Nef Tobias, Chesham Alvin, Schütz Narayan, Botros Angela Amira, Vanbellingen Tim, Burgunder Jean-Marc, Müllner Julia, Martin Müri René, Urwyler Prabitha
Gerontechnology & Rehabilitation, University of Bern, Bern, Switzerland.
ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
Front Aging Neurosci. 2020 Apr 21;12:87. doi: 10.3389/fnagi.2020.00087. eCollection 2020.
There is currently a need for engaging, user-friendly, and repeatable tasks for assessment of cognitive and motor function in aging and neurodegenerative diseases. This study evaluated the feasibility of a maze-like Numberlink puzzle game in assessing differences in game-based measures of cognition and motor function due to age and neurodegenerative diseases. Fifty-five participants, including young (18-31 years, = 18), older (64-79 years, = 14), and oldest adults (86-98 years, = 14), and patients with Parkinson's (59-76 years, = 4) and Huntington's disease (HD; 35-66 years, = 5) played different difficulty levels of the Numberlink puzzle game and completed usability questionnaires and tests for psychomotor, attentional, visuospatial, and constructional and executive function. Analyses of Numberlink game-based cognitive (solving time and errors) and motor [mean velocity and movement direction changes (MDC)] performance metrics revealed statistically significant differences between age groups and between patients with HD and older adults. However, patients with Parkinson's disease (PD) did not differ from older adults. Correlational analyses showed significant associations between game-based performance and movement metrics and performance on neuropsychological tests for psychomotor, attentional, visuospatial, and constructional and executive function. Furthermore, varying characteristics of the Numberlink puzzle game succeeded in creating graded difficulty levels. Findings from this study support recent suggestions that data from a maze-like puzzle game provide potential "digital biomarkers" to assess changes in psychomotor, visuoconstructional, and executive function related to aging and neurodegeneration. In particular, game-based movement measures from the maze-like puzzle Numberlink games are promising as a tool to monitor the progression of motor impairment in neurodegenerative diseases. Further studies are needed to more comprehensively establish the cognitive validity and test-retest reliability of using Numberlink puzzles as a valid cognitive assessment tool.
目前，在评估衰老和神经退行性疾病中的认知和运动功能时，需要引人入胜、用户友好且可重复的任务。本研究评估了一种类似迷宫的数字连接谜题游戏在评估因年龄和神经退行性疾病导致的基于游戏的认知和运动功能差异方面的可行性。55名参与者，包括年轻人（18 - 31岁，n = 18）、老年人（64 - 79岁，n = 14）、高龄老年人（86 - 98岁，n = 14）、帕金森病患者（59 - 76岁，n = 4）和亨廷顿舞蹈病（HD；35 - 66岁，n = 5），玩了不同难度级别的数字连接谜题游戏，并完成了可用性问卷以及心理运动、注意力、视觉空间、结构和执行功能测试。对基于数字连接游戏的认知（解决时间和错误）和运动[平均速度和运动方向变化（MDC）]性能指标的分析显示，年龄组之间以及HD患者与老年人之间存在统计学上的显著差异。然而，帕金森病（PD）患者与老年人没有差异。相关性分析表明，基于游戏的性能与运动指标以及心理运动、注意力、视觉空间、结构和执行功能的神经心理学测试性能之间存在显著关联。此外，数字连接谜题游戏的不同特征成功创建了分级难度级别。本研究结果支持了最近的建议，即类似迷宫的谜题游戏数据提供了潜在的“数字生物标志物”，以评估与衰老和神经退行性变相关的心理运动、视觉结构和执行功能的变化。特别是，类似迷宫的数字连接谜题游戏中基于游戏的运动测量有望作为监测神经退行性疾病中运动障碍进展的工具。需要进一步研究以更全面地确定将数字连接谜题用作有效认知评估工具的认知效度和重测信度。
