Test-retest reliability of the neurotracker compared to the impact test for the management of mild traumatic brain injuries during two consecutive university sport seasons.

INTRODUCTION: Neurocognitive assessment tools such as the Neurotracker and ImPACT have been proposed to optimize sports-related mild traumatic brain injury (mTBI) management. Baseline testing is recommended with such assessments to individualize monitoring of athletes' remission. While the ideal timeframe between baseline updates has been studied for the ImPACT, these data are missing for the Neurotracker. OBJECTIVE: The current study aimed to compare the test-retest reliability of the ImPACT and Neurotracker for two consecutive seasons in university athletes participating in sports at risk for mTBI. METHODS: At the start of two consecutive seasons, 30 athletes with no recent history of mTBI completed a baseline assessment including the Neurotracker and the ImPACT. The test-retest reliability of the results was analyzed by considering intra-class correlation (ICC), Becker's standardized mean difference (dB) and Bland-Altman' plot of each outcome. RESULTS: The Neurotracker and the Visual Motor Speed composite score of the ImPAC were the only outcomes with significative ICCs and acceptable dB between the two seasons. Neurotracker was the only outcome with a significative bias (+0.179). CONCLUSION: Our research suggests that the Neurotracker has an acceptable level of test-retest reliability after one year in comparison to the ImPACT.

A Protocol for Remote Cognitive Training Developed for Use in Clinical Populations During the COVID-19 Pandemic.

Many traumatic brain injury (TBI) survivors face scheduling and transportation challenges when seeking therapeutic interventions. The COVID-19 pandemic created a shift in the use of at-home spaces for work, play, and research, inspiring the development of online therapeutic options. In the current study, we determined the feasibility of an at-home cognitive training tool (NeuroTrackerX) that uses anaglyph three-dimensional (3D) glasses and three-dimensional multiple object tracking (3D-MOT) software. We recruited 20 adults (10 female; mean age = 68.3 years, standard deviation [SD] = 6.75) as the at-home training group. We assessed cognitive health status for participants using a self-report questionnaire and the Mini-Mental State Examination (MMSE), and all participants were deemed cognitively healthy (MMSE >26). At-home participants loaned the necessary equipment (e.g., 3D glasses, computer equipment) from the research facilities and engaged in 10 training sessions over 5 weeks (two times per week). Participant recruitment, retention, adherence, and experience were used as markers of feasibility. For program validation, 20 participants (10 female; mean age = 63.39 years, SD = 12.22), who had previously completed at least eight sessions of the in-lab 3D-MOT program, were randomly selected as the control group. We assessed individual session scores, overall improvement, and learning rates between groups. Program feasibility is supported by high recruitment and retention, 90% participant adherence, and participants' ease of use of the program. Validation of the program is supported. Groups showed no differences in session scores (p > 0.05) and percentage improvement (p > 0.05) despite the differences in screen size and 3D technology. Participants in both groups showed significant improvements in task performance across the training sessions (p < 0.001). NeuroTrackerX provides a promising at-home option for cognitive training in cognitively healthy adults and may be a promising avenue as an at-home therapeutic for TBI survivors. This abstract was previously published on clinicaltrials.gov and can be found at: https://www.clinicaltrials.gov/ct2/show/NCT05278273.

Two-dimensional and three-dimensional multiple object tracking learning performance in adolescent female soccer players: The role of flow experience reflected by heart rate variability.

Three-dimensional multiple object tracking (3D-MOT) has been used in various fields to mimic real-life tracking, especially in perceptual-cognitive skills training for soccer. Yet, the learning efficiency in 3D-MOT tasks has not been compared with 2D-MOT. Further, whether the advantage can be reflected by heart rate variability (HRV) based on the neurovisceral integration model should also be examined. Therefore, we used both 2D- and 3D-MOT in a brief adaptive task procedure for adolescent female soccer players with HRV measurement. A faster tracking speed threshold of participants was found in the 3D- compared to 2D-MOT, as well as average tracking speed in the last training period of 3D-MOT. Moreover, lower low frequency (LF) components of HRV in the 3D-MOT indicated a flow experience, demonstrating the provision of more attentional resources. Therefore, we observed that adolescent female soccer players demonstrated higher learning efficiency in 3D-MOT tasks in virtual reality (VR) through a higher flow experience. This study examined the learning efficiency between the two MOT tasks in the soccer domain using evidence from HRV and highlighted the utility and applicability of 3D-MOT application.

The neuropsychological profile of professional action video game players.

In the past 20 years, there has been growing research interest in the association between video games and cognition. Although many studies have found that video game players are better than non-players in multiple cognitive domains, other studies failed to replicate these results. Until now, the vast majority of studies defined video game players based on the number of hours an individual spent playing video games, with relatively few studies focusing on video game expertise using performance criteria. In the current study, we sought to examine whether individuals who play video games at a professional level in the esports industry differ from amateur video game players in their cognitive and learning abilities. We assessed 14 video game players who play in a competitive league (Professional) and 16 casual video game players (Amateur) on set of standard neuropsychological tests evaluating processing speed, attention, memory, executive functions, and manual dexterity. We also examined participants' ability to improve performance on a dynamic visual attention task that required tracking multiple objects in three-dimensions (3D-MOT) over five sessions. Professional players showed the largest performance advantage relative to Amateur players in a test of visual spatial memory (Spatial Span), with more modest benefits in a test of selective and sustained attention (d2 Test of Attention), and test of auditory working memory (Digit Span). Professional players also showed better speed thresholds in the 3D-MOT task overall, but the rate of improvement with training did not differ in the two groups. Future longitudinal studies of elite video game experts are required to determine whether the observed performance benefits of professional gamers may be due to their greater engagement in video game play, or due to pre-existing differences that promote achievement of high performance in action video games.

Combining 3D-MOT With Sport Decision-Making for Perceptual-Cognitive Training in Virtual Reality.

This study introduces a virtual life-sized perceptual-cognitive training paradigm that combines three-dimensional multiple object tracking (3D-MOT) with motor (Experiment 1) or perceptual (Experiment 2) sport decision-making tasks. We sought to assess the impact of training on task performance and determine optimal training conditions for improvement and learning. Fifty-seven participants were randomly assigned to one of four training conditions (isolated 3D-MOT, 3D-MOT combined with a decision-making task, consolidated 3D-MOT later combined with a decision-making task, and isolated decision-making task). We evaluated task performance using speed thresholds, success rate (%), and reaction time (s). Findings were that the dual-task paradigm was associated with performance beyond chance level on both 3D-MOT and decision-making tasks despite an important dual-task cost. Interestingly, the results seemed to favor consolidated 3D-MOT training over simultaneous 3D-MOT training when combined with a motor decision-making task but not when combined with a perceptual decision-making task. The number of shared attentional resources in the nature of the additional task (i.e., perceptual or motor decision-making) seems to be key in interpreting the dual-task interference. These findings must be considered when designing representative multitask perceptual-cognitive training.

The combined impact of a perceptual-cognitive task and neuromuscular fatigue on knee biomechanics during landing.

BACKGROUND: A large majority of anterior cruciate ligament (ACL) injuries are non-contact, most often occurring during a landing or change of direction. Recent research indicates that cognitive factors may be involved in non-contact ACL injuries. The aim of this study was to determine if a game-situation perceptual-cognitive load leads to altered landing kinematics in physically fatigued female athletes. METHODS: Nineteen female recreational athletes were recruited to perform a series of jumping and landing trials. In a first phase, eight trials were performed in an isolated condition and eight were performed while participants performed a perceptual-cognitive task. Before a second identical phase, participants underwent a muscular fatigue protocol. Knee-joint kinematics were recorded and compared between conditions using paired t-tests. RESULTS: Muscle fatigue led to statistically significant increases in peak knee abduction and peak internal knee rotation as well as a decrease in maximum knee flexion, when comparing conditions without the perceptual-cognitive task. The perceptual-cognitive task had no statistically significant effect on any knee rotations, either pre- or post-fatigue. However, a subgroup of 12 athletes showed a significant increase in knee abduction in the presence of the perceptual-cognitive task, only in the fatigued condition. CONCLUSION: A perceptual-cognitive task combined with muscle fatigue alters knee kinematics of landing for a subset of recreational athletes, potentially increasing the risk of ACL rupture. Further studies are necessary to confirm this finding and to identify characteristics of at-risk individuals to target them for injury prevention protocols.

Perceptual-cognitive three-dimensional multiple-object tracking task can help the monitoring of sport-related concussion.

OBJECTIVES: While the rate of sport-related concussion is increasing, more effective tools are needed to help monitor the diagnosis and return to play of athletes. The three-dimensional multiple-object tracking (3D-MOT) exercise is a perceptual-cognitive task that has shown predictive power towards the dynamic requirements of real-world activities such as sport. This study introduced the use of the 3D-MOT task, along with the Standardized Assessment of Concussion (SAC) and Modified Balance Error Scoring System (M-BESS) tests, for diagnosis and return to play in professional sports. METHODS: Fifty-nine professional athletes were tested with the 3D-MOT, SAC and M-BESS tests at 48 hours following the injury. The same measures were employed to evaluate the return to play following the standard concussion management protocol. The SAC and M-BESS tests were also performed in pre-season (baseline) in 32 out of the 59 athletes. RESULTS: The injured athletes exhibited poor performance on 3D-MOT at 48 hours post injury compared with return to play (p<0.001) as well as compared with healthy professionals' performance scores (p<0.001). Importantly, learning rate, which participants are thought to have an expert advantage on this perceptual-cognitive task, was totally disrupted at 48 hours post injury compared with healthy professionals (p<0.001). The 3D-MOT performance was also correlated to the total number of symptoms (p=0.020), SAC (p=0.031) and M-BESS (p=0.004) scores at 48 hours. Not surprisingly, SAC and M-BESS tests' usefulness for monitoring concussion was found to be weak, particularly when test performance following the injury was compared to baseline (p=0.056 and 0.349 for SAC and M-BESS, respectively). CONCLUSION: 3D-MOT could help monitor sport-related concussion in professional athletes. The discussion also covers the critical importance of perceptual-cognitive assessment following concussion in the athletic population.

Healthy older observers show equivalent perceptual-cognitive training benefits to young adults for multiple object tracking.

The capacity to process complex dynamic scenes is of critical importance in real life. For instance, traveling through a crowd while avoiding collisions and maintaining orientation and good motor control requires fluent and continuous perceptual-cognitive processing. It is well documented that effects of healthy aging can influence perceptual-cognitive processes (Faubert, 2002) and that the efficiency of such processes can improve with training even for older adults (Richards et al., 2006). Here we assess the capacity of older participants to improve their tracking speed thresholds in a dynamic, virtual reality environment. Results show that this capacity is significantly affected by healthy aging but that perceptual-cognitive training can significantly reduce age-related effects in older individuals, who show an identical learning function to younger healthy adults. Data support the notion that learning in healthy older persons is maintained for processing complex dynamic scenes.