Cognitive rehabilitation using immersive virtual reality at young age: A case report on traumatic brain injury.

Adolescents having moderate to severe traumatic brain injury (TBI) often experience long-lasting cognitive, emotional, and behavioral problems. In current clinical practice, rehabilitation techniques to treat cognitive abnormalities may be classified in two main categories, i.e. conventional or advanced. Aim of this case study was to evaluate the safety and efficacy of an immersive virtual environment (Computer Assisted Rehabilitation Environment [CAREN]), in a young boy affected by severe TBI. A 15-year-old boy with TBI involving the right parietal-temporal region underwent two different rehabilitation trainings, including standard cognitive rehabilitation alone in a usual clinical setting (face-to-face intervention with a paper and pencil approach) or the same cognitive program using virtual scenarios by means of CAREN. We evaluated the patient's cognitive status, before and after the two different trainings, by using a specific psychometric battery to evaluate the cognitive and behavioral functioning, such as attention abilities, visuo-spatial and executive functions. Only at the end of the CAREN training, we observed a significant improvement in specific cognitive and motor domains, such as attention abilities, visuo-executive processes, emotional awareness, and balance. Cognitive training, using immersive Virtual Reality, may be a useful tool to facilitate cognitive recovery in TBI patients.

Improving neuropsychiatric symptoms following stroke using virtual reality: A case report.

RATIONALE: Post-stroke cognitive impairment occurs frequently in patients with stroke, with a 20% to 80% prevalence. Anxiety is common after stroke, and is associated with a poorer quality of life. The use of standard relaxation techniques in treating anxiety in patients undergoing post-stroke rehabilitation have shown some positive effects, whereas virtual reality seems to have a role in the treatment of anxiety disorders, especially when associated to neurological damage. PATIENTS CONCERNS: A 50-year-old woman, smokers, affected by hypertension and right ischemic stroke in the chronic phase (i.e., after 12 months by cerebrovascular event), came to our observation for a severe anxiety state and a mild cognitive deficit, mainly involving attention and visuo-executive processes, besides a mild left hemiparesis. DIAGNOSIS: Anxiety in a patient with ischemic stroke. INTERVENTIONS: Standard relaxation techniques alone in a common clinical setting or the same psychological approach in an immersive virtual environment (i.e., Computer Assisted Rehabilitation Environment - CAREN). OUTCOMES: The patient's cognitive and psychological profile, with regard to attention processes, mood, anxiety, and coping strategies, were evaluated before and after the 2 different trainings. A significant improvement in the functional and behavioral outcomes were observed only at the end of the combined approach. LESSONS: The immersive virtual reality environment CAREN might be useful to improve cognitive and psychological status, with regard to anxiety symptoms, in post-stroke individuals.