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Dina LM, Smith TJ, Hauser TU, Dommett EJ. Naturalistic assessments across the lifespan: Systematic review of inhibition measures in ecological settings. Neurosci Biobehav Rev 2024; 167:105915. [PMID: 39395771 PMCID: PMC11870848 DOI: 10.1016/j.neubiorev.2024.105915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 09/27/2024] [Accepted: 09/30/2024] [Indexed: 10/14/2024]
Abstract
Inhibitory control is essential for our everyday lives. Despite this, it is commonly assessed using non-naturalistic assessments. In this systematic review, we argue for the importance of taking an ecological approach to assess cognition. The aims are to present the state-of-knowledge in naturalistic assessments of inhibitory control, focusing on their methodological characteristics, including psychometric properties and user experience. PubMed, PsycINFO and Web of Science were searched until September 2024. Studies were included if they used at least one naturalistic method of assessing inhibition. The included studies (N=64) were grouped into three methodological categories: gamification, virtual reality, and brief, repeated assessments in participants' usual environment in the form of ecological momentary assessments. Sample sizes spanned three orders of magnitude (N=12-22,098). We report considerable heterogeneity in the types of tasks used, and the psychometric details reported. Nonetheless, naturalistic tasks were generally comparable with standardised equivalents, although some tasks assessed mixed-domain constructs. Tasks were feasible and acceptable for participants, with generally high completion rates and engagement. Recommendations for future research are discussed.
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Affiliation(s)
- Larisa-Maria Dina
- Department of Psychology, King's College London, London SE1 1UL, United Kingdom; Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck College, London WC1E 7HX, United Kingdom; Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, United Kingdom.
| | - Tim J Smith
- Centre for Brain and Cognitive Development, Department of Psychological Sciences, Birkbeck College, London WC1E 7HX, United Kingdom; Creative Computing Institute, University of the Arts, London SE5 8UF, United Kingdom
| | - Tobias U Hauser
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, London WC1B 5EH, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London, UK; Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany; German Center for Mental Health (DZPG), Germany
| | - Eleanor J Dommett
- Department of Psychology, King's College London, London SE1 1UL, United Kingdom
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2
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Ong J, Carrabba NV, Waisberg E, Zaman N, Memon H, Panzo N, Lee VA, Sarker P, Vogt AZ, Laylani N, Tavakkoli A, Lee AG. Dynamic Visual Acuity, Vestibulo-Ocular Reflex, and Visual Field in National Football League (NFL) Officiating: Physiology and Visualization Engineering for 3D Virtual On-Field Training. Vision (Basel) 2024; 8:35. [PMID: 38804356 PMCID: PMC11130928 DOI: 10.3390/vision8020035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024] Open
Abstract
The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and sufficient visual field. Prior research has shown that a standardized curriculum in these neuro-ophthalmic principles have demonstrated validity and self-rated improvements in understanding, confidence, and likelihood of future utilization by NFL game officials to maximize visual performance during officiating. Virtual reality technology may also be able to help optimize understandings of specific neuro-ophthalmic principles and simulate real-life gameplay. Personal communication between authors and NFL officials and leadership have indicated that there is high interest in 3D virtual on-field training for NFL officiating. In this manuscript, we review the current and past research in this space regarding a neuro-ophthalmic curriculum for NFL officials. We then provide an overview our current visualization engineering process in taking real-life NFL gameplay 2D data and creating 3D environments for virtual reality gameplay training for football officials to practice plays that highlight neuro-ophthalmic principles. We then review in-depth the physiology behind these principles and discuss strategies to implement these principles into virtual reality for football officiating.
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Affiliation(s)
- Joshua Ong
- Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI 48105, USA
| | | | - Ethan Waisberg
- Department of Ophthalmology, University of Cambridge, Cambridge CB2 1TN, UK
- Moorfields Eye Hospital, NHS Foundation Trust, London EC1V 2PD, UK
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Hamza Memon
- Texas A&M School of Medicine, Bryan, TX 77807, USA
| | | | - Virginia A Lee
- Department of Biology, University of Virginia, Charlottesville, VA 22903, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Ashtyn Z Vogt
- Dean McGee Eye Institute, University of Oklahoma College of Medicine, Oklahoma City, OK 73104, USA
| | - Noor Laylani
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, NV 89557, USA
| | - Andrew G Lee
- Texas A&M School of Medicine, Bryan, TX 77807, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX 77030, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY 10065, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX 77555, USA
- University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
- Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
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3
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Wilkerson GB, Lansey JC, Noblett CN, Sarris CE. Test-Retest Reliability of Immersive Virtual Reality Measures of Perceptual-Motor Performance. Percept Mot Skills 2023; 130:2484-2504. [PMID: 37776022 DOI: 10.1177/00315125231205322] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The duration, accuracy, and consistency of responses to various types of stimuli are widely accepted as indirect indicators of the efficiency of brain information processing, but current clinical tests appear to lack sufficient sensitivity to detect subtle impairments. Immersive virtual reality (VR) offers a new means to acquire measures of perceptual-motor responses to moving visual stimuli that require rapid conflict resolution, but their test-retest reliability has not yet been demonstrated. Repeated measures. We analyzed data from 19 healthy young adults who performed a 40-trial VR test on three consecutive days. We focused on response time (RT) and perceptual latency (PL) for eye, neck, arm, and whole-body step displacements involved in executing a reaching/lunging movement in a right or left direction toward a peripherally located virtual target. Measures of RT and PL included a 40-trial mean, an intra-individual variability (IIV) value, and a rate correct score (RCS) that incorporated both response duration and accuracy. Most mean and IIV values for PL and RT demonstrated a positive distributional skew that was substantially reduced by natural logarithm transformation. While a learning effect was evident between sessions 1 and 2 for 7 of 8 mean PL and RT measures, 3-session intraclass correlation coefficient (ICC) values were moderate to excellent for 15 of 16 transformed PL and RT measures (range: .618 to .922). The composite RCS metric did not require transformation for either PL or RT, whose respective 3-session ICC values were .877 and .851. This moderate to excellent test-retest reliability for various VR measures of perceptual-motor function, combined with evidence of their validity from both past and future research, suggest that these measures can advance clinical detection of impaired brain processing and longitudinal assessments of potentially modifiable performance deficiencies.
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Affiliation(s)
- Gary B Wilkerson
- Graduate Athletic Training Program, University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | | | - Courtney N Noblett
- Graduate Athletic Training Program, University of Tennessee at Chattanooga, Chattanooga, TN, USA
| | - Caroline E Sarris
- Graduate Athletic Training Program, University of Tennessee at Chattanooga, Chattanooga, TN, USA
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4
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Hou X, Zhang Y, Fei X, Zhou Q, Li J. Sports-Related Concussion Affects Cognitive Function in Adolescents: A Systematic Review and Meta-analysis. Am J Sports Med 2023; 51:3604-3618. [PMID: 36799499 DOI: 10.1177/03635465221142855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Rates of sports-related concussion (SRC) are high in adolescents. Ambiguity exists regarding the effect of SRC on cognitive function in adolescents. PURPOSE To rigorously examine adolescents' cognitive function after SRC. STUDY DESIGN Systematic review and meta-analysis; Level of evidence, 4. METHODS Web of Science, Scopus, and PubMed were searched from database inception until September 2021. Studies were included if participants were adolescents aged 13 to 18 years, if the definition of SRC was fully consistent with the Berlin Consensus Statement on Concussion in Sport, if the study included a control group or in-group baseline test, and if the study reported cognitive outcomes (eg, visual memory, processing speed) that could be separately extracted. RESULTS A total of 47 studies were included in the systematic review, of which 31 were included in the meta-analysis, representing 8877 adolescents with SRC. Compared with individuals in the non-SRC group, individuals with SRC had worse performance in cognitive function and reported more symptoms not only in the acute phase but also in the prolonged phase (1-6 months after injury) (visual memory: d = -0.21, 95% CI, -0.37 to -0.05, P = .012; executive function: d = -0.56, 95% CI, -1.07 to -0.06, P = .028; and symptoms: d = 1.17, 95% CI, 0.13 to 2.22, P = .028). Lower scores in most of the outcomes of cognitive function were observed at <3 days and at 3 to 7 days, but higher scores for verbal memory (d = 0.10; 95% CI, 0.03 to 0.17; P = .008) and processing speed (d = 0.17; 95% CI, 0.10 to 0.24; P < .001) were observed at 7 to 14 days after SRC relative to baseline. The effects of SRC on cognitive function decreased over time (100% of the variance in reaction time, P < .001; 99.94% of the variance in verbal memory, P < .001; 99.88% of the variance in visual memory, P < .001; 39.84% of the variance in symptoms, P = .042) in control group studies. Study design, participant sex, measurement tools, and concussion history were found to be modulators of the relationship between cognitive function and SRC. CONCLUSION This study revealed that adolescent cognitive function is impaired by SRC even 1 to 6 months after injury. Results of this study point to the need for tools to measure cognitive function with multiple parallel versions that have demographically diversiform norms in adolescents. Effective prevention of SRC, appropriate treatment, and adequate evaluation of cognitive function before return to play are needed in adolescent SRC management. Moreover, caution is warranted when using the baseline-to-postconcussion paradigm in return-to-play decisions.
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Affiliation(s)
- Xianyun Hou
- School of Psychology, Beijing Sport University, Beijing, China
| | - Yu Zhang
- School of Psychology, Beijing Sport University, Beijing, China
| | - Xueyin Fei
- Sport Science School, Beijing Sport University, Beijing, China
| | - Qian Zhou
- School of Psychology, Beijing Sport University, Beijing, China
| | - Jie Li
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
- Institutes of Psychological Sciences, Hangzhou Normal University, Hangzhou, China
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Palombi T, Galli F, Giancamilli F, D'Amico M, Alivernini F, Gallo L, Neroni P, Predazzi M, De Pietro G, Lucidi F, Giordano A, Chirico A. The role of sense of presence in expressing cognitive abilities in a virtual reality task: an initial validation study. Sci Rep 2023; 13:13396. [PMID: 37591908 PMCID: PMC10435488 DOI: 10.1038/s41598-023-40510-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023] Open
Abstract
There is a raised interest in literature to use Virtual Reality (VR) technology as an assessment tool for cognitive domains. One of the essential advantages of transforming tests in an immersive virtual environment is the possibility of automatically calculating the test's score, a time-consuming process under natural conditions. Although the characteristics of VR can deliver different degrees of immersion in a virtual environment, the sense of presence could jeopardize the evolution of these practices. The sense of presence results from a complex interaction between human, contextual factors, and the VR environment. The present study has two aims: firstly, it contributes to the validation of a virtual version of the naturalistic action test (i.e., virtual reality action test); second, it aims to evaluate the role of sense of presence as a critical booster of the expression of cognitive abilities during virtual reality tasks. The study relies on healthy adults tested in virtual and real conditions in a cross-over research design. The study's results support the validity of the virtual reality action test. Furthermore, two structural equation models are tested to comprehend the role of sense of presence as a moderator in the relationship between cognitive abilities and virtual task performance.
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Affiliation(s)
- Tommaso Palombi
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Federica Galli
- Department of Movement, Human and Health Sciences, University of Rome, Foro Italico, Rome, Italy
| | - Francesco Giancamilli
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Monica D'Amico
- Department of Clinical Psychology, "Sapienza" University of Rome, Rome, Italy
| | - Fabio Alivernini
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Luigi Gallo
- Institute for High-Performance Computing and Networking, National Research Council, Naples, Italy
| | - Pietro Neroni
- Institute for High-Performance Computing and Networking, National Research Council, Naples, Italy
| | | | - Giuseppe De Pietro
- Institute for High-Performance Computing and Networking, National Research Council, Naples, Italy
| | - Fabio Lucidi
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Andrea Chirico
- Department of Psychology of Developmental and Socialization Processes, "Sapienza" University of Rome, Via Dei Marsi, 78, 00185, Rome, Italy.
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6
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McKee CS, Matthews M, Rankin A, Bleakley C. Multisystem recovery after sport-related concussion in adolescent rugby players: a prospective study protocol. BMJ Open 2023; 13:e073677. [PMID: 37532486 PMCID: PMC10401252 DOI: 10.1136/bmjopen-2023-073677] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
INTRODUCTION Sport-related concussion is one of the most common injuries in adolescent rugby players with evidence of prolonged recovery in some concussed athletes. Concussion is a complex pathophysiological process that can affect a variety of subsystems with multifactorial presentation. Most research on adolescents recovery after concussion focuses on neurocognitive functioning and symptom outcomes over the short term. There is a need to explore concussion recovery over time across multiple subsystems in adolescent rugby players. METHODS AND ANALYSIS This prospective study will use sensorimotor and oculomotor outcomes in adolescent male and female rugby players aged 16-18 years. Players will be recruited from school or club rugby teams across the province of Ulster. Baseline assessment will be undertaken at the start of the playing season and will include questionnaires, Quantified Y Balance Test and Pupillary Light Reflex. Players who sustain a concussive event will be reassessed on all outcomes at 3 days, 7 days, 14 days, 23 days, 90 days, 180 days and 365 days postconcussion. For serial outcome data, we will examine response curves for each participant and make comparisons between known groups. We will use logistic regression to explore any association between demographic variables and recovery. The strength of the predictive model will be determined using R2, p values and ORs, with 95% CIs. ETHICS AND DISSEMINATION Ethical approval has been granted for this study from Ulster University Research Ethics Committee (REC/14/0060). This study will be published in an open-access research journal on completion. TRIAL REGISTRATION NUMBER ACTRN12622000931774p.
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Affiliation(s)
| | | | - Alan Rankin
- Sports Medicine NI, Belfast, UK
- Sports Medicine, Sports Institute of Northern Ireland, Newtownabbey, UK
| | - Chris Bleakley
- School of Health Sciences, Ulster University, Belfast, UK
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7
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Wilkerson GB, Colston MA, Acocello SN, Hogg JA, Carlson LM. Subtle impairments of perceptual-motor function and well-being are detectable among military cadets and college athletes with self-reported history of concussion. Front Sports Act Living 2023; 5:1046572. [PMID: 36761780 PMCID: PMC9905443 DOI: 10.3389/fspor.2023.1046572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/03/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction A lack of obvious long-term effects of concussion on standard clinical measures of behavioral performance capabilities does not preclude the existence of subtle neural processing impairments that appear to be linked to elevated risk for subsequent concussion occurrence, and which may be associated with greater susceptibility to progressive neurodegenerative processes. The purpose of this observational cohort study was to assess virtual reality motor response variability and survey responses as possible indicators of suboptimal brain function among military cadets and college athletes with self-reported history of concussion (HxC). Methods The cohort comprised 75 college students (20.7 ± 2.1 years): 39 Reserve Officer Training Corp (ROTC) military cadets (10 female), 16 football players, and 20 wrestlers; HxC self-reported by 20 (29.2 ± 27.1 months prior, range: 3-96). A virtual reality (VR) test involving 40 lunging/reaching responses to horizontally moving dots (filled/congruent: same direction; open/incongruent: opposite direction) was administered, along with the Sport Fitness and Wellness Index (SFWI) survey. VR Dispersion (standard deviation of 12 T-scores for neck, upper extremity, and lower extremity responses to congruent vs. incongruent stimuli originating from central vs. peripheral locations) and SFWI response patterns were the primary outcomes of interest. Results Logistic regression modeling of VR Dispersion (range: 1.5-21.8), SFWI (range: 44-100), and an interaction between them provided 81% HxC classification accuracy (Model χ 2[2] = 26.03, p < .001; Hosmer & Lemeshow χ 2[8] = 1.86, p = .967; Nagelkerke R 2 = .427; Area Under Curve = .841, 95% CI: .734, .948). Binary modeling that included VR Dispersion ≥3.2 and SFWI ≤86 demonstrated 75% sensitivity and 86% specificity with both factors positive (Odds Ratio = 17.6, 95% CI: 5.0, 62.1). Discussion/Conclusion Detection of subtle indicators of altered brain processes that might otherwise remain unrecognized is clearly important for both short-term and long-term clinical management of concussion. Inconsistency among neck, upper extremity, and lower extremity responses to different types of moving visual stimuli, along with survey responses suggesting suboptimal well-being, merit further investigation as possible clinical indicators of persisting effects of concussion that might prove to be modifiable.
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Affiliation(s)
- Gary B Wilkerson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Marisa A Colston
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Shellie N Acocello
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Jennifer A Hogg
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Lynette M Carlson
- Department of Health and Human Performance, University of Tennessee at Chattanooga, Chattanooga, TN, United States
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8
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Kravtsova EN, Meigal AY. [Virtual reality technologies in the rehabilitation of patients with peripheral vestibular dysfunction]. Vestn Otorinolaringol 2021; 86:103-107. [PMID: 33720661 DOI: 10.17116/otorino202186011103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Review of articles published in peer-reviewed international journals devoted to the issues of rehabilitation of patients with peripheral vestibular dysfunction using virtual reality conditions. IN the review provides a neurophysiological rationale for the use of virtual reality techniques for rehabilitation, the technical methods used to recreate the virtual environment, as well as the published results of their clinical application. It is concluded that the application of virtual reality methods in clinical vestibulology is promising. The search was carried out using the search engines Google Scholar, PubMed, PMC, CrossRef, Science Direct.
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Affiliation(s)
| | - A Yu Meigal
- Petrozavodsk State University, Petrozavodsk, Russia
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9
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Gilboa Y, Fogel-Grinvald H, Chevignard M. Virtual Classroom Assessment for Children and Adolescents With Attention Deficits: A Systematic Review and Meta-Analysis of Measurement Properties. J Atten Disord 2021; 25:300-311. [PMID: 30371134 DOI: 10.1177/1087054718808590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: The virtual classroom (VC) is a head-mounted display immersive system for the assessment of attention. A meta-analysis was performed to examine the use of the VC to assess attention in children and adolescents. Method: We conducted a systematic literature search to select articles up to December 2017. Results: Thirteen studies using the VC to assess attention were included. Studies reporting comparisons between patients with various clinical conditions and healthy controls were included in the meta-analysis. The meta-analysis results revealed significant differences between groups for the percentage of identified targets (nine studies; total combined N = 431), for commission errors, and reaction time (eight studies; total combined N = 399) in favor of the nonclinical group. Conclusion: Preliminary evidence establishes the validity of the VC and suggests that this task has the potential to serve as a useful and enjoyable ecological assessment tool for the diagnosis of attention deficits in children and adolescents. (J. of Att. Dis. XXXX; XX(X) XX-XX).
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Affiliation(s)
- Yafit Gilboa
- School of Occupational Therapy, The Hebrew University of Jerusalem, Israel
| | | | - Mathilde Chevignard
- Rehabilitation Department for Children and Adolescents with Acquired Neurological Injury, and Outreach Team for children and adolescents with acquired brain injury, Saint-Maurice Hospitals, France.,Laboratoire d'Imagerie Biomédicale, LIB, 75006 Sorbonne Université, Paris, France.,GRC n°18, Handicap Cognitif et Réadaptation (HanCRe), Sorbonne Université, Paris, France
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10
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Abstract
As avid users of technology, adolescents are a key demographic to engage when designing and developing technology applications for health. There are multiple opportunities for improving adolescent health, from promoting preventive behaviors to providing guidance for adolescents with chronic illness in supporting treatment adherence and transition to adult health care systems. This article will provide a brief overview of current technologies and then highlight new technologies being used specifically for adolescent health, such as artificial intelligence, virtual and augmented reality, and machine learning. Because there is paucity of evidence in this field, we will make recommendations for future research.
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Affiliation(s)
- Ana Radovic
- Department of Pediatrics, School of Medicine, University of Pittsburgh and University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania;
| | - Sherif M Badawy
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and.,Division of Hematology, Oncology, Neurooncology, and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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11
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Diaz-Orueta U, Blanco-Campal A, Lamar M, Libon DJ, Burke T. Marrying Past and Present Neuropsychology: Is the Future of the Process-Based Approach Technology-Based? Front Psychol 2020; 11:361. [PMID: 32210882 PMCID: PMC7069278 DOI: 10.3389/fpsyg.2020.00361] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 02/17/2020] [Indexed: 01/05/2023] Open
Abstract
A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer's disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed.
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Affiliation(s)
- Unai Diaz-Orueta
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Alberto Blanco-Campal
- Department of Psychiatry for the Older Person, Memory Clinic Services, Health Service Executive, Navan and Ardee, Ireland
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - David J. Libon
- New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Stratford, NJ, United States
| | - Teresa Burke
- School of Psychology, Faculty of Science and Health, Dublin City University, Dublin, Ireland
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12
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Abstract
Over the past 2 decades, concussion care is increasingly in demand as research and media attention shed light on the importance of proper diagnosis and medical management to prevent complex, potentially disabling sequelae. The purpose of this review is to discuss the future of clinical concussion care across selected topics under the broad themes of diagnosis/assessment, intervention/treatment, and patient characteristics/presentations with the intent to direct clinicians' attention to important anticipated developments in the field. The current status of biomarkers, clinical settings, models of clinical concussion, return-to-activity, clinical subpopulations, treatment approaches, patient perceptions of injury, and social media are reviewed along with predictions for future developments.
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Affiliation(s)
- Aliyah R Snyder
- David Geffen School of Medicine, University of California, Los Angeles, CA.
| | - Christopher C Giza
- David Geffen School of Medicine, University of California, Los Angeles, CA; Department of Pediatrics, David Geffen School of Medicine and UCLA Mattel Children's Hospital, University of California, Los Angeles, CA
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13
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A Comparison of Virtual Reality Classroom Continuous Performance Tests to Traditional Continuous Performance Tests in Delineating ADHD: a Meta-Analysis. Neuropsychol Rev 2019; 29:338-356. [PMID: 31161465 DOI: 10.1007/s11065-019-09407-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
Abstract
Computerized continuous performance tests (CPTs) are commonly used to characterize attention in attention deficit-hyperactivity disorder (ADHD). Virtual classroom CPTs, designed to enhance ecological validity, are increasingly being utilized. Lacking is a quantitative meta-analysis of clinical comparisons of attention performance in children with ADHD using virtual classroom CPTs. The objective of the present systematic PRISMA review was to address this empirical void and compare three-dimensional (3D) virtual classroom CPTs to traditional two-dimensional (2D) CPTs. The peer-reviewed literature on comparisons of virtual classroom performance between children with ADHD and typically developing children was explored in six databases (e.g., Medline). Published studies using a virtual classroom to compare attentional performance between children with ADHD and typically developing children were included. Given the high heterogeneity with modality comparisons (i.e., computerized CPTs vs. virtual classroom CPTs for ADHD), both main comparisons included only population comparisons (i.e., control vs. ADHD) using each CPT modality. Meta-analytic findings were generally consistent with previous meta-analyses of computerized CPTs regarding the commonly used omission, commission, and hit reaction time variables. Results suggest that the virtual classroom CPTs reliably differentiate attention performance in persons with ADHD. Ecological validity implications are discussed pertaining to subtle meta-analytic outcome differences compared to computerized 2D CPTs. Further, due to an inability to conduct moderator analyses, it remains unclear if modality differences are due to other factors. Suggestions for future research using the virtual classroom CPTs are provided.
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Rausch M, Simon JE, Starkey C, Grooms DR. Smartphone virtual reality to increase clinical balance assessment responsiveness. Phys Ther Sport 2018; 32:207-211. [DOI: 10.1016/j.ptsp.2018.05.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/20/2018] [Accepted: 05/21/2018] [Indexed: 11/17/2022]
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Duffield TC, Parsons TD, Landry A, Karam S, Otero T, Mastel S, Hall TA. Virtual environments as an assessment modality with pediatric ASD populations: a brief report. Child Neuropsychol 2017; 24:1129-1136. [PMID: 28903621 DOI: 10.1080/09297049.2017.1375473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Virtual environments (VEs) have demonstrated promise as a neuropsychological assessment modality and may be well suited for the evaluation of children suspected of having an autism spectrum disorder (ASD). Some recent studies indicate their potential for enhancing reliability, ecologically validity, and sensitivity over traditional neuropsychological evaluation measures. Although research using VEs with ASD is increasing to the degree that several reviews of the literature have been conducted, the reviews to date lack rigor and are not necessarily specific to cognitive or neuropsychological assessment as many focus on intervention. The aim of this project was to comprehensively examine the current literature status of neuropsychological assessment in pediatric ASD using VEs by conducting a systematic review. Specifically, psychometric comparisons of VEs to traditional neuropsychological assessment measures that examined reliability, validity, and/or diagnostic accuracy for pediatric individuals, age 18 and below, with ASD were sought. The search using key words yielded 899 manuscripts, 894 of which were discarded for not meeting inclusion criteria. The remaining five met exclusion criteria. Therefore, the systematic review was modified to a brief report. These findings (or lack thereof) indicate a significant gap in the literature in that psychometric comparisons of these tools for the neuropsychological assessment of pediatric individuals with ASD are lacking. An important future direction of research will be extending the demonstrated incremental validity of VE neuropsychological assessment with other neurodevelopmental (e.g., attention-deficit/hyperactivity disorder) and adult populations to pediatric ASD populations.
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Affiliation(s)
- Tyler C Duffield
- a Department of Family Medicine , Sports Medicine Program, Oregon Health & Science University , Portland , OR , USA
| | - Thomas D Parsons
- b Department of Psychology , University of North Texas , Denton , TX , USA
| | - Allisen Landry
- c Department of Pediatrics , Oregon Health & Science University , Portland , OR , USA
| | - Shaza Karam
- c Department of Pediatrics , Oregon Health & Science University , Portland , OR , USA
| | - Tiffany Otero
- c Department of Pediatrics , Oregon Health & Science University , Portland , OR , USA
| | - Sarah Mastel
- c Department of Pediatrics , Oregon Health & Science University , Portland , OR , USA
| | - Trevor A Hall
- c Department of Pediatrics , Oregon Health & Science University , Portland , OR , USA
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Ahmed OH, Schneiders AG, McCrory PR, Sullivan SJ. Sport Concussion Management Using Facebook: A Feasibility Study of an Innovative Adjunct "iCon". J Athl Train 2017; 52:339-349. [PMID: 28430553 DOI: 10.4085/1062-6050-52.2.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Sport concussion is currently the focus of much international attention. Innovative methods to assist athletic trainers in facilitating management after this injury need to be investigated. OBJECTIVE To investigate the feasibility of using a Facebook concussion-management program termed iCon (interactive concussion management) to facilitate the safe return to play (RTP) of young persons after sport concussion. DESIGN Observational study. SETTING Facebook group containing interactive elements, with moderation and support from trained health care professionals. PATIENTS OR OTHER PARTICIPANTS Eleven participants (n = 9 men, n = 2 women; range, 18 to 28 years old) completed the study. DATA COLLECTION AND ANALYSIS The study was conducted over a 3-month period, with participant questionnaires administered preintervention and postintervention. The primary focus was on the qualitative experiences of the participants and the effect of iCon on their RTP. Usage data were also collected. RESULTS At the completion of the study, all participants (100%) stated that they would recommend an intervention such as iCon to others. Their supporting quotes all indicated that iCon has the potential to improve the management of concussion among this cohort. Most participants (n = 9, 82%) stated they were better informed with regard to their RTP due to participating in iCon. CONCLUSIONS This interactive adjunct to traditional concussion management was appreciated among this participant group, which indicates the feasibility of a future, larger study of iCon. Athletic trainers should consider the role that multimedia technologies may play in assisting with the management of sport concussion.
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Affiliation(s)
- Osman Hassan Ahmed
- Faculty of Health and Social Sciences, Bournemouth University, Dorset, United Kingdom
| | - Anthony G Schneiders
- School of Health, Medical and Applied Sciences, Central Queensland University, Branyan, Australia
| | - Paul R McCrory
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
| | - S John Sullivan
- Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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Salisbury DB, Dahdah M, Driver S, Parsons TD, Richter KM. Virtual reality and brain computer interface in neurorehabilitation. Proc (Bayl Univ Med Cent) 2016; 29:124-7. [PMID: 27034541 DOI: 10.1080/08998280.2016.11929386] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The potential benefit of technology to enhance recovery after central nervous system injuries is an area of increasing interest and exploration. The primary emphasis to date has been motor recovery/augmentation and communication. This paper introduces two original studies to demonstrate how advanced technology may be integrated into subacute rehabilitation. The first study addresses the feasibility of brain computer interface with patients on an inpatient spinal cord injury unit. The second study explores the validity of two virtual environments with acquired brain injury as part of an intensive outpatient neurorehabilitation program. These preliminary studies support the feasibility of advanced technologies in the subacute stage of neurorehabilitation. These modalities were well tolerated by participants and could be incorporated into patients' inpatient and outpatient rehabilitation regimens without schedule disruptions. This paper expands the limited literature base regarding the use of advanced technologies in the early stages of recovery for neurorehabilitation populations and speaks favorably to the potential integration of brain computer interface and virtual reality technologies as part of a multidisciplinary treatment program.
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Affiliation(s)
- David B Salisbury
- Baylor Institute for Rehabilitation, Dallas, Texas (Salisbury, Dahdah, Driver); Baylor Regional Medical Center at Plano, Plano, Texas (Dahdah); the Department of Psychology, the University of North Texas, Denton, Texas (Parsons); and the Center for Clinical Effectiveness, Baylor Scott & White Health, Dallas, Texas (Richter)
| | - Marie Dahdah
- Baylor Institute for Rehabilitation, Dallas, Texas (Salisbury, Dahdah, Driver); Baylor Regional Medical Center at Plano, Plano, Texas (Dahdah); the Department of Psychology, the University of North Texas, Denton, Texas (Parsons); and the Center for Clinical Effectiveness, Baylor Scott & White Health, Dallas, Texas (Richter)
| | - Simon Driver
- Baylor Institute for Rehabilitation, Dallas, Texas (Salisbury, Dahdah, Driver); Baylor Regional Medical Center at Plano, Plano, Texas (Dahdah); the Department of Psychology, the University of North Texas, Denton, Texas (Parsons); and the Center for Clinical Effectiveness, Baylor Scott & White Health, Dallas, Texas (Richter)
| | - Thomas D Parsons
- Baylor Institute for Rehabilitation, Dallas, Texas (Salisbury, Dahdah, Driver); Baylor Regional Medical Center at Plano, Plano, Texas (Dahdah); the Department of Psychology, the University of North Texas, Denton, Texas (Parsons); and the Center for Clinical Effectiveness, Baylor Scott & White Health, Dallas, Texas (Richter)
| | - Kathleen M Richter
- Baylor Institute for Rehabilitation, Dallas, Texas (Salisbury, Dahdah, Driver); Baylor Regional Medical Center at Plano, Plano, Texas (Dahdah); the Department of Psychology, the University of North Texas, Denton, Texas (Parsons); and the Center for Clinical Effectiveness, Baylor Scott & White Health, Dallas, Texas (Richter)
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Use of Virtual Reality Tools for Vestibular Disorders Rehabilitation: A Comprehensive Analysis. Adv Med 2015; 2015:916735. [PMID: 26556560 PMCID: PMC4590967 DOI: 10.1155/2015/916735] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 04/19/2015] [Indexed: 11/18/2022] Open
Abstract
Classical peripheral vestibular disorders rehabilitation is a long and costly process. While virtual reality settings have been repeatedly suggested to represent possible tools to help the rehabilitation process, no systematic study had been conducted so far. We systematically reviewed the current literature to analyze the published protocols documenting the use of virtual reality settings for peripheral vestibular disorders rehabilitation. There is an important diversity of settings and protocols involving virtual reality settings for the treatment of this pathology. Evaluation of the symptoms is often not standardized. However, our results unveil a clear effect of virtual reality settings-based rehabilitation of the patients' symptoms, assessed by objectives tools such as the DHI (mean decrease of 27 points), changing symptoms handicap perception from moderate to mild impact on life. Furthermore, we detected a relationship between the duration of the exposure to virtual reality environments and the magnitude of the therapeutic effects, suggesting that virtual reality treatments should last at least 150 minutes of cumulated exposure to ensure positive outcomes. Virtual reality offers a pleasant and safe environment for the patient. Future studies should standardize evaluation tools, document putative side effects further, compare virtual reality to conventional physical therapy, and evaluate economical costs/benefits of such strategies.
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Detecting everyday action deficits in Alzheimer's disease using a nonimmersive virtual reality kitchen. J Int Neuropsychol Soc 2014; 20:468-77. [PMID: 24785240 DOI: 10.1017/s1355617714000344] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Alzheimer's disease (AD) causes impairments affecting instrumental activities of daily living (IADL). Transdisciplinary research in neuropsychology and virtual reality has fostered the development of ecologically valid virtual tools for the assessment of IADL, using simulations of real life activities. Few studies have examined the benefits of this approach in AD patients. Our aim was to examine the utility of a non-immersive virtual coffee task (NI-VCT) for assessment of IADL in these patients. We focus on the assessment results obtained from a group of 24 AD patients on a task designed to assess their ability to prepare a virtual cup of coffee, using a virtual coffee machine. We compared performance on the virtual task to an identical daily living task involving the actual preparation of a cup of coffee, as well as to global cognitive, executive, and caregiver-reported IADL functioning. Relative to 32 comparable, healthy elderly (HE) controls, AD patients performed worse than HE controls on all tasks. Correlation analyses revealed that NI-VCT measures were related to all other neuropsychological measures. Moreover, regression analyses demonstrated that performance on the NI-VCT predicted actual task performance and caregiver-reported IADL functioning. Our results provide initial support for the utility of our virtual kitchen for assessment of IADL in AD patients.
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Poltavski DV, Biberdorf D. Screening for lifetime concussion in athletes: importance of oculomotor measures. Brain Inj 2014; 28:475-85. [PMID: 24702485 DOI: 10.3109/02699052.2014.888771] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
HYPOTHESIS/OBJECTIVE The purpose of the present study was to determine the utility of oculomotor-based evaluation protocols in screening for lifetime concussion incidence in elite hockey players. METHODS Forty-two Division I collegiate male and female hockey players were evaluated using the guidelines of an overall oculomotor-based diagnostic clinical test protocol for the mTBI population. The sensitivity of the collected measures to lifetime concussion was then compared with the corresponding sensitivity of measures of neuropsychological functioning (ImPACT) often used with athletes for acute concussion diagnosis. RESULTS This model showed that a hockey player with a Near Point of Fixation Disparity (NPFD) equal to or greater than 15 cm, Visagraph comprehension rate less than 85% and the total score on part A of an ADHD questionnaire equal to or greater than 11 was on average 10.72-times more likely to have previously suffered a concussion than an athlete with lower values on the NPFD and ADHD questionnaire and a higher comprehension rate on the Visagraph. None of the IMPACT baseline assessment measures were significantly predictive of the individual's concussion history. CONCLUSION The study provides a relatively sensitive screening tool to assess the probability of previous concussion(s) in an athlete. This model may allow athletic personnel to address in a timely manner the risks associated with repeat concussions and to develop individualized concussion management protocols.
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Affiliation(s)
- Dmitri V Poltavski
- Department of Psychology, University of North Dakota , Grand Forks, ND , USA and
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Henry M, Joyal CC, Nolin P. Development and initial assessment of a new paradigm for assessing cognitive and motor inhibition: the bimodal virtual-reality Stroop. J Neurosci Methods 2012; 210:125-31. [PMID: 22897988 DOI: 10.1016/j.jneumeth.2012.07.025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/20/2012] [Accepted: 07/31/2012] [Indexed: 12/19/2022]
Abstract
Assessing and predicting inhibition in adults is a common assignment for clinicians. However, there is no single measure of inhibition that is complete, sensitive and enjoyable. The main goal of this study was to develop a virtual reality neuropsychological task (the bimodal VR-Stroop) capable of measuring both cognitive (control of internal and external interference) and motor inhibition (a go no-go paradigm with reaction time variation, commission errors and omissions). Preliminary data obtained with 71 healthy adult participants confirmed that the VR-Stroop is capable of eliciting the Stroop effect with bimodal stimuli. Initial validation data also suggested that measures of the VR-Stroop significantly correlate with measures of the Elevator counting with distracters, the Continuous Performance Task (CPT-II), and the Stop-it task. Finally, regression analyses indicated that commission errors and variability of reaction times at the VR-Stroop were significantly predicted by scores of the Elevator task and the CPT-II. These preliminary results suggest that the VR-Stroop is an interesting measure of cognitive and motor inhibition for adults, although confirmatory investigations are warranted.
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Affiliation(s)
- Mylène Henry
- Laboratoire de Recherche Interdisciplinaire en Réalité Virtuelle-LARI-RV, Department of Psychology, Université du Québec à Trois-Rivières, Quebec, Canada
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