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.
Highlights
It is traditionally accepted that humans are able to represent space and recall spatial information with two fundamental spatial representations: one comprising information about the position of the individual in relation to the surrounding objects, and the other one including information about the position of the objects relative to each other in the environment
Delta scores obtained from the pre-post neuropsychological assessment for patients with Alzheimer’s Disease (AD) assigned to the Virtual Reality (VR)-based training (“VR Group-AD”) and for patients with AD assigned to the “Control Group-AD” (“Control Group-AD”)
Scores obtained from the first neuropsychological assessment for patients with AD assigned to the VR-based training (“VR group- AD”) and for cognitively healthy elderly individuals assigned to the VR-based training (“VR Group-Normal Aging”)
Summary
It is traditionally accepted that humans are able to represent space and recall spatial information with two fundamental spatial representations: one comprising information about the position of the individual in relation to the surrounding objects (i.e., egocentric), and the other one including information about the position of the objects relative to each other in the environment (i.e., allocentric). A neurocognitive model was recently advanced to explain how spatial recall works (Burgess et al, 2001; Byrne et al, 2007). Burgess and his colleagues explained that, in the presence of a spatial cue, allocentric representation is retrieved through a process of pattern completion. Though initially allocentric, this representation is translated to egocentric for navigation purposes in the medial parietal areas via information provided by other cells (Hartley et al, 2014). While parahippocampal regions are involved in processing the visuo-spatial structure of the spatial scene, RSC supports the process of spatial recall thanks to the retrieval of reference that allows the scene to be localized within the wider spatial environment (Epstein et al, 2007; Ekstrom et al, 2014)
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