Fusing the Virtual and Physical Worlds to Identify Declines in Instrumental Activities of Daily Living Associated with Parkinson’s Disease (S37.008)

Abstract

<h3>Objective:</h3> The objective of this study was to utilize a novel virtual reality paradigm, Cleveland Clinic Virtual Reality Shopping (CC-VRS), to identify changes in instrumental activities of daily living (IADL) associated with Parkinson’s disease (PD). <h3>Background:</h3> Understanding the effects of medication or surgical interventions on PD IADL performance is necessary to ensure optimized function and maximize independence. The CC-VRS combines virtual reality content with an omnidirectional treadmill to create an immersive full-scale grocery shopping environment that presents cognitive and physical challenges, objectively and quantitatively evaluating cognitive and motor function. <h3>Design/Methods:</h3> Fourteen individuals with PD (UPDRS-III 25.9 ± 13.9, ON antiparkinsonian medication), and 14 age- and gender-matched healthy adults completed Basic and Complex shopping scenarios; the latter includes additional cognitive and physical demands while shopping. During the scenario, participants physically navigated through the virtual grocery store on the omnidirectional treadmill that allowed them to walk in a straight line and perform 90° and 180° turns. The store route, shopping items, and distractors were standardized across participants. <h3>Results:</h3> Motor and cognitive performance differed across PD and control groups. From a motor perspective, PD patients exhibited significantly shorter step length (<i>p</i>&lt;0.05) and experienced multiple freezing episodes while turning. Cognitive function was evaluated through list observation behaviors; PD patients spent significantly more time looking at their virtual shopping list (<i>p</i>&lt;0.01) and time for each list activation was nearly twice that of controls (<i>p</i>&lt;0.01). Both groups tolerated the virtual environment well, as Simulator Sickness Questionnaire scores for both groups were minimal following completion of CC-VRS. <h3>Conclusions:</h3> The CC-VRS platform successfully quantifies PD motor symptoms and subtle cognitive declines in mild PD versus healthy controls. The CC-VRS platform was well-tolerated across groups and offers an innovative approach to objectively quantifying IADL performance, with potential for use in titrating medication and tuning deep brain stimulation parameters. <b>Disclosure:</b> Morgan McGrath has nothing to disclose. Anson Rosenfeldt has received personal compensation for serving as an employee of Cleveland Clinic. Anson Rosenfeldt has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Enspire DBS. The institution of Anson Rosenfeldt has received research support from Michael J. Fox Foundation. The institution of Anson Rosenfeldt has received research support from National Institute of Health. The institution of Anson Rosenfeldt has received research support from Department of Defense. Anson Rosenfeldt has received intellectual property interests from a discovery or technology relating to health care. Mr. Waltz has nothing to disclose. Mandy Koop has nothing to disclose. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel. Dr. Fernandez has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Fernandez has received research support from Biogen. The institution of Dr. Fernandez has received research support from Michael J Fox Founda. The institution of Dr. Fernandez has received research support from Roche. The institution of Dr. Fernandez has received research support from Parkinson Foundation. The institution of Dr. Fernandez has received research support from UCB. Dr. Fernandez has received publishing royalties from a publication relating to health care. Dr. Fernandez has received personal compensation in the range of $10,000-$49,999 for serving as a Steering Committee/Advisory Committee Member with Parkinson Study Group. The institution of Dr. Alberts has received research support from NIH. Dr. Alberts has received intellectual property interests from a discovery or technology relating to health care. Dr. Alberts has received personal compensation in the range of $500-$4,999 for serving as a Member, Health and Wellness Council with Peloton Interactive.