Neural Function Desynchronisation in Left and Right Dorsolateral Prefrontal Cortices During Virtual Reality Earthquake Video Viewing.

During natural disasters such as earthquakes, individuals are required to evacuate calmly amidst significant emotional distress, presenting a considerable challenge. Very few studies have measured emotional responses during disasters, and the emotional responses and brain activity during natural disasters are poorly understood. Therefore, this study aimed to investigate emotional responses during an earthquake using immersive virtual reality (VR), focusing on changes in neural connectivity in the left and right dorsolateral prefrontal cortices (DLPFCs). We measured changes in total haemoglobin concentration (Δtotal-Hb) using 2-channel near infrared spectroscopy (NIRS) while 24 healthy young adults viewed earthquake and neutral videos through a head-mounted display (HMD). Spearman's correlation analysis was applied to the time variation in Δtotal-Hb in the left and right DLPFCs, independently for seismic or neutral video conditions. The findings revealed a negative correlation between the left and right total haemoglobin concentration changes during the earthquake video (ρ = -0.53). Conversely, individuals exposed to the neutral video exhibited a positive correlation (ρ = 0.75). The present steady-state analysis suggests that emotional changes induced by virtual earthquake videos disturbed steady-state neural synchronisation between the left and right DLPFCs.

Development of a Remote Health-Monitoring System for Frail People: A Preliminary Study.

Respiratory and cardiovascular functions decline with age in elderly individuals. Consequently, the incidence of chronic respiratory and cardiovascular diseases increases with age. Heart disease and pneumonia are the leading causes of death in Japan. Given the pathophysiological nature of these diseases, patients inevitably require monitoring of their cardiac and pulmonary functions, such as heart rate and arterial blood oxygenation, as systemic parameters. In addition, monitoring skin temperature and humidity as local parameters is preferable for elderly individuals to maintain healthy daily conditions. In the present study, we developed a wearable vital sign monitoring system and validated the accuracy of the device under development as compared to authorised medical devices that measure these systemic and local parameters in the peripheral tissue of the palm. For the systemic parameters, mean values showed no significant differences between the two devices, but the data bias was greater for the device under development. For the local parameters, mean values showed significant differences between the two devices; however, the data bias was the same for both devices. The acceptable data acquisition of the device under development was approximately 89%, with error acquisition mainly caused by the measurement of systemic parameters. We conclude that further improvements in measurement of systemic parameters are required to increase the data acquisition beyond 90%.

Decision-making involvement and onset of cognitive impairment in community-dwelling older care recipients: a 2-year longitudinal study.

BACKGROUND: The decision-making of older adults and people with dementia is attracting more attention among healthcare professionals. While cognitive impairment has been examined as a factor related to decision-making, it can also be assumed that involvement in decision-making leads to the maintenance of cognitive function. This study examined the association of the decision-making process with the onset of cognitive impairment. METHODS: We analyzed data from a 2-year longitudinal panel survey of community-dwelling care recipients aged ≥65 years in Japan. The sample included 406 participants who responded to both baseline and follow-up surveys, were cognitively intact at baseline, and had no missing cognitive impairment data regarding onset at follow-up. The status of decision-making involvement was assessed using a single item and classified into four categories: 'very involved,' 'less involved,' 'unclear about desired care,' and 'having no one to share the decision.' RESULTS: Among the participants (women, 65.0%; ≥75 years old: 68.2%), the incidence of cognitive impairment during the follow-up was 26.6%. Multivariable logistic regression showed that, compared with highly involved participants, those who lacked clarity about desired care were more likely to develop an onset of cognitive impairment (odds ratio: 5.49; 95% confidence interval: 1.63-18.54; P = 0.006). CONCLUSION: Even among cognitively intact care recipients, those who are not able to formulate their desired care may be at risk of cognitive decline. Therefore, support for the decision-making process, not limited to the final decision, is essential to improving the prognosis of community-dwelling care recipients.

Visual effects on tactile stimulation and its perception: A pilot study using near-infrared spectroscopy.

In rubber hand illusion, visual information affects tactile information, whereas in the mirror box illusion, visual information has the opposite effect. However, its underlying mechanisms are not fully understood. As one of the reasons, non-invasive neuroimaging techniques, such as functional magnetic resonance, positron emission tomography, and electroencephalography, often fail to detect complex and fragile responses in the sensory-motor cortex. Using near-infrared spectroscopy (NIRS), we examined neural activity during tactile tracing on a sine-shaped acrylic board to investigate the effects of (1) visual information and (2) the spatial frequency of the sine shape on brain activity. We used spatial frequencies of 2-3 and 20-30 Hz as low- and high-tactile stimuli, respectively. Two types of experiments, with and without an acrylic board, were conducted. Participants performed the tracing tasks with their index finger at 1 Hz of temporal frequency of a 200 mm length of the acrylic board as main tasks and only space moving without touching as a control task. We show effect of visual information on neural activation, including not only activation intensity but also activation patterns.•Testing of mutual effects of vision and haptics.•Testing of sensory-motor paradox using NIRS.•A high NIRS sensitivity to stimulus-induced hemodynamic change.

Capture of emotional responses under a simulated earthquake experience using near-infrared spectroscopy and virtual reality.

AIM: In a previous study, we reported that watching two-dimensional videos of earthquakes significantly reduced sympathetic nerve activity in healthy young adults. In the present study, we aimed to investigate the emotional responses to earthquakes using immersive virtual reality (VR), which can provide a more realistic experience. METHODS: In total, 24 healthy young adults (12 males, 21.4 ± 0.2 years old) participated. Participants were required to watch earthquake and neutral videos while wearing a head-mounted display and near-infrared spectroscopy (NIRS), during which physiological signals, including pulse rate and cerebral blood flow (CBF) in the dorsolateral prefrontal cortex, were measured. We also analyzed changes in sympathetic and parasympathetic indices and obtained seven emotion ratings: valence, arousal, dominance, fear, astonishment, anxiety, and panic. RESULTS: The VR earthquake videos evoked negative subjective emotions, and the pulse rate significantly decreased. Sympathetic nerve activity tended to decrease, whereas CBF in the left prefrontal cortex showed a slight increase, although this was not significant. CONCLUSIONS: This study showed that measurements combined with NIRS and immersive VR have the potential to capture emotional responses to different stimuli.

Dyadic Art Appreciation and Self-Expression Program (NCGG-ART) for People with Dementia or Mild Cognitive Impairment and Their Family Caregivers: A Feasibility Study.

BACKGROUND: Non-pharmacological interventions effective for depressive mood and bilateral relationships among persons with cognitive impairment (PwCI) and their family caregivers (FCGs) have not been established. OBJECTIVE: To examine the feasibility of a newly developed group-based art appreciation and self-expression program (NCGG-ART) for dyads of PwCI and their FCGs. METHODS: This pilot randomized control trial included 34 dyads of PwCI diagnosed with mild to moderate Alzheimer's disease or mild cognitive impairment, and their FCGs, from an outpatient rehabilitation service (Holistic Physio-Cognitive Rehabilitation [HPCR]). Participants were randomly divided equally into the HPCR (control group) or NCGG-ART and HPCR (intervention group) groups. Both included 1-hour weekly, 6-week programs. The primary outcome was depressive symptoms among FCGs assessed using the Patient Health Questionnaire-9 (PHQ-9). Feasibility outcomes included participant satisfaction and motivation. FCGs were interviewed about their experiences and feelings regarding the program, which were analyzed using content analysis. RESULTS: Thirty-two dyads (intervention group:16; control group:16) completed the study period. High participation rates, satisfaction, and motivation were demonstrated throughout the intervention. Scores in the PHQ-9 among FCGs did not show positive effects: mean changes in the score were 1.3 for the intervention group and -0.8 for the control group (Cohen d:0.56). However, the qualitative analysis revealed favorable experiences and feelings of the FCGs, such as positive emotions, social interactions, and person-centered attitudes to and positive relationships with PwCI. CONCLUSIONS: This program demonstrated high feasibility with FCGs' favorable responses to emotions and relationships with PwCI, ensuring future investigations with a confirmatory study design.

A virtual shopping test for realistic assessment of cognitive function.

BACKGROUND: Cognitive dysfunction caused by brain injury often prevents a patient from achieving a healthy and high quality of life. By now, each cognitive function is assessed precisely by neuropsychological tests. However, it is also important to provide an overall assessment of the patients' ability in their everyday life. We have developed a Virtual Shopping Test (VST) using virtual reality technology. The objective of this study was to clarify 1) the significance of VST by comparing VST with other conventional tests, 2) the applicability of VST to brain-damaged patients, and 3) the performance of VST in relation to age differences. METHODS: The participants included 10 patients with brain damage, 10 age-matched healthy subjects for controls, 10 old healthy subjects, and 10 young healthy subjects. VST and neuropsychological tests/questionnaires about attention, memory and executive function were conducted on the patients, while VST and the Mini-Mental State Examination (MMSE) were conducted on the controls and healthy subjects. Within the VST, the participants were asked to buy four items in the virtual shopping mall quickly in a rational way. The score for evaluation included the number of items bought correctly, the number of times to refer to hints, the number of movements between shops, and the total time spent to complete the shopping. RESULTS: Some variables on VST correlated with the scores of conventional assessment about attention and everyday memory. The mean number of times referring to hints and the mean number of movements were significantly larger for the patients with brain damage, and the mean total time was significantly longer for the patients than for the controls. In addition, the mean total time was significantly longer for the old than for the young. CONCLUSIONS: The results suggest that VST is able to evaluate the ability of attention and everyday memory in patients with brain damage. The time of VST is increased by age.

Characterization of forehead blood flow bias on NIRS signals during neural activation with a verbal fluency task.

The major problem of near-infrared spectroscopy (NIRS) for brain activity measurement during verbal fluency task is the overlapping forehead scalp blood flow (FBF) on the target cerebral blood flow (CBF). There could be among-individual differences in the influence of FBF on CBF. We investigated effects of FBF on CBF by comparing signals obtained through a laser Doppler flowmeter (LDF) and NIRS using the modified Beer-Lambert Law (MBLL). Among 25 healthy individuals, 7 participants showed a strong correlation between LDF and NIRS signals (rs >0.500). There were no significant differences according to age or sex. Subsequently, we applied the hemodynamic separation method to the values calculated using the MBLL (Δ[oxy-Hb]M): to separate the concentration of oxygenated hemoglobin in the forehead (Δ[oxy-Hb]F) and cerebral cortex (Δ[oxy-Hb]C). First, we found that the influence of Δ[oxy-Hb]F on Δ[oxy-Hb]C in the high rs group was almost twice as large as that in the low rs group. Second, presence of sex and age differences in the influence of Δ[oxy-Hb]F on Δ[oxy-Hb]C were suggested. Based on the results, we discuss the factors affecting FBF and the resulting variations in NIRS signals.

Information Management for the Assistive Technology Provision in Community: Perspectives of Local Policymakers and Health Service Providers.

BACKGROUND: Assistive technology (AT) is a way to enhance the performance of daily activities in people with disabilities and help them live more independently. However, an important problem in providing AT lies in the effectiveness of information management. Local policymakers and health service providers have become aware of this problem and their perspectives are the key to solving it. METHODS: This study explored the types of AT provided for people with disabilities in the community and the perspectives on information management of local policymakers and health service providers. A survey checklist and semistructured in-depth interview were the instruments of this study. The key informants in this study included administrators, nurses, and physical therapists from four community areas in Chiang Mai, Thailand. RESULTS: The medical records showed that the types of AT provided were mostly second-hand (57.24%) and borrowed devices (57.73%). All of them were low-tech devices (crutch, cane, walker, wheelchair, and adaptive tricycle). In addition, the results indicated three perspective aspects related to information management: (1) problems in the database recording system, (2) different policies and processes of information management, and (3) improvement of the AT provision system. CONCLUSION: The perspectives of local policymakers and health service providers indicated related problems, impacts of policies, and ways to improve the AT provision system by applying information technology.

Development of a cognitive function test using virtual reality technology: examination in healthy participants.

We developed a virtual reality test to assess the cognitive function of Japanese people in near-daily-life environment, namely, a virtual shopping test (VST). In this test, participants were asked to execute shopping tasks using touch panel operations in a "virtual shopping mall." We examined differences in VST performances among healthy participants of different ages and correlations between VST and screening tests, such as the Mini-Mental State Examination (MMSE) and Everyday Memory Checklist (EMC). We included 285 healthy participants between 20 and 86 years of age in seven age groups. Therefore, each VST index tended to decrease with advancing age; differences among age groups were significant. Most VST indices had a significantly negative correlation with MMSE and significantly positive correlation with EMC. VST may be useful for assessing general cognitive decline; effects of age must be considered for proper interpretation of the VST scores.