Cross-cultural evaluation of learning and memory using a consonant-vowel-consonant trigram list.

OBJECTIVE: Word list-learning tasks are commonly used to evaluate auditory-verbal learning and memory. However, different frequencies of word usage, subtle meaning nuances, unique word phonology, and different preexisting associations among words make translation across languages difficult. We administered lists of consonant-vowel-consonant (CVC) nonword trigrams to independent American and Italian young adult samples. We evaluated whether an auditory list-learning task using CVC nonword trigrams instead of words could be applied cross-culturally to evaluate similar learning and associative memory processes. PARTICIPANTS AND METHODS: Seventy-five native English-speaking (USA) and 104 native Italian-speaking (Italy) university students were administered 15-item lists of CVC trigrams using the Rey Auditory Verbal Learning Test paradigm with five study-test trials, an interference trial, and short- and long-term delayed recall. Bayesian t tests and mixed-design ANOVAs contrasted the primary learning indexes across the two samples and biological sex. RESULTS: Performance was comparable between nationalities on all primary memory indices except the interference trial (List B), where the Italian group recalled approximately one item more than the American sample. For both nationalities, recall increased across the five learning trials and declined significantly on the postinterference trial, demonstrating susceptibility to retroactive interference. No effects of sex, age, vocabulary, or depressive symptoms were observed. CONCLUSIONS: Using lists of unfamiliar nonword CVC trigrams, Italian and American younger adults showed a similar performance pattern across immediate and delayed recall trials. Whereas word list-learning performance is typically affected by cultural, demographic, mood, and cognitive factors, this trigram list-learning task does not show such effects, demonstrating its utility for cross-cultural memory assessment.

Disentangling the Contribution of Spatial Reference Frames to Executive Functioning in Healthy and Pathological Aging: An Experimental Study with Virtual Reality.

A growing body of evidence pointed out that a decline in effectively using spatial reference frames for categorizing information occurs both in normal and pathological aging. Moreover, it is also known that executive deficits primarily characterize the cognitive profile of older individuals. Acknowledging this literature, the current study was aimed to specifically disentangle the contribution of the cognitive abilities related to the use of spatial reference frames to executive functioning in both healthy and pathological aging. 48 healthy elderly individuals and 52 elderly suffering from probable Alzheimer's Disease (AD) took part in the study. We exploited the potentiality of Virtual Reality to specifically measure the abilities in retrieving and syncing between different spatial reference frames, and then we administrated different neuropsychological tests for evaluating executive functions. Our results indicated that allocentric functions contributed significantly to the planning abilities, while syncing abilities influenced the attentional ones. The findings were discussed in terms of previous literature exploring relationships between cognitive deficits in the first phase of AD.

Longevity as a Responsibility: Constructing Healthy Aging by Enacting within Contexts over the Entire Lifespan.

Studying aging now requires going beyond the bio-psycho-social model and incorporating a broader multidisciplinary view capable of capturing the ultimate complexity of being human that is expressed as individuals age. Current demographic trends and the lengthening of life expectancies allow the observation of long-lived individuals in full health. These super-agers are no longer an exception. Indeed, individuals can have a good quality of life even over age 70 and living with chronic or neurodegenerative diseases. This change is driven in part by the cohort effect observed in people who are about to age today (e.g., better schooling, more advanced health conditions, and technologization) but more so by the gradual overcoming of ageist views. An aged person is no longer seen as a quitter but rather as one empowered to direct their own trajectory of potentially healthy longevity. According to this vision, this article proposes a situated lifespan perspective for the study of aging that integrates pedagogical models of developmental ecology with psychological theories of optimal experience to understand the individual motivational perspective on aging. At the same time, it does not disregard analyzing the daily and cultural contexts in which everyone situates and that guide aging trajectories. Nor does it forget that aging people are body-mind (embodied) organisms that, with contexts and through motivations, seize opportunities for action (affordances) to evolve in an optimal way during their lifespan. This theoretical reflection sheds new light on the aging process and on future trends in healthy longevity research.

The Italian version of the Virtual Dementia Tour: Manual translation and an analysis of consistency, validity, and reliability of its pre- post-experience survey.

Introduction: Clinical indications on how to approach caregiving with a person living with dementia underline the need "to have an empathic attitude" requiring the caregiver to view the world from the perspective of the person with dementia. However, it is not easy for the caregiver to understand the perspective their patients have on day-to-day experiences. To put the caregivers in the person with dementia's shoes, the Virtual Dementia Tour (VDT) was developed in 2001, and has been administered to millions of health professionals, community leaders, and family caregivers. Method: In this paper we present the Italian version of the VDT and discuss its internal validity and test-retest reliability for the pre-post experience survey defined by the VDT procedure. Results: An Italian sample (N = 419; mean age = 44.8; standard deviation 14.2) completed the tour and a 5-item survey provided before and after the experience revealed the disposition toward people with dementia changed. Discussion: The VDT Italian version wasrevealed to be valid in supporting a positive perspective change in the perception of dementia as is seen in the original VDT used in English-speaking countries. Highlights: Empathy predicts a higher quality of caregiving for the person living with dementia.The Virtual Dementia Tour (VDT) provides an experience from the person living with dementia's perspective and supports empathy.We present the first Italian version of VDT and its manual translation and validation.Italian VDT internal consistency and test-retest reliability were calculated.Results confirms the reliability and validity of the Italian VDT for empathy.

Validation of a Neuro Virtual Reality-based version of the Multiple Errands Test for the assessment of executive functions.

The purpose of this study was to establish ecological validity and initial construct validity of the Virtual Reality (VR) version of the Multiple Errands Test (MET) (Shallice & Burgess, 1991; Fortin et al., 2003) based on the NeuroVR software as an assessment tool for executive functions. In particular, the MET is an assessment of executive functions in daily life, which consists of tasks that abide by certain rules and is performed in a shopping mall-like setting where items need to be bought and information needs to be obtained. The study population included three groups: post-stroke participants (n = 5), healthy, young participants (n = 5), and healthy, older participants (n = 5). Specific objectives were (1) to examine the relationships between the performance of three groups of participants in the Virtual Multiple Errands Test (VMET) and at the traditional neuropsychological tests employed to assess executive functions and (2) to compare the performance of post-stroke participants to those of healthy, young controls and older controls in the VMET and at the traditional neuropsychological tests employed to assess executive functions.

Sleep dysfunctions influence decision making in undemented Parkinson's disease patients: a study in a virtual supermarket.

In the early-middle stages of Parkinson's disease (PD), polysomnographic studies show early alterations of the structure of the sleep, which may explain frequent symptoms reported by patients, such as daytime drowsiness, loss of attention and concentration, feeling of tiredness. The aim of this study was to verify if there is a correlation between the sleep dysfunction and decision making ability. We used a Virtual Reality version of the Multiple Errand Test (VMET), developed using the NeuroVR free software (http://www.neurovr2.org), to evaluate decision-making ability in 12 PD not-demented patients and 14 controls. Five of our not-demented 12 PD patients showed abnormalities in the polysomnographic recordings associated to significant differences in the VMET performance.

Implementation of the multiple errands test in a NeuroVR-supermarket: a possible approach.

Our goal was to develop a tool for the assessment of executive functions by customizing a virtual reality (VR) version of the Multiple Errands Test (MET) [Shallice & Burgess, 1991; Fortin et al., 2003]. The MET is an assessment of executive functions in daily life which consists of tasks that abide by certain rules. It is performed in an actual shopping mall-like setting where there are items to be bought and information to be obtained. The specific goal of this study was to conduct a pilot study using the virtual version of MET (VMET) with both control subjects and patients with cognitive impairment derived from stroke.

Executive functions in a virtual world: a study in Parkinson's disease.

In Parkinson's disease executive functions are altered. We used a Virtual Reality version of the Multiple Errand Test in order to evaluate decision-making ability in 12 patients and 14 controls. Patients with Parkinson's disease, even if not-demented, showed strategies full of errors, suggesting that impulse control disorder, very frequent in course of disease, could precede cognitive dysfunctions.

Take the First-Person Perspective to Become Dementia-Friendly: The Use of 360° Video for Experiencing Everyday-Life Challenges With Cognitive Decline.

The current spread of dementia is engendering an emergency that is not limited to the medical issues but also involves its social dimension. Accordingly, it is necessary to promote a perspective change about the disease that supports a more inclusive view of people with dementia. To ensure this, Dementia-Friendly Communities (DFCs) have recently been developed. Nonetheless, it is not always effortless to deal with people with dementia in an inclusive way because of misconceptions about how they perceive everyday contexts and react in everyday situations. We asked 170 individuals (aged between 13 and 75) to "put themselves in the shoes of a person with dementia" for a few minutes, facilitating this through the use of a 360° video, and to try to experience how activities such as going shopping feel from the first-person perspective. Before and after the experience, participants expressed their opinions about the needs and the autonomies that are deemed to be granted to a person with dementia. The results revealed changes to social perspective after having experienced firsthand what living with dementia could be like. A deeper comprehension of what it is like to live with dementia appeared to be gained, and participants' beliefs about the needs and daily autonomies of those with dementia were modified after the experience. It is possible to conclude that, through the change of perspective, people are more willing to be inclusive toward people with dementia, as is wished for in the DFC approach, although a wider formative intervention on how to be really inclusive still seems to be required.

Italian Version of the Scale of Body Connection: Validation and Correlations with the Interpersonal Reactivity Index.

In recent years there has been considerable research on body awareness, which is believed to arise from interoceptive and from exteroceptive signals. In addition, body awareness may be related to empathetic disposition during social interaction. In this paper we assess the psychometric properties of the Italian version of the Scale of Body Connection (SBC). We also examine SBC correlations with the Interpersonal Reactivity Index, a measure of empathy. An Italian sample (N = 576) aged from 17 to 72 years old (M = 30.43; sd 9.41) completed these surveys online. The SBC Italian translation was validated by confirmatory factor analysis showing a good model fit. The two-scale SBC factor structure was confirmed. The SBC was positively associated with the Iterpersonal Reactivity Index (IRI), demonstrating convergent validity between these two scales. Specifically SBC-Bodily Dissociation was positively correlated with IRI-Personal Distress subscale and SBC-Body Awareness was positively correlated with IRI-Emotional Concerns, -Fantasy and -Perspective Taking subscales.

Neuropsychological and virtual reality assessment in topographical disorientation.

Although literature does not provide a unique explanation, the importance of hippocampus for human topographical learning and orientation is assumed to be relevant by most of the authors. There is considerable evidence that the hippocampus is necessary for acquiring cognitive maps of allocentric space, which includes topographical knowledge of large-scale real environments. This study aimed to investigate neuropsychological and behavioral characteristics of topographical disorientation in a 71 years old patient, affected by an ischemic bilateral occipital lesion involving the hippocampus. Several assessment methods have been involved: neuropsychological test, paper and pencil test for the evaluation of topographical abilities, and a Virtual Reality tool. Experimental evidences for the value of an integrated evaluation approach in underlying spatial orientation difficulties are provided.

Computer-guided mental practice in neurorehabilitation.

Motor imagery is the mental simulation of a movement without motor output. In recent years, there has been growing interest towards the application of motor imagery-based training, or "mental practice", in stroke rehabilitation. We have developed a virtual reality prototype (the VR Mirror) to support patients in performing mental practice. The VR Mirror displays a three-dimensional simulation of the movement to be imagined, using data acquired from the healthy arm. We tested the system with nine post-stroke patients with chronic motor impairment of the upper limb. After eight weeks of training with the VR Mirror, remarkable improvement was noted in three cases, slight improvement in two cases, and no improvement in four cases. All patients showed a good acceptance of the procedure, suggesting that virtual reality technology can be successfully integrated in mental practice interventions.

A NeuroVR based tool for cognitive assessment and rehabilitation of post-stroke patients: two case studies.

Neuropsychological disorders are common in stroke patients, ranging from an isolated impairment to impairment in multiple cognitive functions. The cognitive domains affected are in particular executive functions. These comprise planning, organising, conducting, assessing and controlling actions. Dual task abilities, that is the ability to perform successive or simultaneous tasks, are not easy to be evaluated and recovered by traditional paper and pencil methods, due to their ecological and contextual nature. NeuroVR 1.5 is a cost-free virtual reality platform based on open-source software, allowing professionals to easily modify a virtual world, to best suit the needs of the clinical setting.The present study was designed to develop and test a NeuroVR based tool for the rehabilitation of shifting of attention and action planning functions using tasks reminiscent of daily life tasks. We present the virtual environment and the cognitive procedure we developed, discussing two stroke patients case studies, which underwent an integrated neuropsychological and VR assessment.

Long-lasting topographical disorientation in new environments.

We describe the case of a young woman with long-lasting topographical disorientation following a haemorrhagic lesion of the right temporo-occipital region involving the hippocampus. She was unable to orient herself in novel environments and to perform learning spatial tasks both in real-world settings and laboratory conditions. Her ability to recall and navigate through known routes as well as to recognize familiar landmarks was preserved. Neuropsychological evaluation revealed a mild long-term memory deficit. A similar neuropsychological and experimental pattern was observed 8 years later (at the time of follow-up) when she showed a persistent topographical disorientation and a slight worsening of verbal and visuo-spatial long-term memory disorders. Her topographical disorientation was characterized by an impairment confined to the anterograde memory domain, a not frequent pattern reported in literature, in the absence of remote topographical memory disorders. The presence of a lesion localized in the right occipito-temporal region and hippocampus combined with the results observed in some experimental tasks could also contribute to the debate of the role of neural correlates involved in topographical spatial knowledge.

The use of virtual environments for survey spatial ability evaluation in topographical disorientation.

Due to their interactivity and to the sense of presence they afford, virtual environments constitute an interesting opportunity to study spatial cognition. In accordance with this perspective, we aimed to introduce a spatial test in virtual simulation in order to investigate the survey spatial ability in patients with topographical disorientation. To do this, we used the "planning in advance task" in a virtual environment that constitutes an effective procedure to experimentally evaluate survey maps. With this procedure we present the single case of a woman, with a right medial temporal lobe lesion, who shows a selective impairment in the acquisition of new spatial relationships. The patient's performance in "planning in advance task" was compared with that of a control group made up of 40 female subjects matched for age and education. Results show how the patient revealed a significantly lower spatial performance when compared to the control group, demonstrating an inability to solve survey-type spatial tasks in complex virtual environments.

Enacting Space in Virtual Reality: A Comparison Between Money's Road Map Test and Its Virtual Version.

In the field of spatial cognition research the mutual relationship between perception and action that brings out spatial orientation was lately investigated. Besides, the sameness between creating a cognitive map from the exploration of a not simulated environment, from the use of an allocentric (survey-like) sketched map, and from the interaction with egocentric (route-like) 3D virtual environments, is generally contrived. To understand if different embodied affordances could provide different knowledge organization during wayfinding through the use of distinct spatial simulations, the same group of 61 healthy subjects experienced both the classical version of the Money's Road Map test (M-RMT) and a virtual reality version of the Road Map test (VR-RMT). The M-RMT requires a allocentric to egocentric right/left reasoning to explore a stylized city provided in a survey perspective. The VR-RMT is a 3D version of the same environment through which participants can actively navigate by choosing egocentric-based right/left directions in a route perspective. The results showed that the different embodiments afforded by the two environments and the increasing complexity in turn types provides different spatial outcomes. Results were discussed according to the sensorimotor coupling theory provided from the enactive cognition approach and significances for spatial cognition research were provided.

The Neuropsychiatric Inventory-Diary Rating Scale (NPI-Diary): A Method for Improving Stability in Assessing Neuropsychiatric Symptoms in Dementia.

BACKGROUND: In health-care settings, the use of the Neuropsychiatric Inventory-Nursing Home (NPI-NH) may not always be consistent with the authors' guidelines, which affects its reliability. To avoid this bias, a diary version of the NPI (NPI-Diary) was developed. AIMS: This study aimed to evaluate the psychometric properties (internal consistency and reliability) of the NPI-Diary, and examined its convergence with the NPI-NH. METHODS: Two raters administered the NPI-NH and NPI-Diary to 40 participants with Alzheimer's disease, selected randomly from a hospital's weekly turnover. RESULTS: The NPI-Diary exhibited adequate internal consistency (total: α = 0.581) and test-retest reliability (total: ρ = 0.711; p < 0.01). The interrater reliability values (ICC) for the NPI-NH and NPI-Diary differed significantly (Total: NPI-NH ICC = 0.506, NPI-Diary ICC = 0.879; Frequency: NPI-NH ICC = 0.51, NPI-Diary ICC = 0.798; Severity: NPI-NH ICC = 0.491, NPI-Diary ICC = 0.809). The convergent validity between the two inventories was also significant (total: ρ = 0.48; p < 0.01). CONCLUSIONS: The NPI-Diary showed more appropriate validity and reliability compared to the NPI-NH, when administered in a highly variable sample, as is generally the case in the current health-care setting.

Two new virtual reality tasks for the assessment of spatial orientation Preliminary results of tolerability, sense of presence and usability.

Spatial orientation is a cognitive domain frequently impaired in Alzheimer's Disease and can be one of its earliest symptoms. OBJECTIVE: This paper describes the results of tolerability, sense of presence and usability of two immersive virtual reality tasks for the assessment of spatial orientation, using VR headset in adults. METHODS: 31 healthy adults recruited from university and the local community performed two experimental immersive virtual reality tasks of spatial orientation: the SOIVET-Maze for the assessment of allocentric to egocentric spatial abilities and the SOIVET-Route for the assessment of spatial memory and landmark recognition. Participants completed questionnaires about sense of presence, cybersickness symptoms, technology use profile and motion sickness history. Usability measures were assessed by spontaneous feedback from participants. RESULTS: All participants were able to understand the task instructions and how to interact with the system. Both tasks seemed to induce a strong sense of presence, as assessed by the Witmer and Singer Presence Questionnaires (M=128 and 143 for SOIVET-Maze and SOIVET-Route, respectively). The SOIVET-Route had a small numeric advantage over the SOIVET-Maze tolerability scores assessed by the Cybersickness Questionnaire (M=4.19, SD=5.576 and M=3.52, SD=6.418 for SOIVET-Maze and SOIVET-Route respectively). Also, there were no drop-outs on the SOIVET-Route due to tolerability issues, unlike the SOIVET-Maze, which had two drop-outs. However, this difference was not statistically significant (Z= -.901, p= 0.368, Wilcoxon signed-rank test).

A orientação espacial é um domínio cognitivo freqüentemente comprometido na doença de Alzheimer e pode ser um dos primeiros sintomas manifestados. OBJETIVO: Este artigo descreve os resultados de tolerabilidade, sensação de presença e usabilidade de duas tarefas imersivas de realidade virtual para avaliação da orientação espacial, utilizando óculos de RV em adultos. MÉTODOS: 31 adultos saudáveis, ​​recrutados entre estudantes universitários e da comunidade local, realizaram duas tarefas de realidade virtual imersiva para avaliação da orientação espacial: A tarefa SOIVET-Maze para avaliação da capacidade de transposição da orientação alocêntrica para egocêntrica e a tarefa SOIVET-Route para avaliação da memória espacial e reconhecimento de pontos de referência. Os participantes também responderam questionários sobre Sensação de Presença, Sintomas de cybersickness, Perfil de Uso de Tecnologia e Histórico de cinetose. Feedback espontâneo dos participantes foi utilizado como medida de usabilidade. RESULTADOS: Todos os participantes conseguiram compreender as instruções da tarefa e como interagir com o sistema. Ambas tarefas parecem induzir forte sensação de presença, avaliada pelo Questionário de Presença de Witmer e Singer (M=128 e 143 para SOIVET-Maze e SOIVET-Route, respectivamente). A tarefa SOIVET-Route teve uma pequena vantagem numérica em relação à tarefa SOIVET-Maze na pontuação de tolerabilidade avaliada pelo Questionário de Cybersickness (M=4,19, SD=5,576 e M=3,52, SD=6,418 para SOIVET-Maze e SOIVET-Route respectivamente). Além disso, não houve desistências na SOIVET-Route devido a problemas de tolerabilidade, ao contrário da SOIVET-Maze, que teve dois drop-outs. No entanto, essa diferença não foi estatisticamente significativa (Z= -901, p=0,368, teste de postos sinalizados de Wilcoxon).

A virtual reality extended neuropsychological assessment for topographical disorientation: a feasibility study.

BACKGROUND: Topographical disorientation represents one of the main consequences of brain injury. Up to now several methodological approaches have been used in the assessment of the brain injured patient's navigational abilities showing a moderate correlation with the impairments observed in everyday contexts. METHODS: We propose a combination of standardized neuropsychological tests and a more situated virtual reality-based assessment for the evaluation of spatial orientation in brain injured patients. RESULTS: When tested with this virtual reality integrated procedure patients showed performance and execution times congruent with their neuropsychological evaluation. When compared to a control group, patients revealed significantly slower times and greater errors in solving virtual reality based spatial tasks. CONCLUSION: The use of virtual reality, when combined with classical neuropsychological tests, can provide an effective tool for the study of topographical disorientation.

Affective interactions using virtual reality: the link between presence and emotions.

Many studies showed the ability of movies and imagery techniques to elicit emotions. Nevertheless, it is less clear how to manipulate the content of interactive media to induce specific emotional responses. In particular, this is true for the emerging medium virtual reality (VR), whose main feature is the ability to induce a feeling of "presence" in the computer-generated world experienced by the user. The main goal of this study was to analyze the possible use of VR as an affective medium. Within this general goal, the study also analyzed the relationship between presence and emotions. The results confirmed the efficacy of VR as affective medium: the interaction with "anxious" and "relaxing" virtual environments produced anxiety and relaxation. The data also showed a circular interaction between presence and emotions: on one side, the feeling of presence was greater in the "emotional" environments; on the other side, the emotional state was influenced by the level of presence. The significance of these results for the assessment of affective interaction is discussed.