IEEE J Biomed Health Inform. 2019 May;23(3):1269-1277. doi: 10.1109/JBHI.2019.2893897. Epub 2019 Jan 18.
Individuals with cognitive impairments are evaluated using clinically validated cognitive assessment tools, which need to be administered by trained therapists. This serves as a major barrier for frequent and longitudinal monitoring of patients' cognitive impairment level. We introduce Neuro-World, a set of six mobile games designed to challenge visuospatial short-term memory and selective attention, which allows one to self-administer the assessment of his/her cognitive impairment level. Game performance is analyzed to estimate a widely accepted clinical measure, the mini mental state examination (MMSE), which highlights the translational impact of the system in real-world settings. We collected game-specific performance data from 12 post-stroke patients at baseline and a three-month follow-up, which were used to train supervised machine learning models to estimate the corresponding MMSE scores. The results presented herein show that the proposed approach can estimate the MMSE scores with a normalized root mean square error of 5.75%. We also validate the system's responsiveness to longitudinal changes in cognitive impairment level and demonstrate the system's positive usability in cognitively impaired individuals and their willingness to adhere to the longitudinal use. This study demonstrates that Neuro-world has great potential to be used to evaluate the cognitive impairment level and monitor its long-term change. This study enables new clinical and research opportunities for accurate, longitudinal assessment of cognitive function via mobile games.
个体的认知能力损伤可以通过临床验证的认知评估工具来评估，而这些工具需要由经过训练的治疗师来操作。这对于频繁且纵向监测患者的认知损伤水平来说是一个主要障碍。我们引入了 Neuro-World，这是一组旨在挑战视空间短期记忆和选择性注意的六个移动游戏，允许个人自行评估其认知损伤水平。我们分析游戏表现来估算一个广泛接受的临床指标，即简易精神状态检查（MMSE），这突出了该系统在现实环境中的转化影响。我们在基线和三个月的随访中从 12 名中风后患者收集了特定于游戏的表现数据，并使用监督机器学习模型来训练以估算相应的 MMSE 分数。本文呈现的结果表明，所提出的方法可以用归一化均方根误差 5.75%来估算 MMSE 分数。我们还验证了该系统对认知损伤水平的纵向变化的响应能力，并证明了该系统在认知受损个体中的积极可用性及其对纵向使用的依从性。本研究表明，Neuro-World 具有很大的潜力可用于评估认知损伤水平并监测其长期变化。本研究通过移动游戏为准确、纵向的认知功能评估开辟了新的临床和研究机会。
