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Tuena C, Serino S, Goulene KM, Pedroli E, Stramba-Badiale M, Riva G. Bodily and Visual-Cognitive Navigation Aids to Enhance Spatial Recall in Mild Cognitive Impairment. J Alzheimers Dis 2024:JAD240122. [PMID: 38701150 DOI: 10.3233/jad-240122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background Individuals with mild cognitive impairment (MCI) syndrome often report navigation difficulties, accompanied by impairments in egocentric and allocentric spatial memory. However, studies have shown that both bodily (e.g., motor commands, proprioception, vestibular information) and visual-cognitive (e.g., maps, directional arrows, attentional markers) cues can support spatial memory in MCI. Objective We aimed to assess navigation cues for innovative spatial training in aging. Methods Fifteen MCI patients were recruited for this study. Their egocentric and allocentric memory recall performances were tested through a navigation task with five different virtual reality (VR) assistive encoding navigation procedures (bodily, vision only, interactive allocentric map, reduced executive load, free navigation without cues). Bodily condition consisted of an immersive VR setup to engage self-motion cues, vision only condition consisted of passive navigation without interaction, in the interactive allocentric map condition patients could use a bird-view map, in the reduced executive load condition directional cues and attentional markers were employed, and during free navigation no aid was implemented. Results Bodily condition improved spatial memory compared to vision only and free navigation without cues. In addition, the interactive allocentric map was superior to the free navigation without cues. Surprisingly, the reduced executive load was comparable to vison only condition. Moreover, a detrimental impact of free navigation was observed on allocentric memory across testing trials. Conclusions These findings challenge the notion of an amodal representation of space in aging, suggesting that spatial maps can be influenced by the modality in which the environment was originally encoded.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Silvia Serino
- Department of Psychology, Università degli Studi Milano-Bicocca, Milan, Italy
| | - Karine Marie Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
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Cammisuli DM, Tuena C, Riva G, Repetto C, Axmacher N, Chandreswaran V, Isella V, Pomati S, Zago S, Difonzo T, Pavanello G, Prete LA, Stramba-Badiale M, Mauro A, Cattaldo S, Castelnuovo G. Exploring the Remediation of Behavioral Disturbances of Spatial Cognition in Community-Dwelling Senior Citizens with Mild Cognitive Impairment via Innovative Technological Apparatus (BDSC-MCI Project): Protocol for a Prospective, Multi-Center Observational Study. J Pers Med 2024; 14:192. [PMID: 38392625 PMCID: PMC10890288 DOI: 10.3390/jpm14020192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Spatial navigation (SN) has been reported to be one of the first cognitive domains to be affected in Alzheimer's disease (AD), which occurs as a result of progressive neuropathology involving specific brain areas. Moreover, the epsilon 4 isoform of apolipoprotein-E (APOE-ε4) has been associated with both sporadic and familial late-onset AD, and patients with mild cognitive impairment (MCI) due to AD are more likely to progressively deteriorate. Spatial navigation performance will be examined on a sample of 76 community-dwelling senior citizens (25 healthy controls; 25 individuals with subjective cognitive decline (SCD); and 26 patients with MCI due to AD) via a virtual computer-based task (i.e., the AppleGame) and a naturalistic task (i.e., the Detour Navigation Test-modified version) for which a wearable device with sensors will be used for recording gait data and revealing physiological parameters that may be associated with spatial disorientation. We expect that patients with MCI due to AD and APOE-ε4 carriers will show altered SN performances compared to individuals with SCD and healthy controls in the experimental tasks, and that VR testing may predict ecological performance. Impaired SN performances in people at increased risk of developing AD may inform future cognitive rehabilitation protocols for counteracting spatial disorientation that may occur during elders' traveling to unfamiliar locations. The research protocol has been approved by the Ethics Committee of the Istituto Auxologico Italiano. Findings will be published in peer-reviewed medical journals and discussed in national and international congresses.
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Affiliation(s)
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
- Human Technology Lab, Catholic University, 20145 Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University, 20123 Milan, Italy
| | - Nikolai Axmacher
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr University, 44801 Bochum, Germany
| | - Varnan Chandreswaran
- Department of Neuropsychology, Faculty of Psychology, Institute of Cognitive Neuroscience, Ruhr University, 44801 Bochum, Germany
| | - Valeria Isella
- Department of Neurology, School of Medicine, University of Milano-Bicocca, 20126 Milan, Italy
- Milan Center for Neurosciences, 20133 Milan, Italy
| | - Simone Pomati
- Neurology Unit, Luigi Sacco University Hospital, 20157 Milan, Italy
| | - Stefano Zago
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Teresa Difonzo
- Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, 20122 Milan, Italy
| | - Giada Pavanello
- School of Specialization in Clinical Psychology, Catholic University, 20123 Milan, Italy
| | - Lorenzo Augusto Prete
- School of Specialization in Clinical Psychology, Catholic University, 20123 Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Alessandro Mauro
- "Rita Levi Montalcini" Department of Neurosciences, University of Turin, 10126 Turin, Italy
- Neurology and Neurorehabilitation Unit, IRCCS Istituto Auxologico Italiano, "San Giuseppe" Hospital, 33081 Piancavallo, Italy
| | - Stefania Cattaldo
- Clinic Neurobiology Laboratory, IRCCS Istituto Auxologico Italiano, "San Giuseppe" Hospital, 33081 Piancavallo, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University, 20123 Milan, Italy
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
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Tuena C, Pupillo C, Stramba-Badiale C, Stramba-Badiale M, Riva G. Predictive power of gait and gait-related cognitive measures in amnestic mild cognitive impairment: a machine learning analysis. Front Hum Neurosci 2024; 17:1328713. [PMID: 38348371 PMCID: PMC10859484 DOI: 10.3389/fnhum.2023.1328713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/20/2023] [Indexed: 02/15/2024] Open
Abstract
Introduction Gait disorders and gait-related cognitive tests were recently linked to future Alzheimer's Disease (AD) dementia diagnosis in amnestic Mild Cognitive Impairment (aMCI). This study aimed to evaluate the predictive power of gait disorders and gait-related neuropsychological performances for future AD diagnosis in aMCI through machine learning (ML). Methods A sample of 253 aMCI (stable, converter) individuals were included. We explored the predictive accuracy of four predictors (gait profile plus MMSE, DSST, and TMT-B) previously identified as critical for the conversion from aMCI to AD within a 36-month follow-up. Supervised ML algorithms (Support Vector Machine [SVM], Logistic Regression, and k-Nearest Neighbors) were trained on 70% of the dataset, and feature importance was evaluated for the best algorithm. Results The SVM algorithm achieved the best performance. The optimized training set performance achieved an accuracy of 0.67 (sensitivity = 0.72; specificity = 0.60), improving to 0.70 on the test set (sensitivity = 0.79; specificity = 0.52). Feature importance revealed MMSE as the most important predictor in both training and testing, while gait type was important in the testing phase. Discussion We created a predictive ML model that is capable of identifying aMCI at high risk of AD dementia within 36 months. Our ML model could be used to quickly identify individuals at higher risk of AD, facilitating secondary prevention (e.g., cognitive and/or physical training), and serving as screening for more expansive and invasive tests. Lastly, our results point toward theoretically and practically sound evidence of mind and body interaction in AD.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Pupillo
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
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Stramba-Badiale C, Tuena C, Goulene KM, Cipresso P, Morelli S, Rossi M, D’Avenio G, Stramba-Badiale M, Riva G. Enhancing spatial navigation skills in mild cognitive impairment patients: a usability study of a new version of ANTaging software. Front Hum Neurosci 2024; 17:1310375. [PMID: 38259329 PMCID: PMC10801043 DOI: 10.3389/fnhum.2023.1310375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Mild Cognitive Impairment (MCI) often presents challenges related to spatial navigation and retention of spatial information. Navigating space involves intricate integration of bodily and environmental cues. Spatial memory is dependent on two distinct frame of reference systems for organizing this information: egocentric and allocentric frames of reference. Virtual Reality (VR) has emerged as a promising technology for enhancing spatial navigation skills and spatial memory by facilitating the manipulation of bodily, environmental, and cognitive cues. Methods This usability study was based on a fully within-subjects design in which seven MCI patients underwent two kinds of VR conditions: participants were required to complete the ANTaging demo both in Oculus Rift S (immersive condition) and in Samsung UHD 4K monitor (semi-immersive condition). Participants were seated and they had to use a foot-motion pad to navigate and explore the environment to collect and relocate some objects in the virtual environment. Post-interaction, users provided feedback on their experiences. Additionally, usability, potential side effects, data analysis feasibility, and user preferences with immersive and semi-immersive technologies were assessed through questionnaires. Results Results indicated higher usability ratings for the semi-immersive setup, with fewer negative effects reported compared to the immersive counterpart. According to qualitative analyses of the interviews, patients do seem to like both VR apparatuses even though the semi-immersive condition was perceived as the most suitable choice because of the size of the screen. Patients generally found it difficult to remember object locations. Participants expressed the need for more practice with the foot-motion pad, despite an overall positive experience. They generally would like to use this system to improve their memory. Discussion Identifying these key aspects was crucial for refining the system before the upcoming clinical trial. This study sheds light on the potential of semi-immersive VR in aiding individuals with MCI, paving the way for enhanced spatial navigation interventions.
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Affiliation(s)
- Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Karine Marie Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Department of Psychology, University of Turin, Turin, Italy
- IRCCS Istituto Auxologico Italiano, Cusano Milanino, Italy
| | - Sandra Morelli
- National Center for Innovative Technologies in Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Mirko Rossi
- National Center for Innovative Technologies in Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Giuseppe D’Avenio
- National Center for Innovative Technologies in Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
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Brizzi G, Sansoni M, Di Lernia D, Frisone F, Tuena C, Riva G. The multisensory mind: a systematic review of multisensory integration processing in Anorexia and Bulimia Nervosa. J Eat Disord 2023; 11:204. [PMID: 37974266 PMCID: PMC10655389 DOI: 10.1186/s40337-023-00930-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023] Open
Abstract
Individuals with Anorexia Nervosa and Bulimia Nervosa present alterations in the way they experience their bodies. Body experience results from a multisensory integration process in which information from different sensory domains and spatial reference frames is combined into a coherent percept. Given the critical role of the body in the onset and maintenance of both Anorexia Nervosa and Bulimia Nervosa, we conducted a systematic review to examine multisensory integration abilities of individuals affected by these two conditions and investigate whether they exhibit impairments in crossmodal integration. We searched for studies evaluating crossmodal integration in individuals with a current diagnosis of Anorexia Nervosa and Bulimia Nervosa as compared to healthy individuals from both behavioral and neurobiological perspectives. A search of PubMed, PsycINFO, and Web of Sciences databases was performed to extract relevant articles. Of the 2348 studies retrieved, 911 were unique articles. After the screening, 13 articles were included. Studies revealed multisensory integration abnormalities in patients affected by Anorexia Nervosa; only one included individuals with Bulimia Nervosa and observed less severe impairments compared to healthy controls. Overall, results seemed to support the presence of multisensory deficits in Anorexia Nervosa, especially when integrating interoceptive and exteroceptive information. We proposed the Predictive Coding framework for understanding our findings and suggested future lines of investigation.
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Affiliation(s)
- Giulia Brizzi
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy.
| | - Maria Sansoni
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
| | - Daniele Di Lernia
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
| | - Fabio Frisone
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro- Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149, Milan, Italy
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
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Tuena C, Di Lernia D, Rodella C, Bellinzona F, Riva G, Costello MC, Repetto C. The interaction between motor simulation and spatial perspective-taking in action language: a cross-cultural study. Mem Cognit 2023; 51:1870-1880. [PMID: 37204674 PMCID: PMC10638199 DOI: 10.3758/s13421-023-01427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2023] [Indexed: 05/20/2023]
Abstract
Growing evidence has revealed the crucial role of motor simulation and spatial perspective-taking in action language. However, there is still a lack of understanding of how motor and spatial processes interact when there are multiple actors involved, and if embodied processes are consistent across different cultures. To address this gap, we examined the interaction between motor simulation and spatial perspective-taking in action-sentences comprehension, along with the consistency of embodied processes across cultures. We collected data from Italian and US English speakers using an online sentence-picture verification task. The participants completed four conditions: two congruent (i.e., the participant is the agent in the sentence and the photo; the agent is someone else interacting with the participant in both the sentence and the picture) and two incongruent (i.e., the agents of the sentence and the picture do not match). The results show that when the perspective of the picture matched that described in the sentence-processing reaction times (RTs) were faster than in the incongruent conditions. In the congruent conditions where the agent is someone else, RTs were slower compared to the condition where the participant is the agent. This has been interpreted as claiming that motor simulation and perspective-taking are independent processes interacting during sentence comprehension (e.g., motor simulation is always run in the role of the agent, but we can adopt multiple perspectives depending on the pronouns and the contextual cues). Furthermore, Bayesian analysis provided evidence that embodied processing of action language entwines a common mechanism, suggesting cross-cultural consistency of embodied processes.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Claudia Rodella
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Claudia Repetto
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy.
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Tuena C, Di Lernia D, Riva G, Serino S, Repetto C. Phonological similarity between words is represented in declarative memory as spatial distance. Psychol Res 2023; 87:2499-2510. [PMID: 37204615 PMCID: PMC10197043 DOI: 10.1007/s00426-023-01830-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 04/21/2023] [Indexed: 05/20/2023]
Abstract
Space can be used as a metaphor to describe semantic and perceptual similarity. Research has shown that similarity and spatial information can influence each other. On the one hand, similarity entails spatial closeness; on the other hand, proximity leads to similarity judgment. This spatial information can be stored in declarative memory and measured later on. However, it is unknown if phonological similarity/dissimilarity between words is represented as spatial closeness/distance in declarative memory. In this study, 61 young adults were tested on a remember-know (RK) spatial distance task. Participants learned noun pairs on the PC screen that were manipulated concerning their phonological similarity (similar vs. dissimilar) and reciprocal spatial distance (near vs. far). In the recognition phase, old-new, RK, and spatial distance judgments were asked. We found that for hit responses in both R and K judgments, phonologically similar word pairs were remembered closer compared to phonologically dissimilar pairs. This was also true for false alarms after K judgments. Lastly, the actual spatial distance at encoding was only retained for hit R responses. Results suggest that phonological similarity/dissimilarity is represented respectively with spatial closeness/distance and that this information is stored in the neurocognitive system of declarative memory.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Silvia Serino
- Present Address: Department of Psychology, Università degli Studi Milano – Bicocca, Piazza Dell’Ateneo Nuovo, 20126 Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University of the Sacred Heart of Milan, Milan, Italy
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Ibáñez A, Kühne K, Miklashevsky A, Monaco E, Muraki E, Ranzini M, Speed LJ, Tuena C. Ecological Meanings: A Consensus Paper on Individual Differences and Contextual Influences in Embodied Language. J Cogn 2023; 6:59. [PMID: 37841670 PMCID: PMC10573819 DOI: 10.5334/joc.228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/20/2022] [Indexed: 10/17/2023] Open
Abstract
Embodied theories of cognition consider many aspects of language and other cognitive domains as the result of sensory and motor processes. In this view, the appraisal and the use of concepts are based on mechanisms of simulation grounded on prior sensorimotor experiences. Even though these theories continue receiving attention and support, increasing evidence indicates the need to consider the flexible nature of the simulation process, and to accordingly refine embodied accounts. In this consensus paper, we discuss two potential sources of variability in experimental studies on embodiment of language: individual differences and context. Specifically, we show how factors contributing to individual differences may explain inconsistent findings in embodied language phenomena. These factors include sensorimotor or cultural experiences, imagery, context-related factors, and cognitive strategies. We also analyze the different contextual modulations, from single words to sentences and narratives, as well as the top-down and bottom-up influences. Similarly, we review recent efforts to include cultural and language diversity, aging, neurodegenerative diseases, and brain disorders, as well as bilingual evidence into the embodiment framework. We address the importance of considering individual differences and context in clinical studies to drive translational research more efficiently, and we indicate recommendations on how to correctly address these issues in future research. Systematically investigating individual differences and context may contribute to understanding the dynamic nature of simulation in language processes, refining embodied theories of cognition, and ultimately filling the gap between cognition in artificial experimental settings and cognition in the wild (i.e., in everyday life).
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Affiliation(s)
- Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés and CONICET, Buenos Aires, Argentina
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), California, US
- Trinity College Dublin (TCD), Dublin, Ireland, IE
| | - Katharina Kühne
- Potsdam Embodied Cognition Group, Cognitive Sciences, University of Potsdam, Potsdam, DE
| | - Alex Miklashevsky
- Potsdam Embodied Cognition Group, Cognitive Sciences, University of Potsdam, Potsdam, DE
| | - Elisa Monaco
- Laboratory for Cognitive and Neurological Sciences, Department of Neuroscience and Movement Science, Faculty of Science and Medicine, University of Fribourg, CH
| | - Emiko Muraki
- Department of Psychology & Hotchkiss Brain Institute, University of Calgary, CA
| | | | | | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, IT
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Lernia DDI, Serino S, Tuena C, Cacciatore C, Polli N, Riva G. Mental health meets computational neuroscience: A predictive Bayesian account of the relationship between interoception and multisensory bodily illusions in anorexia nervosa. Int J Clin Health Psychol 2023; 23:100383. [PMID: 36937547 PMCID: PMC10017360 DOI: 10.1016/j.ijchp.2023.100383] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 02/21/2023] [Indexed: 03/09/2023] Open
Abstract
Mental health disorders pose a significant challenge to society. The Bayesian perspective on the mind offers unique insights and tools that may help address a variety of mental health conditions. Psychopathological dysfunctions are often connected to altered predictive and active inference processes, in which cognitive and physiological pathogenic beliefs shape the clinical condition and its symptoms. However, there is a lack of general empirical models that integrate cognitive beliefs, physiological experience, and symptoms in healthy and clinical populations. In this study, we examined the relationship between altered predictive mechanisms, interoception, and pathological bodily distortions in healty individuals and in individuals suffering from anorexia nervosa (AN). AN patients (N=15) completed a Virtual Reality Full-Body Illusion along with interoceptive tasks twice: at hospital admission during an acute symptomatological phase (Time 1) and after a 12-week outpatient clinical weight-restoring rehabilitative program (Time 2). Results were compared to a healthy control group. Our findings indicated that higher levels of interoceptive metacognitive awareness were associated with a greater embodiment. However, unlike in healthy participants, AN patients' interoceptive metacognition was linked to embodiment even in multisensory mismatching (asynchronous) conditions. In addition, unlike in healthy participants, higher interoceptive metacognition in AN patients was related to prior abnormal bodily distortions during the acute symptomatology phase. Prediction errors in bodily estimates predicted posterior bodily estimate distortions after the illusion, but while this relationship was only significant in the synchronous condition in healthy participants, there was no significant difference between synchronous and asynchronous conditions in AN patients. Despite the success of the rehabilitation program in restoring some dysfunctional patterns in the AN group, prediction errors and posterior estimate distortions were present at hospital discharge. Our findings suggest that individuals with AN prioritize interoceptive metacognitive processes (i.e., confidence in their own perceived sensations rather than their actual perceptions), disregarding bottom-up bodily inputs in favour of their prior altered top-down beliefs. Moreover, even if the rehabilitative program partially mitigated these alterations, the pathological condition impaired the patients' ability to coherently update their prior erroneous expectations with real-time multisensory bottom-up bodily information, possibly locking the patients in the experience of a distorted prior top-down belief. These results suggest new therapeutic perspectives and introduce the framework of regenerative virtual therapy (RVT), which aims at utilizing technology-based somatic modification techniques to restructure the maladaptive priors underlying a pathological condition.
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Affiliation(s)
- Daniele DI Lernia
- Humane Technology Lab, Università Cattolica del Sacro Cuore di Milano, Italy
| | - Silvia Serino
- Humane Technology Lab, Università Cattolica del Sacro Cuore di Milano, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Cacciatore
- UO di Endocrinologia e Malattie Metaboliche, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nicoletta Polli
- UO di Endocrinologia e Malattie Metaboliche, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore di Milano, Italy
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Tuena C, Borghesi F, Bruni F, Cavedoni S, Maestri S, Riva G, Tettamanti M, Liperoti R, Rossi L, Ferrarin M, Stramba-Badiale M. Correction: Technology-Assisted Cognitive Motor Dual-Task Rehabilitation in Chronic Age-Related Conditions: Systematic Review. J Med Internet Res 2023; 25:e51591. [PMID: 37751594 PMCID: PMC10565613 DOI: 10.2196/51591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 09/28/2023] Open
Abstract
[This corrects the article DOI: 10.2196/44484.].
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology LabIstituto Auxologico ItalianoIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
| | | | | | - Silvia Cavedoni
- Applied Technology for Neuro-Psychology LabIstituto Auxologico ItalianoIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
| | - Sara Maestri
- Applied Technology for Neuro-Psychology LabIstituto Auxologico ItalianoIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology LabIstituto Auxologico ItalianoIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
- Humane Technology LabUniversità Cattolica del Sacro CuoreMilanItaly
| | - Mauro Tettamanti
- Laboratory of Geriatric EpidemiologyIstituto di Ricerche Farmacologiche Mario NegriIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
| | - Rosa Liperoti
- Fondazione Policlinico Universitario Agostino GemelliIstituto di Ricovero e Cura a Carattere ScientificoRomeItaly
| | | | - Maurizio Ferrarin
- Fondazione Don Carlo GnocchiIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular MedicineIstituto Auxologico ItalianoIstituto di Ricovero e Cura a Carattere ScientificoMilanItaly
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Tuena C, Zeng L, Hashmi M, Riva G. VRBodyMem: A Virtual Full-Body Illusion for the Study of Episodic Memory. Cyberpsychol Behav Soc Netw 2023; 26:724-726. [PMID: 37358797 DOI: 10.1089/cyber.2023.29287.ceu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Ling Zeng
- Universidade Lusofona de Humanidades e Technologias-ULHT, Lisbon, Portugal
- Université Paris Cité, Paris, France
| | - Maria Hashmi
- Universidade Lusofona de Humanidades e Technologias-ULHT, Lisbon, Portugal
- Universitat de Barcelona, Barcelona, Spain
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Laboratory, Catholic University of Milan, Milan, Italy
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Riva G, Di Lernia D, Tuena C, Bernardelli L, Maldonado JG, Ferrer-Garcia M, Porras-Garcia B, Meyer ML, Shiban Y, Castelnuovo G, Pagnini F, Pedroli E, Sforza F, Clementi A, Sansoni M, Wiederhold BK, Serino S. A Self-Help Virtual Therapeutic Experience Intervention for Overcoming Psychological Distress Related to the COVID-19 Pandemic: Results From the European Multicentric COVID Feel Good Trial. Psychosom Med 2023; 85:639-650. [PMID: 37053096 DOI: 10.1097/psy.0000000000001198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
OBJECTIVE The general objective of the current study was to investigate the efficacy of a novel self-help virtual therapeutic experience (specifically, the COVID Feel Good intervention) in lowering the psychological burden experienced during the COVID-19 lockdowns in four European countries. METHODS We focused on participants recruited from June 2020 to May 2021 in the context of a European multicenter project including four university/academic sites. The total number of participants in the longitudinal studies was 107 (study 1, N = 40; study 2, N = 29; study 3, N = 38). The randomized controlled trial (study 4) included 31 participants in total, 16 in the intervention group and 15 in the control group. Primary outcome measures were depression, anxiety, stress symptoms, perceived stress level, and perceived hopelessness. The secondary outcome was experienced social connectedness. RESULTS Using separate linear mixed-effects models, the most consistent result across countries was a reduction in perceived stress after the participation in the COVID Feel Good intervention. By pooling the results of the models using a random-effects meta-analysis, we found that after the COVID Feel Good intervention, participants reported a decrease in perceived general distress (mean standardized effect size for general distress in the treatment groups compared with the control conditions was -0.52 [ p = .008, 95% confidence interval = -0.89 to -0.14]) and an increase in the perceived social connection (mean standardized effect size for social connection using COVID Feel Good compared with the control conditions was 0.50 [ p ≤ .001, 95% confidence interval = 0.25 to 0.76]). CONCLUSIONS Findings of this study indicate that a virtual self-help intervention is effective in reducing psychological distress. These results contribute to the growing literature supporting the use of digital psychological therapies to relieve psychological distress among the general population during the COVID-19 pandemic.Trial Registration : ISRCTN63887521.
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Affiliation(s)
- Giuseppe Riva
- From the Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano (Riva, Tuena, Pedroli); Humane Technology Lab, Università Cattolica del Sacro Cuore (Riva, Di Lernia, Pedroli); Become-Hub (Bernardelli, Sforza, Pedroli), Milan, Italy; Department of Clinical Psychology and Psychobiology (Gutiérrez Maldonado, Ferrer-Garcia, Porras-Garcia, Pedroli), University of Barcelona, Barcelona, Spain; Department of Psychology (Meyer, Shiban, Pedroli), Private University of Applied Science, Goettingen, Germany; Clinical Psychology Research Laboratory (Castelnuovo, Pedroli), Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania; Department of Psychology (Castelnuovo, Pagnini, Pedroli, Clementi, Sansoni, Serino), Università Cattolica del Sacro Cuore, Milan, Italy; Faculty of Psychology (Pedroli), University of eCampus, Novedrate, Italy; Virtual Reality Medical Center (Wiederhold), La Jolla, California; Virtual Reality Medical Institute (Wiederhold), Brussels, Belgium
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Gallucci A, Trimarchi PD, Tuena C, Cavedoni S, Pedroli E, Greco FR, Greco A, Abbate C, Lattanzio F, Stramba-Badiale M, Giunco F. Correction to: Technologies for frailty, comorbidity, and multimorbidity in older adults: a systematic review of research designs. BMC Med Res Methodol 2023; 23:176. [PMID: 37528386 PMCID: PMC10391966 DOI: 10.1186/s12874-023-01996-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Affiliation(s)
| | | | - Cosimo Tuena
- Applied Technology for Neuro‑Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Silvia Cavedoni
- Applied Technology for Neuro‑Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro‑Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, University of eCampus, Novedrate, Italy
| | - Francesca Romana Greco
- Geriatric Unit, Department of Medical Sciences, IRCCS ''Casa Sollievo della Sofferenza'', San Giovanni Rotondo, Italy
| | - Antonio Greco
- Geriatric Unit, Department of Medical Sciences, IRCCS ''Casa Sollievo della Sofferenza'', San Giovanni Rotondo, Italy
| | - Carlo Abbate
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | | | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Tuena C, Maestri S, Serino S, Pedroli E, Stramba-Badiale M, Riva G. Prognostic relevance of gait-related cognitive functions for dementia conversion in amnestic mild cognitive impairment. BMC Geriatr 2023; 23:462. [PMID: 37525134 PMCID: PMC10388514 DOI: 10.1186/s12877-023-04175-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/15/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Increasing research suggests that gait abnormalities can be a risk factor for Alzheimer's Disease (AD). Notably, there is growing evidence highlighting this risk factor in individuals with amnestic Mild Cognitive Impairment (aMCI), however further studies are needed. The aim of this study is to analyze cognitive tests results and brain-related measures over time in aMCI and examine how the presence of gait abnormalities (neurological or orthopedic) or normal gait affects these trends. Additionally, we sought to assess the significance of gait and gait-related measures as prognostic indicators for the progression from aMCI to AD dementia, comparing those who converted to AD with those who remained with a stable aMCI diagnosis during the follow-up. METHODS Four hundred two individuals with aMCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database were included. Robust linear mixed-effects models were used to study the impact of gait abnormalities on a comprehensive neuropsychological battery over 36 months while controlling for relevant medical variables at baseline. The impact of gait on brain measures was also investigated. Lastly, the Cox proportional-hazards model was used to explore the prognostic relevance of abnormal gait and neuropsychological associated tests. RESULTS While controlling for relevant covariates, we found that gait abnormalities led to a greater decline over time in attention (DSST) and global cognition (MMSE). Intriguingly, psychomotor speed (TMT-A) and divided attention (TMT-B) declined uniquely in the abnormal gait group. Conversely, specific AD global cognition tests (ADAS-13) and auditory-verbal memory (RAVLT immediate recall) declined over time independently of gait profile. All the other cognitive tests were not significantly affected by time or by gait profile. In addition, we found that ventricles size increased faster in the abnormal gait group compared to the normal gait group. In terms of prognosis, abnormal gait (HR = 1.7), MMSE (HR = 1.09), and DSST (HR = 1.03) covariates showed a higher impact on AD dementia conversion. CONCLUSIONS The importance of the link between gait and related cognitive functions in terms of diagnosis, prognosis, and rehabilitation in aMCI is critical. We showed that in aMCI gait abnormalities lead to executive functions/attention deterioration and conversion to AD dementia.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Sara Maestri
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Silvia Serino
- Department of Psychology, Università degli Studi Milano-Bicocca, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, Università eCampus, Novedrate, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
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Gallucci A, Trimarchi PD, Tuena C, Cavedoni S, Pedroli E, Greco FR, Greco A, Abbate C, Lattanzio F, Stramba-Badiale M, Giunco F. Technologies for frailty, comorbidity, and multimorbidity in older adults: a systematic review of research designs. BMC Med Res Methodol 2023; 23:166. [PMID: 37434136 PMCID: PMC10334509 DOI: 10.1186/s12874-023-01971-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 06/09/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Frailty, neurodegeneration and geriatric syndromes cause a significant impact at the clinical, social, and economic level, mainly in the context of the aging world. Recently, Information and Communication Technologies (ICTs), virtual reality tools, and machine learning models have been increasingly applied to the care of older patients to improve diagnosis, prognosis, and interventions. However, so far, the methodological limitations of studies in this field have prevented to generalize data to real-word. This review systematically overviews the research designs used by studies applying technologies for the assessment and treatment of aging-related syndromes in older people. METHODS Following the PRISMA guidelines, records from PubMed, EMBASE, and Web of Science were systematically screened to select original articles in which interventional or observational designs were used to study technologies' applications in samples of frail, comorbid, or multimorbid patients. RESULTS Thirty-four articles met the inclusion criteria. Most of the studies used diagnostic accuracy designs to test assessment procedures or retrospective cohort designs to build predictive models. A minority were randomized or non-randomized interventional studies. Quality evaluation revealed a high risk of bias for observational studies, while a low risk of bias for interventional studies. CONCLUSIONS The majority of the reviewed articles use an observational design mainly to study diagnostic procedures and suffer from a high risk of bias. The scarce presence of methodologically robust interventional studies may suggest that the field is in its infancy. Methodological considerations will be presented on how to standardize procedures and research quality in this field.
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Affiliation(s)
| | | | - Cosimo Tuena
- Department of Psychology, Catholic University of the Sacred Hearth, Milan, Italy
| | - Silvia Cavedoni
- Applied Technology for Neuro‑Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro‑Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, University of eCampus, Novedrate, Italy
| | - Francesca Romana Greco
- Geriatric Unit, Department of Medical Sciences, IRCCS ''Casa Sollievo della Sofferenza'', San Giovanni Rotondo, Italy
| | - Antonio Greco
- Geriatric Unit, Department of Medical Sciences, IRCCS ''Casa Sollievo della Sofferenza'', San Giovanni Rotondo, Italy
| | - Carlo Abbate
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | | | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Magni G, Tuena C, Riva G. A predictive coding approach to psychedelic virtual-induced hallucinations and creative cognition in aging. Front Hum Neurosci 2023; 17:1219052. [PMID: 37484922 PMCID: PMC10359985 DOI: 10.3389/fnhum.2023.1219052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/23/2023] [Indexed: 07/25/2023] Open
Abstract
Recent research has investigated the potential of psychedelic substances in treating various neurological and psychiatric disorders. In particular, there has been a growth in studies concerning the intersection of psychedelics, Virtual Reality (VR), and Cognitive Flexibility (CF). Indeed, the use of immersive technology allows the simulation of the perceptual and cognitive effects of psychedelic substances without the potential risks associated with them. CF is strongly associated with creative cognition, a complex cognitive mechanism involved in creative thinking and associated with the prefrontal cortex and the neural networks supporting executive functions, memory, attention, and spontaneous modes of thought. The Bayesian brain approach, which is rooted in predictive coding, has emerged as a promising framework for understanding the effects of psychedelic hallucinations on cognitive functioning. Psychedelic substances may enhance creativity by inducing a state of CF, allowing for a wider range of associations and possibilities to be explored and increasing openness to experience. A decline in cognitive abilities, including creative processing and divergent thinking, is observed during the aging process. In particular, studies on Mild Cognitive Impairment (MCI) show poorer performance in executive functions, including CF. The present paper suggests that psychedelic hallucinations induced by VR may help optimize the balance between top-down expectations and bottom-up sensory information. Therefore, enhanced CF and creativity may be crucial during the aging process for maintaining cognitive functions and preventing pathological conditions.
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Affiliation(s)
- Giulia Magni
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
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Tuena C, Borghesi F, Bruni F, Cavedoni S, Maestri S, Riva G, Tettamanti M, Liperoti R, Rossi L, Ferrarin M, Stramba-Badiale M. Technology-Assisted Cognitive Motor Dual-Task Rehabilitation in Chronic Age-Related Conditions: Systematic Review. J Med Internet Res 2023; 25:e44484. [PMID: 37213200 PMCID: PMC10242476 DOI: 10.2196/44484] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/09/2023] [Accepted: 03/30/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Cognitive-motor dual-task (CMDT) is defined as the parallel processing of motor (eg, gait) and cognitive (eg, executive functions) activities and is an essential ability in daily life. Older adults living with frailty, chronic conditions (eg, neurodegenerative diseases), or multimorbidity pay high costs during CMDT. This can have serious consequences on the health and safety of older adults with chronic age-related conditions. However, CMDT rehabilitation can provide useful and effective therapies for these patients, particularly if delivered through technological devices. OBJECTIVE This review aims to describe the current technological applications, CMDT rehabilitative procedures, target populations, condition assessment, and efficacy and effectiveness of technology-assisted CMDT rehabilitation in chronic age-related conditions. METHODS We performed this systematic review, following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, on 3 databases (Web of Science, Embase, and PubMed). Original articles that were published in English; involved older adults (>65 years) with ≥1 chronic condition and/or frailty; and tested, with a clinical trial, a technology-assisted CMDT rehabilitation against a control condition were included. Risk of bias (Cochrane tool) and the RITES (Rating of Included Trials on the Efficacy-Effectiveness Spectrum) tool were used to evaluate the included studies. RESULTS A total of 1097 papers were screened, and 8 (0.73%) studies met the predefined inclusion criteria for this review. The target conditions for technology-assisted CMDT rehabilitation included Parkinson disease and dementia. However, little information regarding multimorbidity, chronicity, or frailty status is available. The primary outcomes included falls, balance, gait parameters, dual-task performance, and executive functions and attention. CMDT technology mainly consists of a motion-tracking system combined with virtual reality. CMDT rehabilitation involves different types of tasks (eg, obstacle negotiation and CMDT exercises). Compared with control conditions, CMDT training was found to be pleasant, safe, and effective particularly for dual-task performances, falls, gait, and cognition, and the effects were maintained at midterm follow-up. CONCLUSIONS Despite further research being mandatory, technology-assisted CMDT rehabilitation is a promising method to enhance motor-cognitive functions in older adults with chronic conditions.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | | | | | - Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Sara Maestri
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Epidemiology, Istituto di Ricerche Farmacologiche Mario Negri, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Rosa Liperoti
- Fondazione Policlinico Universitario Agostino Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Lorena Rossi
- Scientific Direction, IRCCS INRCA, Ancona, Italy
| | - Maurizio Ferrarin
- Fondazione Don Carlo Gnocchi, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
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Farahimanesh S, Serino S, Tuena C, Di Lernia D, Wiederhold BK, Bernardelli L, Riva G, Moradi A. Effectiveness of a Virtual-Reality-Based Self-Help Intervention for Lowering the Psychological Burden during the COVID-19 Pandemic: Results from a Randomized Controlled Trial in Iran. J Clin Med 2023; 12:jcm12052006. [PMID: 36902793 PMCID: PMC10004117 DOI: 10.3390/jcm12052006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/13/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic. In this framework, digital self-help interventions have the potential to provide flexible and scalable solutions for delivering evidence-based treatments that do not necessitate face-to-face meetings. OBJECTIVE as part of a multicentric project, the purpose of the current randomized controlled trial was to evaluate the efficacy of a Virtual-Reality-based self-help intervention (namely, COVID Feel Good) in lowering the psychological distress experienced during the COVID-19 pandemic in Iran. METHODS 60 participants were randomly assigned to the experimental (COVID Feel Good intervention group) or the control (no-treatment control group) condition. At the beginning of the intervention (Day 0), at the end of the intervention (Day 7), and after a 2-week follow-up (Day 21), measurements of depressive and anxiety levels, general distress, perceived levels of stress, hopelessness (primary outcome measures), perceived interpersonal closeness with the social world, and fear of COVID-19 (secondary outcome measure) were collected. The protocol consists of two integrated parts: the first part includes a relaxing 10-min three-hundred-sixty-degree (360°) video, while the second one includes social tasks with specified objectives. RESULTS In terms of the primary outcomes, participants in the COVID Feel Good intervention group improved in depression, stress, anxiety, and perceived stress but not hopelessness. Secondary outcome results showed an improvement in perceived social connectedness and a substantial decrease in fear of COVID-19. CONCLUSIONS these findings on the efficacy of COVID Feel Good training add to the growing body of evidence demonstrating the feasibility of digital self-help interventions in promoting well-being during this unique period.
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Affiliation(s)
- Sharareh Farahimanesh
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran 1983969411, Iran
- Institute for Cognitive Science Studies, Tehran 1658344575, Iran
- Correspondence:
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | - Brenda K. Wiederhold
- Virtual Reality Medical Center, La Jolla, CA 92037, USA
- Virtual Reality Medical Institute, 1200 Brussels, Belgium
| | | | - Giuseppe Riva
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | - Alireza Moradi
- Institute for Cognitive Science Studies, Tehran 1658344575, Iran
- Faculty of Psychology & Education, Department of Psychology, Kharazmi University, Tehran 1571914911, Iran
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Tuena C, Serino S, Stramba-Badiale C, Pedroli E, Goulene KM, Stramba-Badiale M, Riva G. Usability of an Embodied CAVE System for Spatial Navigation Training in Mild Cognitive Impairment. J Clin Med 2023; 12:jcm12051949. [PMID: 36902733 PMCID: PMC10003531 DOI: 10.3390/jcm12051949] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Individuals with mild cognitive impairment (MCI) usually report navigation and spatial memory impairments. Spatial navigation is an embodied process that requires the active involvement of both physical (e.g., motor commands and proprioception) and cognitive (e.g., decision-making and mental rotation) information. Immersive virtual reality (IVR) is a valuable tool that employs this information as real-world navigation does. Given the crucial impact of spatial navigation on daily life, research should focus on ways to enhance it. Though they are still in their development, contemporary IVR methods for spatial navigation training in MCI seem promising. In this usability study, eight patients with MCI syndrome tested an IVR spatial navigation training demo and interacted with the CAVE using active stereo glasses, a foot-motion pad, and a joypad. During the demo, users were asked to report their impressions on the IVR training using the thinking-aloud procedure. Moreover, questionnaires regarding usability, presence and cybersickness were administered at the end of the experience. Our results show that the first version of this system is usable by the patients even if most of them did not have experience with PC/IVR. The system provided a moderate sense of spatial presence and limited negative effects. Issues found during the thinking-aloud procedure concerned the visual aspects, which affected the interaction user-system. Participants reported that they needed more practice with the foot-motion pad even though the overall experience was positively evaluated. Identifying these critical features was essential to develop an improved version of the current system.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Correspondence: ; Tel.: +39-02-61-911-2726
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Faculty of Psychology, Università eCampus, Via Isimbardi 10, 22060 Novedrate, Italy
| | - Karine Marie Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Via Mosè Bianchi 90, 20149 Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Via Mosè Bianchi 90, 20149 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
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Sajno E, Bartolotta S, Tuena C, Cipresso P, Pedroli E, Riva G. Machine learning in biosignals processing for mental health: A narrative review. Front Psychol 2023; 13:1066317. [PMID: 36710855 PMCID: PMC9880193 DOI: 10.3389/fpsyg.2022.1066317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 12/16/2022] [Indexed: 01/15/2023] Open
Abstract
Machine Learning (ML) offers unique and powerful tools for mental health practitioners to improve evidence-based psychological interventions and diagnoses. Indeed, by detecting and analyzing different biosignals, it is possible to differentiate between typical and atypical functioning and to achieve a high level of personalization across all phases of mental health care. This narrative review is aimed at presenting a comprehensive overview of how ML algorithms can be used to infer the psychological states from biosignals. After that, key examples of how they can be used in mental health clinical activity and research are illustrated. A description of the biosignals typically used to infer cognitive and emotional correlates (e.g., EEG and ECG), will be provided, alongside their application in Diagnostic Precision Medicine, Affective Computing, and brain-computer Interfaces. The contents will then focus on challenges and research questions related to ML applied to mental health and biosignals analysis, pointing out the advantages and possible drawbacks connected to the widespread application of AI in the medical/mental health fields. The integration of mental health research and ML data science will facilitate the transition to personalized and effective medicine, and, to do so, it is important that researchers from psychological/ medical disciplines/health care professionals and data scientists all share a common background and vision of the current research.
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Affiliation(s)
- Elena Sajno
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy,Department of Computer Science, University of Pisa, Pisa, Italy,*Correspondence: Elena Sajno, ✉
| | - Sabrina Bartolotta
- ExperienceLab, Università Cattolica del Sacro Cuore, Milan, Italy,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy,Department of Psychology, University of Turin, Turin, Italy
| | - Elisa Pedroli
- Department of Psychology, eCampus University, Novedrate, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy,Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
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21
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Parisi A, Bellinzona F, Di Lernia D, Repetto C, De Gaspari S, Brizzi G, Riva G, Tuena C. Efficacy of Multisensory Technology in Post-Stroke Cognitive Rehabilitation: A Systematic Review. J Clin Med 2022; 11:jcm11216324. [PMID: 36362551 PMCID: PMC9656411 DOI: 10.3390/jcm11216324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 12/02/2022] Open
Abstract
Post-stroke, in addition to sensorimotor signs and symptoms, could lead to cognitive deficits. Theories of embodiment stress the role of sensorimotor system and multisensory integration in sustaining high-order cognitive domains. Despite conventional post-stroke cognitive rehabilitation being effective, innovative technologies could overcome some limitations of standard interventions and exploit bodily information during cognitive rehabilitation. This systematic review aims to investigate whether ‘multisensory technologies’ compared to usual care treatment can be a viable alternative for cognitive rehabilitation. By applying PRISMA guidelines, we extracted data and assessed the bias of 10 studies that met the required criteria. We found that multisensory technologies were at least comparable to standard treatment but particularly effective for attention, spatial cognition, global cognition, and memory. Multisensory technologies consisted principally of virtual reality alone or combined with a motion tracking system. Multisensory technologies without motion tracking were more effective than standard procedures, whereas those with motion tracking showed balanced results for the two treatments. Limitations of the included studies regarded the population (e.g., no study on acute stroke), assessment (e.g., lack of multimodal/multisensory pre-post evaluation), and methodology (e.g., sample size, blinding bias). Recent advancements in technological development and metaverse open new opportunities to design embodied rehabilitative programs.
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Affiliation(s)
- Alessandra Parisi
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Francesca Bellinzona
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Daniele Di Lernia
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Stefano De Gaspari
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Giulia Brizzi
- Applied Technology for Neuro-Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
| | - Giuseppe Riva
- Humane Technology Laboratory, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
- Applied Technology for Neuro-Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Laboratory, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Correspondence: ; Tel.: +39-02-61-911-2726
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22
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Tuena C, Riva G, Murru I, Campana L, Goulene KM, Pedroli E, Stramba-Badiale M. Contribution of cognitive and bodily navigation cues to egocentric and allocentric spatial memory in hallucinations due to Parkinson's disease: A case report. Front Behav Neurosci 2022; 16:992498. [PMID: 36311858 PMCID: PMC9606325 DOI: 10.3389/fnbeh.2022.992498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Parkinson's disease (PD) manifestations can include visual hallucinations and illusions. Recent findings suggest that the coherent integration of bodily information within an egocentric representation could play a crucial role in these phenomena. Egocentric processing is a key aspect of spatial navigation and is supported by the striatum. Due to the deterioration of the striatal and motor systems, PD mainly impairs the egocentric rather than the allocentric spatial frame of reference. However, it is still unclear the interplay between spatial cognition and PD hallucinations and how different navigation mechanisms can influence such spatial frames of reference. We report the case of A.A., a patient that suffers from PD with frequent episodes of visual hallucinations and illusions. We used a virtual reality (VR) navigation task to assess egocentric and allocentric spatial memory under five navigation conditions (passive, immersive, map, path decision, and attentive cues) in A.A. and a PD control group without psychosis. In general, A.A. exhibited a statistically significant classical dissociation between the egocentric and allocentric performance with a greater deficit for the former. In particular, the dissociation was statistically significant in the “passive” and “attentive cues” conditions. Interestingly in the “immersive” condition, the dissociation was not significant and, in contrast to the other conditions, trends showed better performance for egocentric than allocentric memory. Within the theories of embodiment, we suggest that body-based information, as assessed with VR navigation tasks, could play an important role in PD hallucinations. In addition, the possible neural underpinnings and the usefulness of VR are discussed.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- *Correspondence: Cosimo Tuena
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Immacolata Murru
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luca Campana
- Department of Neurology and Laboratory of Neuroscience, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Karine M. Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Faculty of Psychology, Università eCampus, Novedrate, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Pedroli E, Mancuso V, Stramba-Badiale C, Cipresso P, Tuena C, Greci L, Goulene K, Stramba-Badiale M, Riva G, Gaggioli A. Brain M-App’s Structure and Usability: A New Application for Cognitive Rehabilitation at Home. Front Hum Neurosci 2022; 16:898633. [PMID: 35782042 PMCID: PMC9248351 DOI: 10.3389/fnhum.2022.898633] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Cognitive frailty is defined as a clinical condition characterized by both physical frailty and cognitive impairment, without reaching the criteria for dementia. The major goal of rehabilitation intervention is to assist patients in performing ordinary personal duties without the assistance of another person, or at the very least to remove the need for additional support, using adaptive approaches and facilities. In this regard, home-based rehabilitation allows patients to continue an intervention begun in a hospital setting while also ensuring support and assistance when access to healthcare systems is limited, such as during the present pandemic situation. We thus present Brain m-App, a tablet-based application designed for home-based cognitive rehabilitation of frail subjects, addressing spatial memory, attention, and executive functions. This app exploits the potential of 360° videos which are well-suited to home-based rehabilitation. The Brain m-app is made up of 10 days of activities that include a variety of exercises. The activities were chosen based on those patients used to do during their clinical practice in the hospital with the aim to improve their independence and autonomy in daily tasks. The preliminary usability test, which was conducted on five older people, revealed a sufficient level of usability, however, the sample size was modest. Results from the clinical study with 10 patients, revealed that Brain m-App improved especially executive functions and memory performances.
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Affiliation(s)
- Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Valentina Mancuso
- Faculty of Psychology, eCampus University, Novedrate, Italy
- *Correspondence: Valentina Mancuso,
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Luca Greci
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing – National Research Council, Milan, Italy
| | - Karine Goulene
- Department of Geriatrics and Cardiovascular Medicine, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Universitá Cattolica del Sacro Cuore, Milan, Italy
| | - Andrea Gaggioli
- Applied Technology for Neuro-Psychology Lab, I.R.C.C.S. Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy
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24
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Meyer ML, Kaesler A, Wolffgramm S, Perić NL, Bunjaku G, Dickmann L, Serino S, Di Lernia D, Tuena C, Bernardelli L, Pedroli E, Wiederhold BK, Riva G, Shiban Y. COVID Feel Good: Evaluation of a Self-Help Protocol to Overcome the Psychological Burden of the COVID-19 Pandemic in a German Sample. J Clin Med 2022; 11:jcm11082080. [PMID: 35456172 PMCID: PMC9029872 DOI: 10.3390/jcm11082080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 01/27/2023] Open
Abstract
The COVID-19 pandemic has severe consequences for physical as well as mental well-being. In times of restricted social contact, online self-help programs offer a low-threshold first aid to cope with the psychological burden. This current study evaluates the online self-help protocol “COVID Feel Good” in a German sample. The multicentric study was designed as a single cohort with a waiting list control condition. The convenience sample consisted of 38 German individuals who experienced at least two months of restrictions during the COVID-19 pandemic. The 7-day self-help protocol included the VR video “Secret Garden” as well as a social or cognitive exercise each day. General distress, depression, anxiety, stress, and hopelessness were assessed as primary outcomes. Social connectedness and fear of coronavirus were measured as secondary outcomes. Results showed a significant decrease in all primary outcomes except for hopelessness. Furthermore, the results indicated a significant improvement in social connectedness. Treatment effects on general distress, depression, stress, and anxiety persisted for two weeks after participation. The present study indicates that VR-based self-help protocols can mitigate the psychological burden associated with the pandemic, supporting recent findings.
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Affiliation(s)
- Marie Lisa Meyer
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Arne Kaesler
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Stefanie Wolffgramm
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Nicolina Laura Perić
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Gentian Bunjaku
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Lilith Dickmann
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (D.D.L.)
| | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (S.S.); (D.D.L.)
| | - Cosimo Tuena
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (C.T.); (G.R.)
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy;
| | | | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy;
- Faculty of Psychology, University of eCampus, 22060 Novedrate, Italy
| | - Brenda K. Wiederhold
- Virtual Reality Medical Center, La Jolla, CA 92037, USA;
- Virtual Reality Medical Institute, 1200 Brussels, Belgium
| | - Giuseppe Riva
- Humane Technology Lab, Università Cattolica del Sacro Cuore, 20123 Milan, Italy; (C.T.); (G.R.)
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy;
| | - Youssef Shiban
- Department of Psychology, Private University of Applied Science, 37073 Goettingen, Germany; (M.L.M.); (A.K.); (S.W.); (N.L.P.); (G.B.); (L.D.)
- Correspondence:
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Riva G, Tuena C. Transforming Brain Rehabilitation: Smartphone Solution Underpins Innovative Treatment of Brain Disorders. Cyberpsychol Behav Soc Netw 2022; 25:154-155. [PMID: 35073181 DOI: 10.1089/cyber.2022.29238.ceu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Giuseppe Riva
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
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26
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Tuena C, Riva G. Active Navigation Training: An Innovative Embodied-Based Training System for Spatial Navigation in Aging. Cyberpsychol Behav Soc Netw 2022; 25:77-78. [PMID: 34962135 DOI: 10.1089/cyber.2021.29236.ceu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Cosimo Tuena
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
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27
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Riva G, Tuena C. FRAILTY VR: VR for the Rehabilitation of Frailty in the Elderly. Cyberpsychol Behav Soc Netw 2021; 24:695-696. [PMID: 34525310 DOI: 10.1089/cyber.2021.29228.ceu] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Giuseppe Riva
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Humane Technology Lab, Catholic University of Milan, Milan, Italy
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
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Gallucci A, Trimarchi PD, Abbate C, Tuena C, Pedroli E, Lattanzio F, Stramba-Badiale M, Cesari M, Giunco F. ICT technologies as new promising tools for the managing of frailty: a systematic review. Aging Clin Exp Res 2021; 33:1453-1464. [PMID: 32705589 DOI: 10.1007/s40520-020-01626-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Frailty is a major health issue as it encompasses functional decline, physical dependence, and increased mortality risk. Recent studies explored Information and Communication Technology (ICT) interventions as alternatives to manage frailty in older persons. The aim of the present systematic review was to synthesize current evidence on ICT application within the complex models of frailty care in older people. METHODS Data sources included PubMed, PsycINFO, EMBASE and Web of Science, considering eligible those reviews on ICT application in samples of older persons formally assessed as frail. Records were screened by two independent researchers, who extracted data and appraised methodological quality of reviews and studies. RESULTS Among the 764 retrieved papers, two systematic reviews were included. Most of the studies analyzed defined frailty considering only few components of the phenotype and used ICT to stratify different levels of frailty or to support traditional screening strategies. Assessment of frailty was the context in which ICT has been mostly tested as compared to intervention. Cost effectiveness evaluations of the ICT technologies were not reported. CONCLUSIONS The research investigating the use of ICT in the context of frailty is still at the very beginning. Few studies strictly focused on the assessment of frailty, while intervention on frailty using ICT was rarely reported. The lack of a proper characterization of the frail condition along with the methodological limitations prevented the investigation of ICT within complex care models. Future studies are needed to effectively integrate ICT in the care of frailty in orders.
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Affiliation(s)
- Alessia Gallucci
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
| | | | - Carlo Abbate
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Hearth, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, University of eCampus, Novedrate, Italy
| | | | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione Ca' Granda IRCCS Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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29
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Tuena C, Mancuso V, Stramba-Badiale C, Pedroli E, Stramba-Badiale M, Riva G, Repetto C. Egocentric and Allocentric Spatial Memory in Mild Cognitive Impairment with Real-World and Virtual Navigation Tasks: A Systematic Review. J Alzheimers Dis 2021; 79:95-116. [PMID: 33216034 PMCID: PMC7902987 DOI: 10.3233/jad-201017] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Spatial navigation is the ability to estimate one's position on the basis of environmental and self-motion cues. Spatial memory is the cognitive substrate underlying navigation and relies on two different reference frames: egocentric and allocentric. These spatial frames are prone to decline with aging and impairment is even more pronounced in Alzheimer's disease (AD) or in mild cognitive impairment (MCI). OBJECTIVE To conduct a systematic review of experimental studies investigating which MCI population and tasks are used to evaluate spatial memory and how allocentric and egocentric deficits are impaired in MCI after navigation. METHODS PRISMA and PICO guidelines were applied to carry out the systematic search. Down and Black checklist was used to assess methodological quality. RESULTS Our results showed that amnestic MCI and AD pathology are the most investigated typologies; both egocentric and allocentric memory are impaired in MCI individuals, and MCI due to AD biomarkers has specific encoding and retrieval impairments; secondly, spatial navigation is principally investigated with the hidden goal task (virtual and real-world version), and among studies involving virtual reality, the privileged setting consists of non-immersive technology; thirdly, despite subtle differences, real-world and virtual versions showed good overlap for the assessment of MCI spatial memory. CONCLUSION Considering that MCI is a subclinical entity with potential risk for conversion to dementia, investigating spatial memory deficits with navigation tasks might be crucial to make accurate diagnosis and rehabilitation.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Valentina Mancuso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Faculty of Psychology, Universitá eCampus, Novedrate, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.,Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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30
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Tuena C, Pedroli E, Trimarchi PD, Gallucci A, Chiappini M, Goulene K, Gaggioli A, Riva G, Lattanzio F, Giunco F, Stramba-Badiale M. Usability Issues of Clinical and Research Applications of Virtual Reality in Older People: A Systematic Review. Front Hum Neurosci 2020; 14:93. [PMID: 32322194 PMCID: PMC7156831 DOI: 10.3389/fnhum.2020.00093] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 03/02/2020] [Indexed: 12/23/2022] Open
Abstract
Aging is a condition that may be characterized by a decline in physical, sensory, and mental capacities, while increased morbidity and multimorbidity may be associated with disability. A wide range of clinical conditions (e.g., frailty, mild cognitive impairment, metabolic syndrome) and age-related diseases (e.g., Alzheimer's and Parkinson's disease, cancer, sarcopenia, cardiovascular and respiratory diseases) affect older people. Virtual reality (VR) is a novel and promising tool for assessment and rehabilitation in older people. Usability is a crucial factor that must be considered when designing virtual systems for medicine. We conducted a systematic review with Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines concerning the usability of VR clinical systems in aging and provided suggestions to structure usability piloting. Findings show that different populations of older people have been recruited to mainly assess usability of non-immersive VR, with particular attention paid to motor/physical rehabilitation. Mixed approach (qualitative and quantitative tools together) is the preferred methodology; technology acceptance models are the most applied theoretical frameworks, however senior adapted models are the best within this context. Despite minor interaction issues and bugs, virtual systems are rated as usable and feasible. We encourage usability and user experience pilot studies to ameliorate interaction and improve acceptance and use of VR clinical applications in older people with the aid of suggestions (VR-USOP) provided by our analysis.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Hearth, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, University of eCampus, Novedrate, Italy
| | | | | | - Mattia Chiappini
- Applied Technology for Neuro-Psychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Karine Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Andrea Gaggioli
- Applied Technology for Neuro-Psychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Hearth, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Hearth, Milan, Italy
| | | | | | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
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31
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Riva G, Bernardelli L, Browning MHEM, Castelnuovo G, Cavedoni S, Chirico A, Cipresso P, de Paula DMB, Di Lernia D, Fernández-Álvarez J, Figueras-Puigderrajols N, Fuji K, Gaggioli A, Gutiérrez-Maldonado J, Hong U, Mancuso V, Mazzeo M, Molinari E, Moretti LF, Ortiz de Gortari AB, Pagnini F, Pedroli E, Repetto C, Sforza F, Stramba-Badiale C, Tuena C, Malighetti C, Villani D, Wiederhold BK. COVID Feel Good-An Easy Self-Help Virtual Reality Protocol to Overcome the Psychological Burden of Coronavirus. Front Psychiatry 2020; 11:563319. [PMID: 33173511 PMCID: PMC7538634 DOI: 10.3389/fpsyt.2020.563319] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/31/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Living in the time of the COVID-19 means experiencing not only a global health emergency but also extreme psychological stress with potential emotional side effects such as sadness, grief, irritability, and mood swings. Crucially, lockdown and confinement measures isolate people who become the first and the only ones in charge of their own mental health: people are left alone facing a novel and potentially lethal situation, and, at the same time, they need to develop adaptive strategies to face it, at home. In this view, easy-to-use, inexpensive, and scientifically validated self-help solutions aiming to reduce the psychological burden of coronavirus are extremely necessary. AIMS This pragmatic trial aims to provide the evidence that a weekly self-help virtual reality (VR) protocol can help overcome the psychological burden of the Coronavirus by relieving anxiety, improving well-being, and reinforcing social connectedness. The protocol will be based on the "Secret Garden" 360 VR video online (www.covidfeelgood.com) which simulates a natural environment aiming to promote relaxation and self-reflection. Three hundred sixty-degree or spherical videos allow the user to control the viewing direction. In this way, the user can explore the content from any angle like a panorama and experience presence and immersion. The "Secret Garden" video is combined with daily exercises that are designed to be experienced with another person (not necessarily physically together), to facilitate a process of critical examination and eventual revision of core assumptions and beliefs related to personal identity, relationships, and goals. METHODS This is a multicentric, pragmatic pilot randomized controlled trial involving individuals who experienced the COVID-19 pandemic and underwent a lockdown and quarantine procedures. The trial is approved by the Ethics Committee of the Istituto Auxologico Italiano. Each research group in all the countries joining the pragmatic trial, aims at enrolling at least 30 individuals in the experimental group experiencing the self-help protocol, and 30 in the control group, over a period of 3 months to verify the feasibility of the intervention. CONCLUSION The goal of this protocol is for VR to become the "surgical mask" of mental health treatment. Although surgical masks do not provide the wearer with a reliable level of protection against the coronavirus compared with FFP2 or FFP3 masks, surgical masks are very effective in protecting others from the wearer's respiratory emissions. The goal of the VR protocol is the same: not necessarily to solve complex mental health problems but rather to improve well-being and preserve social connectedness through the beneficial social effects generated by positive emotions.
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Affiliation(s)
- Giuseppe Riva
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Gianluca Castelnuovo
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Alice Chirico
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Pietro Cipresso
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Daniele Di Lernia
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Kei Fuji
- Division of Psychology, University of Tsukuba, Tokyo, Japan
| | - Andrea Gaggioli
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Upyong Hong
- Department of Media and Communication, Konkuk University, Seoul, South Korea
| | | | - Milena Mazzeo
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Enrico Molinari
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Luciana F Moretti
- Sociedad Española de Realidad Virtual y Psicología, Las Rozas - Madrid, Spain
| | - Angelica B Ortiz de Gortari
- The Centre for the Science of Learning & Technology (SLATE), University of Bergen, Bergen, Norway.,Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Francesco Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elisa Pedroli
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Faculty of Psychology, University of eCampus, Novedrate, Italy
| | - Claudia Repetto
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | | | - Cosimo Tuena
- IRCCS Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Clelia Malighetti
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Daniela Villani
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Brenda K Wiederhold
- Virtual Reality Medical Center, La Jolla, CA, United States.,Virtual Reality Medical Institute, Brussels, Belgium
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Cipresso P, Mauri M, Semonella M, Tuena C, Balgera A, Villamira M, Riva G. Looking at One's Self Through Facebook Increases Mental Stress: A Computational Psychometric Analysis by Using Eye-Tracking and Psychophysiology. Cyberpsychol Behav Soc Netw 2019; 22:307-314. [PMID: 30973269 DOI: 10.1089/cyber.2018.0602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to investigate if Mental Stress was superior, inferior, or equal navigating on Facebook own profile or others profiles. An experimental manipulation would invalidate the results since it would force the participants to navigate in only one condition each time. To overcome this problem, we used an eye-tracker to get clear time markers that identified the areas where the participants focused during all of the Facebook navigation. While the gazes were being recorded for 30 participants, we simultaneously recorded their psychophysiological signals, which were extracted and paired with each specific focus area. Consequently, we obtained the psychophysiological correlates of Facebook navigation for both the conditions related to "own" and "others." The areas related to own were about the own profile (such as exploring and focusing on one's own information, posting one's own news, and similar activities). The areas related to others were about Facebook friends (e.g., exploring others' profiles and reading comments). The results showed that, based on cardiovascular measures (strong measurements of psychological stress), looking at one's own profile increased mental stress level. Bayesian analyses showed that these differences between the two conditions were not due to the cognitive load or the different attentional and emotional content in the two conditions. The study posed new questions about the expression of one's self to others, and indicated potential detrimental effects of chronic stress deriving from being more oriented to the self than the others.
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Affiliation(s)
- Pietro Cipresso
- 1 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,2 Department of Psychology, Catholic University of Milan, Milan, Italy
| | | | - Michelle Semonella
- 1 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | - Cosimo Tuena
- 1 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, IRCCS, Milan, Italy
| | | | | | - Giuseppe Riva
- 1 Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, IRCCS, Milan, Italy.,2 Department of Psychology, Catholic University of Milan, Milan, Italy
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Muratore M, Tuena C, Pedroli E, Cipresso P, Riva G. Virtual Reality as a Possible Tool for the Assessment of Self-Awareness. Front Behav Neurosci 2019; 13:62. [PMID: 31019454 PMCID: PMC6458281 DOI: 10.3389/fnbeh.2019.00062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 03/13/2019] [Indexed: 11/17/2022] Open
Abstract
The absence of self-awareness is a crucial aspect in the symptomatology of various neurodegenerative disorders. This characteristic becomes relevant due to the strong implications it has on the patient’s quality of life, on the effects that functional dependence has on the caregiver and on the efficacy of the therapy. Faced with a construct as complex as self-awareness, there are in the literature investigations on different aspects of this phenomenon, such as the creation of cognitive models, the study of the neural substrate and the research of appropriate assessment methods that can reliably detect this function. With regard to the assessment methods, there are methodologies in the literature that provide complementary information. The first modality is a quantitatively online measurement based on the discrepancy between the estimate of the patient of his performance and his actual performance, but often neglecting the ecological validity and the real functioning of the subject. The second kind collecting subjective information on the actual daily functioning of the patient resulting from clinical observation or interviews with the subject and caregivers, but obtaining offline information on the functioning of the subject, liable to bias that may imply an overestimation or underestimation of subject’s ability. The absence of acknowledged metacognitive functional assessment with normative data to evaluate awareness winks at the emerging and increasingly consistent use of virtual reality (VR) also in the context of cognitive research and clinical assessment. This article aims to make a theoretical proposal regarding the use of this innovative and promising tool as a supplement to the assessment methods of self-awareness.
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Affiliation(s)
- Manuel Muratore
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Laboratory, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Cipresso P, Pedroli E, Serino S, Semonella M, Tuena C, Colombo D, Pallavicini F, Riva G. Assessment of Unilateral Spatial Neglect Using a Free Mobile Application for Italian Clinicians. Front Psychol 2018; 9:2241. [PMID: 30524341 PMCID: PMC6262901 DOI: 10.3389/fpsyg.2018.02241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 10/29/2018] [Indexed: 01/12/2023] Open
Abstract
Background: Unilateral Spatial Neglect (USN) is traditionally assessed with paper-and-pencil tests or computer-based tests. Thanks to the wide-spreading of mobile devices, and the extensive capabilities that they have in dealing complex elements, it is possible to provide clinicians with tools for cognitive assessment. Contemporary 3D engine is, in general generally, able to deploy complex 3D environments for iOS, Android and Windows mobile, i.e., most of the mobile phone and tablet operative systems. Results: This brand-new scenario and pressing requests from professionals, pushed us to build an application for the assessment of USN. Our first attempt was to replicate the classic cognitive tests, traditionally used at this purpose. Ecological assessment is difficult in real scenarios so we implemented virtual environments to assess patients' abilities in realistic situations. At the moment, the application is available only for iPad and iPhone for free, from the Apple Store, under the name of "Neglect App." The App contains traditional tests (e.g., barrage with and without distractors) and ecological tests (e.g., to distribute the tea in a table to close people). Scoring of each test is available to the clinicians through a database with the executed ecological tasks, that are stored locally. Conclusion: In conclusion, Neglect App is an advanced mobile platform for the assessment of Neglect.
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Affiliation(s)
- Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Silvia Serino
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Michelle Semonella
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Desirée Colombo
- Department of Basic Psychology, Clinic and Psychobiology, Universitat Jaume I, Castellón de la Plana, Spain
| | - Federica Pallavicini
- "Riccardo Massa" Department of Human Sciences for Education, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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35
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Colombo D, Serino S, Tuena C, Pedroli E, Dakanalis A, Cipresso P, Riva G. Egocentric and allocentric spatial reference frames in aging: A systematic review. Neurosci Biobehav Rev 2017; 80:605-621. [DOI: 10.1016/j.neubiorev.2017.07.012] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/29/2017] [Accepted: 07/27/2017] [Indexed: 01/07/2023]
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36
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Serino S, Pedroli E, Tuena C, De Leo G, Stramba-Badiale M, Goulene K, Mariotti NG, Riva G. A Novel Virtual Reality-Based Training Protocol for the Enhancement of the "Mental Frame Syncing" in Individuals with Alzheimer's Disease: A Development-of-Concept Trial. Front Aging Neurosci 2017; 9:240. [PMID: 28798682 PMCID: PMC5529401 DOI: 10.3389/fnagi.2017.00240] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 07/10/2017] [Indexed: 01/21/2023] Open
Abstract
A growing body of evidence suggests that people with Alzheimer's Disease (AD) show compromised spatial abilities. In addition, there exists from the earliest stages of AD a specific impairment in "mental frame syncing," which is the ability to synchronize an allocentric viewpoint-independent representation (including object-to-object information) with an egocentric one by computing the bearing of each relevant "object" in the environment in relation to the stored heading in space (i.e., information about our viewpoint contained in the allocentric viewpoint-dependent representation). The main objective of this development-of-concept trial was to evaluate the efficacy of a novel VR-based training protocol focused on the enhancement of the "mental frame syncing" of the different spatial representations in subjects with AD. We recruited 20 individuals with AD who were randomly assigned to either "VR-based training" or "Control Group." Moreover, eight cognitively healthy elderly individuals were recruited to participate in the VR-based training in order to have a different comparison group. Based on a neuropsychological assessment, our results indicated a significant improvement in long-term spatial memory after the VR-based training for patients with AD; this means that transference of improvements from the VR-based training to more general aspects of spatial cognition was observed. Interestingly, there was also a significant effect of VR-based training on executive functioning for cognitively healthy elderly individuals. In sum, VR could be considered as an advanced embodied tool suitable for treating spatial recall impairments.
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Affiliation(s)
- Silvia Serino
- Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy.,IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LabMilan, Italy
| | - Elisa Pedroli
- IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LabMilan, Italy
| | - Cosimo Tuena
- Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy
| | - Gianluca De Leo
- Department of Clinical and Digital Health Sciences, College of Allied Health Sciences, Augusta UniversityAugusta, GA, United States
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Karine Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico ItalianoMilan, Italy
| | - Noemi G Mariotti
- IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LabMilan, Italy
| | - Giuseppe Riva
- Department of Psychology, Università Cattolica del Sacro CuoreMilan, Italy.,IRCCS Istituto Auxologico Italiano, Applied Technology for Neuro-Psychology LabMilan, Italy
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