Enhance VR: a multisensory approach to cognitive assessment and training
Victòria Brugada-Ramentol
Virtuleap, Inc, Lisbon, Portugal
Introduction
The deterioration of cognitive functioning is present in healthy aging and it is more pronounced as a result of neuropathological conditions, such as Alzheimer’s disease [1]. Together with lifestyle interventions, cognitive training systems have been proposed to delay cognitive decline in older adults [2]. Virtual Reality (VR) systems, in contrast to screen-based applications, present the user with
body-related information, such as proprioceptive and visuomotor information, allowing for an embodied experience of the environment [3]. Thus, VR becomes an interesting tool for cognitive training and neurorehabilitation.
Methods
Enhance VR (virtuleap.com/enhance) is a cognitive training and assessment app that takes advantage of the multisensory experience and the naturalistic interaction offered by immersive VR environments. The Enhance VR app offers daily, short (∼10 minutes) sessions, consisting of three
different cognitive exercises (or mini-games). Each of the currently available mini-games is designed to assess performance in a specific cognitive area and inspired by a validated neuropsychological tool.
The continuously growing library is divided into seven cognitive abilities: memory (games: Memory Wall, Magic Deck, and Maestro), information processing (Harmonize and Assembly), spatial
orientation (Hide and Seek), cognitive flexibility (React), problem-solving (Odd Egg), attention (Whack-a-mole and Pizza Builder), and motor control (Balance and Slinger).
User performance is tracked longitudinally by (1) the Enhance Performance Index (i.e., global cognitive status), (2) the scores of the main cognitive categories and subcategories, and (3) scores for each of the games. Additionally, the app collects a wide range of behavioral data (such as reaction
times), game-related events, and self-assessed mood and sleep reports.
Discussion
Regular and long-term use of the Enhance VR could serve as a cognitive stimulation tool for elderly individuals with healthy and impaired cognitive functioning. Additionally, by collecting long-term cognitive performance data, the Enhance VR app could serve as a cognitive assessment tool that uses the individual’s scores as a baseline for comparison, allowing for more sensitive detection of changes in cognitive performance. Finally, by combining the vast amount of longitudinal cognitive data
collected by the Enhance VR app and machine learning algorithms, we aim to identify dynamic digital markers of cognitive decline that could serve for the early detection of cognitive impairment in
populations at risk of cognitive decline.
Conclusions
VR systems offer a unique platform for cognitive training and assessment, as they present the user with an immersive environment. The Enhance VR app is a multidomain library of short cognitive
exercises that collects longitudinal volumetric data of cognitive performance. The large dataset combined with machine learning could provide predictive algorithms for sensitive and timely detection of cognitive decline.
References
[1] Villemagne VL et al (2013). Lancet Neurol., 12(4): 357–367.
[2] Ngandu T et al (2015). Lancet, 385(9984): 2255–2263.
[3] Sánchez-Vives MV and Slater M (2005). Nat. Rev. Neurosci., 6(4): 332–339
