Usefulness of cognitive training program using virtual reality and mixed reality

Abstract

AbstractBackgroundNowadays virtual reality (VR) and mixed reality (MR) is used as a psychological and occupational therapeutic option to the patients of depression, phobia, post traumatic stress disorder and stroke patients. VR and MR have a number of advantages because it is entertaining, thus motivating the patient. Therefore VR and MR can be used for cognitive therapy to the elderly cognitive declined people because it can give attention, motivation and stimulation to them. Our previous pilot study showed that cognitive training program using VR and MR improved cognitive function, depressive mood and electrophysiologic brain activity on Mild cognitive impairment (MCI) patients. This is the extensive study to show the usefulness of VR and MR using cognitive training on MCI patients, which added more session, program and enrolled more patient in comparison with previous pilot study.MethodThis study was an 8‐week, single‐blind study of 20 patients with MCI. The cognitive training program included art therapy, aerobic exercises, memory training, including face‐name association, object recall training, and spaced retrieval; visuo‐motor organization using software; similarity and ruled based categorization; and behavior modification and sequencing (e.g., making change, paying bills) using VR and MR and computerized program. Neuropsychological function was assessed using K‐MMSE (Korean Mini‐Mental State Examination), Clinical dementia rating(CDR), Alzheimer`s Disease Assessment Scale‐Cognition(ADAS‐cog), Korean version of short form Geriatric Depression Scale(SGDS‐K) and Neuropsychiatric Inventory(NPI). Quantitative electroencephalogram (EEG) was assessed on cognitive training days before treatment and after each treatment phase. Then EEG was analyzed by using “iSyncbrain” which is cloud‐based, AI‐driven EEG analysis platform.ResultAfter two months (8 sessions) of treatment, cognitive function, neuropsychiatric symptoms and depression, which were assessed by using MMSE, NPI and SGDS respectively, showed significant improvements (p<0.05). Also there were significant increase of the EEG alpha/theta ratio on both dorsolateral prefrontal cortex and right parietal cortex, which may imply improvement of frontal and visuospatial function. However, there were no statistically significant differences except Source ROI Power and connectivity.ConclusionCognitive training program using VR and MR showed improvement of cognitive function, depressive mood and electrophysiologic brain activity.