Influence of spatial orientation training in a centrifuge on the ability of fighter pilots to assess the bank angle during flight without visual references.

Without visual references, nonpilots exposed to coordinated flight turns underestimate the bank angle, because of discordant information of the roll-angular displacement from the otoliths, consistently signaling vertical position, versus the semicircular canals, enabling detection of the displacement. Pilots may also use their ability to perceive the G load and knowledge of the relation between load and angle to assess the bank angle. Our aim was to investigate whether the perception of bank angle can be improved by spatial orientation training in a centrifuge. Sixteen pilots/pilot students assessed their roll tilt, in complete darkness, during both real coordinated flight turns and gondola centrifugation, at roll tilts of 30° and 60°. The experiments were repeated after a 3-wk period, during which eight of the subjects performed nine training sessions in the centrifuge, comprising feedback on roll angle vs. G load, and on indicating requested angles. Before training, the subjects perceived in the aircraft and centrifuge, respectively: 37 (17)°, 38 (14)° during 60° turns and 19 (12)°, 20 (10)° during 30° turns. Training improved the perception of angle during the 60° [to 60 (7)°, 55 (10)°; P ≤ 0.04] but not the 30° [21 (10)°, 15 (9)°; P ≥ 0.30] turns; the improvement disappeared within 2 yr after training. Angle assessments did not change in the untrained group. The results suggest that it is possible to, in a centrifuge, train a pilot's ability to perceive large but not discrete-to-moderate roll-angular displacements. The transient training effect is attributable to improved capacity to perceive and translate G load into roll angle and/or to increased reliance on semicircular canal signals.NEW & NOTEWORTHY Spatial disorientation is a major problem in aviation. When performing coordinated flight turns without external visual cues (e.g., flying in clouds or darkness), the pilot underestimates the aircraft bank angle because the vestibular system provides unreliable information of roll tilt. The present study demonstrates that it is possible to, in a long-arm centrifuge, train a pilot's ability to perceive large but not discrete-to-moderate roll-angular displacements.

A computational model of motion sickness dynamics during passive self-motion in the dark.

Predicting the time course of motion sickness symptoms enables the evaluation of provocative stimuli and the development of countermeasures for reducing symptom severity. In pursuit of this goal, we present an Observer-driven model of motion sickness for passive motions in the dark. Constructed in two stages, this model predicts motion sickness symptoms by bridging sensory conflict (i.e., differences between actual and expected sensory signals) arising from the Observer model of spatial orientation perception (stage 1) to Oman's model of motion sickness symptom dynamics (stage 2; presented in 1982 and 1990) through a proposed "Normalized Innovation Squared" statistic. The model outputs the expected temporal development of human motion sickness symptom magnitudes (mapped to the Misery Scale) at a population level, due to arbitrary, 6-degree-of-freedom, self-motion stimuli. We trained model parameters using individual subject responses collected during fore-aft translations and off-vertical axis of rotation motions. Improving on prior efforts, we only used datasets with experimental conditions congruent with the perceptual stage (i.e., adequately provided passive motions without visual cues) to inform the model. We assessed model performance by predicting an unseen validation dataset, producing a Q2 value of 0.91. Demonstrating this model's broad applicability, we formulate predictions for a host of stimuli, including translations, earth-vertical rotations, and altered gravity, and we provide our implementation for other users. Finally, to guide future research efforts, we suggest how to rigorously advance this model (e.g., incorporating visual cues, active motion, responses to motion of different frequency, etc.).

Visually induced involuntary arm, head, and torso movements.

We explored in 75 s long trials the effects of visually induced self-rotation and displacement (SR&D) on the horizontally extended right arm of standing subjects (N = 12). A "tool condition" was included in which subjects held a long rod. The extent of arm movement was contingent on whether the arm was extended out Freely or Pointing at a briefly proprioceptively specified target position. The results were nearly identical when subjects held the rod. Subjects in the Free conditions showed significant unintentional arm deviations, averaging 55° in the direction opposite the induced illusory self-motion. Deviations in the Pointing conditions were on average a fifth of those in the Free condition. Deviations of head and torso positions also occurred in all conditions. Total arm and head deviations were the sum of deviations of the arm and head with respect to the torso and deviations of the torso with respect to space. Pointing subjects were able to detect and correct for arm and head deviations with respect to the torso but not for the arm and head deviations with respect to space due to deviations of the torso. In all conditions, arm, head, and torso deviations began before subjects experienced SR&D. We relate our findings to being an extension of the manual following response (MFR) mechanism to influence passive arm control and arm target maintenance as well. Visual-vestibular convergence at vestibular nuclei cells and multiple cortical movement related areas can explain our results, MFR results, and classical Pass Pointing. We distinguish two Phases in the induction of SR&D. In Phase 1, the visual stimulation period prior to SR&D onset, the arm, head, and torso deviations are first apparent, circa < 1 s after stimulus begins. They are augmented at the onset of Phase 2 that starts when SR&D is first sensed. In Phase 2, reaching movements first show curved paths that are compensatory for the Coriolis forces that would be generated on the reaching arm were subjects actually physically rotating. These movement deviations are in the opposite direction to the MFR and the arm, head, and torso deviations reported here. Our results have implications for vehicle control in environments that can induce illusory self motion and displacement.

Factors of significance for the ability of fighter pilots to visually indicate the magnitude of roll tilt during simulated turns in a centrifuge.

During coordinated flight and centrifugation, pilots show interindividual variability in perceived roll tilt. The study explored how this variability is related to perceptual and cognitive functions. Twelve pilots underwent three 6-min centrifugations on two occasions (G levels: 1.1G, 1.8G, and 2.5G; gondola tilts: 25°, 56°, and 66°). The subjective visual horizontal (SVH) was measured with an adjustable luminous line and the pilots gave estimates of experienced G level. Afterward, they were interrogated regarding the relationship between G level and roll tilt and adjusted the line to numerically mentioned angles. Generally, the roll tilt during centrifugation was underestimated, and there was a large interindividual variability. Both knowledge on the relationship between G level and bank angle, and ability to adjust the line according to given angles contributed to the prediction of SVH in a multiple regression model. However, in most cases, SVH was substantial smaller than predictions based on specific abilities.

Attentional Tunneling in Pilots During a Visual Tracking Task With a Head Mounted Display.

OBJECTIVE: We examined whether active head aiming with a Helmet Mounted Display (HMD) can draw the pilot's attention away from a primary flight task. Furthermore, we examined whether visual clutter increases this effect. BACKGROUND: Head up display symbology can result in attentional tunneling, and clutter makes it difficult to identify objects. METHOD: Eighteen military pilots had to simultaneously perform an attitude control task while flying in clouds and a head aiming task in a fixed-base flight simulator. The former consisted of manual compensation for roll disturbances of the aircraft, while the latter consisted of keeping a moving visual target inside a small or large head-referenced circle. A "no head aiming" condition served as a baseline. Furthermore, all conditions were performed with or without visual clutter. RESULTS: Head aiming led to deterioration of the attitude control task performance and an increase of the amount of roll-reversal errors (RREs). This was even the case when head aiming required minimal effort. Head aiming accuracy was significantly lower when the roll disturbances in the attitude control task were large compared to when they were small. Visual clutter had no effect on both tasks. CONCLUSION: We suggest that active head aiming of HMD symbology can cause attentional tunneling, as expressed by an increased number of RREs and less accuracy on a simultaneously performed attitude control task. APPLICATION: This study improves our understanding in the perceptual and cognitive effects of (military) HMDs, and has implications for operational use and possibly (re)design of HMDs.

A computational model of motion sickness dynamics during passive self-motion in the dark.

Predicting the time course of motion sickness symptoms enables the evaluation of provocative stimuli and the development of countermeasures for reducing symptom severity. In pursuit of this goal, we present an observer-driven model of motion sickness for passive motions in the dark. Constructed in two stages, this model predicts motion sickness symptoms by bridging sensory conflict (i.e., differences between actual and expected sensory signals) arising from the observer model of spatial orientation perception (stage 1) to Oman's model of motion sickness symptom dynamics (stage 2; presented in 1982 and 1990) through a proposed "Normalized innovation squared" statistic. The model outputs the expected temporal development of human motion sickness symptom magnitudes (mapped to the Misery Scale) at a population level, due to arbitrary, 6-degree-of-freedom, self-motion stimuli. We trained model parameters using individual subject responses collected during fore-aft translations and off-vertical axis of rotation motions. Improving on prior efforts, we only used datasets with experimental conditions congruent with the perceptual stage (i.e., adequately provided passive motions without visual cues) to inform the model. We assessed model performance by predicting an unseen validation dataset, producing a Q2 value of 0.86. Demonstrating this model's broad applicability, we formulate predictions for a host of stimuli, including translations, earth-vertical rotations, and altered gravity, and we provide our implementation for other users. Finally, to guide future research efforts, we suggest how to rigorously advance this model (e.g., incorporating visual cues, active motion, responses to motion of different frequency, etc.).

At Crossroads in a Virtual City: Effect of Spatial Disorientation on Gait Variability and Psychophysiological Response among Healthy Older Adults.

INTRODUCTION: Aging has been associated with a decline in cognitive and motor performance, often expressed in multitasking situations, which could include wayfinding. A major challenge to successful wayfinding is spatial disorientation, occurring mostly at crossings. Although gait changes have been observed in various dual-task conditions, little is known about the effect of disorientation on gait and psychophysiological response among older adults during wayfinding. The study aimed at identifying the effect of spatial disorientation on gait variability and psychophysiological response among healthy older adults during wayfinding in a controlled environment. METHOD: We analyzed data of 28 participants (age 70.8 ± 4.6, 18 female), 14 experimental and 14 controls. Participants performed a wayfinding task consisting of 14 major decision points (7 intersections) within a virtual environment (VE) projected on a 180° screen while walking on a self-paced treadmill equipped with a marker-based optical motion-capture system. The VE was held constant for the controls and manipulated for the experimental participants. Disorientation was identified based on a customized annotation scheme. Variability in gait, including the coefficient of variation (CV), was measured as the primary endpoint. Psychophysiological response measures, including heart rate variability (RMSSD) and skin conductance response (SCR), were continuously monitored as secondary endpoints and estimates of cognitive effort. Linear Mixed Effects models were applied to hypothesis-driven outcome measures extracted from decision points. RESULTS: Walking speed and step length decreased when disoriented (p < 0.05), while stride time, stance time, walking speed CV, stance time CV, SCR amplitude, and SCR count increased when disoriented (p < 0.05). A higher RMSSD was associated with being disoriented at crossings (p < 0.05). SCR count was greater in the older experimental group (p < 0.001), including when disoriented (p < 0.001). DISCUSSION/CONCLUSION: The results provide evidence for the impact of spatial disorientation on changes in gait pattern and psychophysiological response among older adults during wayfinding. Location also had implications for the effect of disorientation on gait and cognitive effort. This gives further insight into the substrates of real-world navigation challenges among older adults, with an emphasis on viable features for designing situation-adaptive interventional devices aiding independent mobility.

Galvanic vestibular stimulation to counteract leans illusion: comparing step and ramped waveforms.

Leans is a common type of Spatial Disorientation (SD) illusion that causes pilots to be confused about the position of the aircraft during a flight. This illusion could lead to serious adverse effects and even flight mishaps. Therefore, an effective means to deal with leans is crucial for flight safety. This study aims to investigate the effects of Galvanic Vestibular Stimulation (GVS) technology with different waveforms as a tool to mitigate the negative effects of leans. 20 Air Force pilots participated in leans-induced flight simulation experiment with three GVS conditions (without-GVS, step-GVS, ramped-GVS). Bank angle error, subjective SD, perceived strength, and annoyance were measured as the dependent variables. Analysis revealed that step-GVS and ramped-GVS yielded lower bank angle errors and subjective SD than without-GVS. In addition, annoyance ratings were lower for ramped-GVS than step-GVS. This study suggests that GVS has the potential to be utilised as a counteracting tool to cope with leans.Practitioner summary: Galvanic Vestibular Stimulation (GVS) can be utilised as a tool to counteract the detrimental effects of leans illusion, specifically the ramped style GVS, considering that it is less annoying and distracting for the pilots. In general, GVS induces a roll sensation that can offset the false sensation caused by the leans, which can potentially help maintain flight safety and avoid spatial disorientation-related accidents.Abbreviations: SD: spatial disorientation; GVS: galvanic vestibular stimulation; MSSQ: motion sickness susceptibility questionniare; SSQ: simulator sickness questionnaire; BLE: bluetooth low energy; PCB: printed circuit board; RPM: revolution per minute.

Induction of spatial anxiety in a virtual navigation environment.

Spatial anxiety (i.e., feelings of apprehension and fear about navigating everyday environments) can adversely impact people's ability to reach desired locations and explore unfamiliar places. Prior research has either assessed spatial anxiety as an individual-difference variable or measured it as an outcome, but there are currently no experimental inductions to investigate its causal effects. To address this lacuna, we developed a novel protocol for inducing spatial anxiety within a virtual environment. Participants first learnt a route using directional arrows. Next, we removed the directional arrows and randomly assigned participants to navigate either the same route (n = 22; control condition) or a variation of this route in which we surreptitiously introduced unfamiliar paths and landmarks (n = 22; spatial-anxiety condition). The manipulation successfully induced transient (i.e., state-level) spatial anxiety and task stress but did not significantly reduce task enjoyment. Our findings lay the foundation for an experimental paradigm that will facilitate future work on the causal effects of spatial anxiety in navigational contexts. The experimental task is freely available via the Open Science Framework ( https://osf.io/uq4v7/ ).

The role of spatial acuity in a dynamic balancing task without gravitational cues.

In earlier studies, blindfolded participants used a joystick to orient themselves to the direction of balance in the horizontal roll plane while in a device programmed to behave like an inverted pendulum. In this spaceflight analog situation, position relevant gravitational cues are absent. Most participants show minimal learning, positional drifting, and failure of path integration. However, individual differences are substantial, some participants show learning and others become progressively worse. In Experiment 1, our goal was to determine whether spatial acuity could explain these individual differences in active balancing. We exposed blindfolded participants to passive movement profiles, with different frequency components, in the vertical and horizontal roll planes. They pressed a joystick trigger to indicate every time they passed the start point. We found greater spatial acuity for higher frequencies but no relation between passive spatial accuracy and active balance control in the horizontal roll plane, suggesting that spatial acuity in the horizontal roll plane does not predict performance in a disorienting spaceflight condition. In Experiment 2, we found significant correlations between passive spatial acuity in the vertical roll plane, where participants have task relevant gravitational cues, and early active balancing in the horizontal roll plane. These correlations appeared after participants underwent brief provocative vestibular stimulation by making a pitch head movement during vertical yaw rotation. Our findings suggest that vestibular stimulation may be a valuable part of assessments of individual differences in performance during initial exposure to disorienting spaceflight conditions where there are no reliable gravity dependent positional cues.

Leans Illusion in Hexapod Simulator Facilitates Erroneous Responses to Artificial Horizon in Airline Pilots.

OBJECTIVE: We tested whether a procedure in a hexapod simulator can cause incorrect assumptions of the bank angle (i.e., the "leans") in airline pilots as well as incorrect interpretations of the attitude indicator (AI). BACKGROUND: The effect of the leans on interpretation errors has previously been demonstrated in nonpilots. In-flight, incorrect assumptions can arise due to misleading roll cues (spatial disorientation). METHOD: Pilots (n = 18) performed 36 runs, in which they were asked to roll to wings level using only the AI. They received roll cues before the AI was shown, which matched with the AI bank angle direction in most runs, but which were toward the opposite direction in a leans-opposite condition (four runs). In a baseline condition (four runs), they received no roll cues. To test whether pilots responded to the AI, the AI sometimes showed wings level following roll cues in a leans-level condition (four runs). RESULTS: Overall, pilots made significantly more errors in the leans-opposite (19.4%) compared to the baseline (6.9%) or leans-level condition (0.0%). There was a pronounced learning effect in the leans-opposite condition, as 38.9% of pilots made an error in the first exposure to this condition. Experience (i.e., flight hours) had no significant effects. CONCLUSION: The leans procedure was effective in inducing AI misinterpretations and control input errors in pilots. APPLICATION: The procedure can be used in spatial disorientation demonstrations. The results underline the importance of unambiguous displays that should be able to quickly correct incorrect assumptions due to spatial disorientation.

Orientation Comes First: Becoming Aware of Spatial Disorientation Interferes with Cognitive Performance.

BACKGROUND: Previous research has shown that experiencing motion stimuli negatively impacts cognitive performance. OBJECTIVE: In the current study, we investigate whether this impact relates to Type-II spatial disorientation (SD), to motion stimulus magnitude, or to an interaction of these factors. METHOD: Stimuli for participants (n = 23) consisted of Earth-vertical yaw rotations on a rotating chair in a completely darkened room. In the surprise condition, the stimulus started with subthreshold acceleration, followed by suprathreshold deceleration to a non-zero velocity, inducing a sensation of rotation that is opposite to the actual rotation revealed when the lights were switched on. In the no-surprise condition, the same changes in velocity were used, but starting from (almost) zero velocity, which induced a sensation of rotation in the same direction as the actual rotation. Participants performed a self-paced arithmetic task and measurement of their cognitive performance started after the environment was revealed. Stimulus magnitude was operationalized through higher or lower peak suprathreshold deceleration. RESULTS: The results revealed that counting speed decreased significantly when participants were surprised, constituting a large effect size. The proportion of counting errors likewise increased significantly when participants were surprised, but only in the high-magnitude condition. APPLICATION: The findings suggest that surprise caused by the recognition of SD has an involuntary disruptive effect on cognition, which may impact performance of piloting tasks. These results are relevant when modeling motion stimuli effects on performance, and when developing SD awareness training for pilots.

Real-Time Detection of Spatial Disorientation in Persons with Mild Cognitive Impairment and Dementia.

BACKGROUND: Detecting manifestations of spatial disorientation in real time is a key requirement for adaptive assistive navigation systems for people with dementia. OBJECTIVE: To identify predictive patterns of spatial disorientation in cognitively impaired people during unconstrained locomotion behavior in an urban environment. METHODS: Accelerometric data and GPS records were gathered during a wayfinding task along a route of about 1 km in 15 people with amnestic mild cognitive impairment or clinically probable Alzheimer's disease dementia (13 completers). We calculated a set of 48 statistical features for each 10-s segment of the acceleration sensor signal to characterize the physical motion. We used different classifiers with the wrapper method and leave-one-out cross-validation for feature selection and for determining accuracy of disorientation detection. RESULTS: Linear discriminant analysis using three features showed the best classification results, with a cross-validated ROC AUC of 0.75, detecting 65% of all scenes of spatial disorientation in real time. Consideration of an additional feature that informed about a person's distance to the next traffic junction did not provide an additional information gain. CONCLUSIONS: Accelerometric data are able to capture the uniformity and activity of a person's walking, which are identified as the most informative locomotion features of spatially disoriented behavior. This serves as an important basis for real-time navigation assistance. To improve the required accuracy of real-time disorientation prediction, as a next step we will analyze whether location-based behavior is able to inform about person-centered habitual factors of orientation.

Learning and long-term retention of dynamic self-stabilization skills.

In earlier studies, we had subjects use a joystick to balance themselves when seated in a device programmed to behave like an inverted pendulum. Subjects tested in a vertically oriented roll plane showed rapid learning for dynamically stabilizing themselves about the direction of balance when it corresponded with the direction of gravity. Subjects tested in a horizontally oriented roll plane, unlike the vertical roll plane subjects, did not have gravitational cues to determine their angular positions and showed minimal learning and persistent cyclical drifting. We describe here a training program to enhance learning and performance of dynamic stabilization in the horizontal roll plane based on our previous finding that balance control involves two dissociable components: alignment using gravity-dependent positional cues and alignment using dynamic cues. We hypothesized that teaching subjects to balance in a vertical roll plane to directions of balance that did not correspond with the direction of gravity would enhance the ability to stabilize at the direction of balance in the horizontal roll plane where gravity-dependent cues are absent. All subjects trained in vertical roll later showed greatly improved performance in horizontal plane balance. Control subjects exposed only to horizontal roll plane balancing showed minimal improvements. When retested 4 months later, the training subjects showed further performance improvements during the course of the retest trials whereas the control group showed no further improvement. Our findings indicate that balance control can be enhanced in situations lacking gravitationally dependent position cues as in weightlessness, when initial training occurs with such cues present.

Learning dynamic control of body yaw orientation.

To investigate the role of gravitational cues in the learning of a dynamic balancing task, we placed blindfolded subjects in a device programmed with inverted pendulum dynamics about the yaw axis. Subjects used a joystick to try and maintain a stable orientation at the direction of balance during 20 100 s-long trials. They pressed a trigger button on the joystick to indicate whenever they felt at the direction of balance. Three groups of ten subjects each participated. One group balanced with their body and the yaw axis vertical, and thus did not have gravitational cues to help them to determine their angular position. They showed minimal learning, inaccurate indications of the direction of balance, and a characteristic pattern of positional drifting away from the balance point. A second group balanced with the yaw axis pitched 45° from the gravitational vertical and had gravity relevant position cues. The third group balanced with their yaw axis horizontal where they had gravity-dependent cues about body position in yaw. Groups 2 and 3 showed better initial balancing performance and more learning across trials than Group 1. These results indicate that in the absence of vision, the integration of transient semicircular canal and somatosensory signals about angular acceleration is insufficient for determining angular position during dynamic balancing; direct position-dependent gravity cues are necessary.

[Pilot study: Determination of the subjective trunk vertical in upright head position]. / Pilotstudie: Bestimmung der subjektiven Rumpfvertikalen in lotrechter Kopfposition.

BACKGROUND: Consensus has been established that the subjective vertical (SV) is a result of multimodal sensory integration. In order to be able to calculate the vestibulocervical sensory competence for the SV, the isolated subjective trunk vertical axis (STV) was measured under conditions of vertical head fixation. MATERIALS AND METHODS: Young, healthy volunteers (n = 49) were compared to older, healthy volunteers (n = 50) on a three-dimensionally deflectable (tilt, torsion, pitch) trunk excursion chair in which the volunteer's head remains in an upright position. Another young, healthy group was divided into a placebo (n = 27) and a monophasic cervical transcutaneous electrical nerve stimulation (C-TENS; n = 22) group to examine verticality perception. RESULTS: In the STV after trunk pitch, age was a significant variable (p = 0.021). The older, healthy group of subjects missed the physical vertical by an average of 1.8° more than the younger group. Only the placebo group showed an average improvement in STV of 4.3° after torsion. CONCLUSION: Apart from the macular organs the vestibulocervical sensory afference is involved in finding the trunk vertical. A difference in age to the disadvantage of the older healthy subjects was observed, as well as a lack of learning success after applied C­TENS. The presented pilot study was able to confirm that a correct vertical trunk sensation is caused by vestibulocervical sensory afference in upright head position.

Using virtual reality to distinguish subjects with multiple- but not single-domain amnestic mild cognitive impairment from normal elderly subjects.

AIM: Spatial disorientation is a hallmark of amnestic mild cognitive impairment (aMCI) and Alzheimer's disease. Our aim was to use virtual reality to determine the allocentric and egocentric memory deficits of subjects with single-domain aMCI (aMCIsd) and multiple-domain aMCI (aMCImd). For this purpose, we introduced an advanced virtual reality navigation task (VRNT) to distinguish these deficits in mild Alzheimer's disease (miAD), aMCIsd, and aMCImd. METHODS: The VRNT performance of 110 subjects, including 20 with miAD, 30 with pure aMCIsd, 30 with pure aMCImd, and 30 cognitively normal controls was compared. Our newly developed VRNT consists of a virtual neighbourhood (allocentric memory) and virtual maze (egocentric memory). Verbal and visuospatial memory impairments were also examined with Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, respectively. RESULTS: We found that miAD and aMCImd subjects were impaired in both allocentric and egocentric memory, but aMCIsd subjects performed similarly to the normal controls on both tasks. The miAD, aMCImd, and aMCIsd subjects performed worse on finding the target or required more time in the virtual environment than the aMCImd, aMCIsd, and normal controls, respectively. Our findings indicated the aMCImd and miAD subjects, as well as the aMCIsd subjects, were more impaired in egocentric orientation than allocentric orientation. CONCLUSION: We concluded that VRNT can distinguish aMCImd subjects, but not aMCIsd subjects, from normal elderly subjects. The VRNT, along with the Rey Auditory-Verbal Learning Test and Rey-Osterrieth Complex Figure Test, can be used as a valid diagnostic tool for properly distinguishing different forms of aMCI.

Detection method for unrecognized spatial disorientation based on optical flow stimuli.

BACKGROUND: Flight accidents caused by spatial disorientation (SD) greatly affect flight safety. OBJECTIVE: Few studies have been devoted to the evaluation of SD. METHODS: 10 pilots and 10 non-pilots were recruited for the experimental induction of SD. Videos for giving optical flow stimuli were played at two different flow speeds to induce SD. Subjective judgment and center of foot pressure (CoP) data were collected from the tests. The data were combined to determine the occurrence of SD and analyze the SD types. RESULTS: The number of self-reported SD events was slightly smaller in the pilots than in the non-pilots. The average upper bound of the confidence interval for the standard deviation of CoP was 0.32 ± 0.09 cm and 0.38 ± 0.12 cm in the pilots and non-pilots, respectively. This indicator was significantly lower in the pilots than in the non-pilots (P= 0.03). The success rate of the experimental induction of unrecognized SD was 26.7% and 45.0% in the pilots and non-pilots, respectively. CONCLUSION: The method offered a new to analyze unrecognized SD. We could determine the occurrence unrecognized SD. This is an essential means of reducing flight accidents caused by unrecognized SD.

Evaluation of Subjective Visual Vertical and Cervical Neuromotor Control in Young Nomophobians: A Cross Sectional Study.

Misperceptions of subjective visual vertical are associated with poor balance, increasing the risk of falls and accidents. The aim of the present study was to evaluate the effect of nomophobia on verticality perception using subjective visual vertical (S.V.V.) test and cervical neuromotor control of the deep neck flexors (DNF) in adults aged 18-29 years old. This cross-sectional study employed convenience sampling and was conducted at a tertiary health institute over an eight-month period.After obtaining the written informed consent, 102 participants were asked to fill the Nomophobia Questionnaire (NMP-Q) and based on the responses participants were stratified into mild (n1 = 34), moderate(n2 = 34), and severe(n3 = 34) nomophobian group. Each nomophobian group underwent testing for verticality perception by using the SVV test and cervical neuromotor control. 102 healthy age and gender matched controls were recruited and underwent testing for verticality perception by using the SVV test and cervical neuromotor control. The mean age of the study participants was 22 ± 3.15 years with 35(33.98%) males and 67(65.04%) females. There was a statistically significant difference between the median scores across the three nomophobian groups with S.V.V. (p = 0.005), activation score (p = 0.012), and endurance score (p = 0.000) of the deep neck flexors in the severe nomophobia group. This study demonstrated that SVV and cervical neuromotor control was predominantly affected in the severe nomophobian group.

Behavioral Disorders of Spatial Cognition in Patients with Mild Cognitive Impairment due to Alzheimer's Disease: Preliminary Findings from the BDSC-MCI Project.

(1) Background: Spatial cognition (SC) is one of the earliest cognitive domains to be impaired in the course of Alzheimer's disease (AD), resulting in spatial disorientation and becoming lost even in familiar surroundings as later dementia symptoms. To date, few studies have identified initial alterations of spatial navigation (SN) in the premorbid AD phase by real-world paradigms, and none have adopted an innovative technological apparatus to better detect gait alterations as well as physiological aspects correlated to spatial disorientation (SD). The present study aimed at exploring initial SN defects in patients with prodromal AD via a naturalistic task by using a sensory garment. (2) Methods: 20 community-dwelling patients with Mild Cognitive Impairment (MCI) due to AD and 20 age/education controls were assessed on their sequential egocentric and allocentric navigation abilities by using a modified version of the Detour Navigation Test (DNT-mv). (3) Results: When compared to controls, patients with MCI due to AD exhibited higher wrong turns (WT) and moments of hesitation (MsH) in the DNT-mv, reflecting difficulties both in sequential egocentric and allocentric navigation, depending on hippocampal deterioration. Moreover, they reported more complaints about their SN competencies and lower long-term visuospatial memory abilities than controls. Remarkably, WTs and MsH manifested in the allocentric naturalistic task of the DNT-mv were associated with autonomic nervous system alteration pertaining to cardiac functioning in the whole sample. (4) Conclusions: Naturalistic navigation tests of hippocampal function using a continuous non-invasive monitoring device can provide early markers of spatial disorientation in patients with MCI due to AD. Future studies should develop cognitive remediation techniques able to enhance SC residual abilities in patients at high risk of conversion into dementia and ecological paradigms to be replicated on a large scale.