking and significantly impact walking performance, especially among ageing and neurological populations. More studies have been focusing on complex walking situations, with or without the addition of cognitive tasks, creating a multitude of walking situations. Given the lack of a clear and extensive definition of complex walking, this narrative review aims to identify and more precisely characterize situations and related tests, improve understanding of behavioral adaptations in ageing and neurological populations, and report the clinical applications of complex walking. Based on the studies collected, we are proposing a framework that categorizes the different forms of complex walking, considering whether a cognitive task is added or not, as well as the number of distinct objectives within a given situation. We observed that combining complex walking tasks with a cognitive assignment places even greater strain on attentional resources, resulting in a more pronounced decline in walking and/or cognitive performance. This work highlights the relevance of complex walking as a simple tool for early detection of cognitive impairments and risk of falls, and its potential value in cognitive-motor rehabilitation. Future studies should explore various complex walking tasks in ageing and neurological populations, under varied conditions in real-life or in extended virtual environments.

Metabotropic NMDA Receptor Signaling Contributes to Sex Differences in Synaptic Plasticity and Episodic Memory

Men generally outperform women on encoding spatial components of episodic memory whereas the reverse holds for semantic elements. Here we show that female mice outperform males on tests for non-spatial aspects of episodic memory ("what", "when"), suggesting that the human findings are influenced by neurobiological factors common to mammals. Analysis of hippocampal synaptic plasticity mechanisms and encoding revealed unprecedented, sex-specific contributions of non-classical metabotropic NMDA receptor (NMDAR) functions. While both sexes used non-ionic NMDAR signaling to trigger actin polymerization needed to consolidate long-term potentiation (LTP), NMDAR GluN2B subunit antagonism blocked these effects in males only and had the corresponding sex-specific effect on episodic memory. Conversely, blocking estrogen receptor alpha eliminated metabotropic stabilization of LTP and episodic memory in females only. The results show that sex differences in metabotropic signaling critical for enduring synaptic plasticity in hippocampus have significant consequences for encoding episodic memories.