Efficacy of serious exergames in improving neuropsychiatric symptoms in neurocognitive disorders: Results of the X-TORP cluster randomized trial.

INTRODUCTION: The aim of this study was to evaluate the efficacy of a serious exergame in improving the neuropsychiatric symptoms of patients with neurocognitive disorders. METHODS: X-Torp is a serious exergame combining motor and cognitive activities. Ninety-one subjects (mean age = 81.7 years, mean Mini-Mental State Examination = 18.3) were recruited in 16 centers. Centers were randomized into intervention and control centers. Subjects underwent assessment for cognitive and behavioral symptoms at baseline (BL), the end of the intervention (W12), and 12 weeks after the end of the intervention (W24). RESULTS: The comparison of neuropsychiatric symptoms between BL and W12 and W24 showed that subjects of the intervention group improved in apathy between BL and W12. Mixed analysis (time BL, W12, W24 x group) indicated a significant increase in apathy and neuropsychiatric symptoms in the control subjects. DISCUSSION: The use of X-Torp improved neuropsychiatric symptoms, particularly apathy. Future studies should more consistently use behavioral and neuropsychiatric symptoms as outcome measures.

Linguistic processes do not beat visuo-motor constraints, but they modulate where the eyes move regardless of word boundaries: Evidence against top-down word-based eye-movement control during reading.

Where readers move their eyes, while proceeding forward along lines of text, has long been assumed to be determined in a top-down word-based manner. According to this classical view, readers of alphabetic languages would invariably program their saccades towards the center of peripheral target words, as selected based on the (expected) needs of ongoing (word-identification) processing, and the variability in within-word landing positions would exclusively result from systematic and random errors. Here we put this predominant hypothesis to a strong test by estimating the respective influences of language-related variables (word frequency and word predictability) and lower-level visuo-motor factors (word length and saccadic launch-site distance to the beginning of words) on both word-skipping likelihood and within-word landing positions. Our eye-movement data were collected while forty participants read 316 pairs of sentences, that differed only by one word, the prime; this was either semantically related or unrelated to a following test word of variable frequency and length. We found that low-level visuo-motor variables largely predominated in determining which word would be fixated next, and where in a word the eye would land. In comparison, language-related variables only had tiny influences. Yet, linguistic variables affected both the likelihood of word skipping and within-word initial landing positions, all depending on the words' length and how far on average the eye landed from the word boundaries, but pending the word could benefit from peripheral preview. These findings provide a strong case against the predominant word-based account of eye-movement guidance during reading, by showing that saccades are primarily driven by low-level visuo-motor processes, regardless of word boundaries, while being overall subject to subtle, one-off, language-based modulations. Our results also suggest that overall distributions of saccades' landing positions, instead of truncated within-word landing-site distributions, should be used for a better understanding of eye-movement guidance during reading.