Kim Ko Woon, Choi Jong Doo, Chin Juhee, Lee Byung Hwa, Choi Jee Hyun, Na Duk L
Department of Neurology, Jeonbuk National University Medical School and Hospital, Jeonju, Republic of Korea.
Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea.
Front Aging Neurosci. 2023 Nov 23;15:1236084. doi: 10.3389/fnagi.2023.1236084. eCollection 2023.
Visuospatial memory impairment is a common symptom of Alzheimer's disease; however, conventional visuospatial memory tests are insufficient to fully reflect visuospatial memory impairment in daily life.
To address patients' difficulties in locating and recalling misplaced objects, we introduced a novel visuospatial memory test, the Hidden Objects Test (HOT), conducted in a virtual environment. We categorized HOT scores into prospective memory, item free-recall, place free-recall, item recognition, and place-item matching scores. To validate the VR memory test, we compared HOT scores among individuals with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), and normal controls (NC), and also compared these scores with those of conventional neuropsychological tests. We tracked the participants' movement paths in the virtual environment and assessed basic features, such as total distance, duration, and speed. Additionally, we performed walking trajectory pattern mining such as outlier and stay-point detection.
We designed and implemented the HOT to simulate a house's living room and assess participants' ability to locate hidden objects. Our preliminary results showed that the total HOT score differed among 17 patients with AD, 14 with aMCI, and 15 NC ( < 0.001). The total HOT score correlated positively with conventional memory test scores ( < 0.001). Walking trajectories showed that patients with AD and aMCI wandered rather than going straight to the hidden objects. In terms of basic features, the total duration was significantly greater in AD than in NC ( = 0.008). In terms of trajectory pattern mining, the number of outliers, which were over 95% of the estimated trajectory, was significantly higher in AD than in NC ( = 0.002). The number of stay points, an index in which participants stayed in the same position for more than 2 s, was significantly higher in patients with AD and aMCI compared with NC (AD vs. NC: = 0.003, aMCI vs. NC: = 0.019).
The HOT simulating real life showed potential as an ecologically valid test for assessing visuospatial memory function in daily life. Walking trajectory analysis suggested that patients with AD and aMCI wandered rather than going straight toward the hidden objects.
视觉空间记忆障碍是阿尔茨海默病的常见症状；然而，传统的视觉空间记忆测试不足以充分反映日常生活中的视觉空间记忆障碍。
为了解决患者定位和回忆放错位置物品的困难，我们引入了一种新的视觉空间记忆测试，即隐藏物体测试（HOT），该测试在虚拟环境中进行。我们将HOT分数分为前瞻性记忆、物品自由回忆、位置自由回忆、物品识别和位置-物品匹配分数。为了验证虚拟现实记忆测试，我们比较了阿尔茨海默病（AD）患者、遗忘型轻度认知障碍（aMCI）患者和正常对照组（NC）的HOT分数，并将这些分数与传统神经心理学测试的分数进行比较。我们跟踪了参与者在虚拟环境中的移动路径，并评估了诸如总距离、持续时间和速度等基本特征。此外，我们还进行了行走轨迹模式挖掘，如异常值和停留点检测。
我们设计并实施了HOT，以模拟房屋的客厅并评估参与者定位隐藏物体的能力。我们的初步结果表明，17例AD患者、14例aMCI患者和15例NC患者的HOT总分存在差异（<0.001）。HOT总分与传统记忆测试分数呈正相关（<0.001）。行走轨迹显示，AD患者和aMCI患者四处徘徊，而不是直接走向隐藏物体。在基本特征方面，AD患者的总持续时间显著长于NC患者（=0.008）。在轨迹模式挖掘方面，异常值数量（超过估计轨迹的95%）在AD患者中显著高于NC患者（=0.002）。停留点数量是参与者在同一位置停留超过2秒的一个指标，AD患者和aMCI患者的停留点数量显著高于NC患者（AD与NC比较：=0.003，aMCI与NC比较：=0.019）。
模拟现实生活的HOT作为一种生态有效测试，在评估日常生活中的视觉空间记忆功能方面显示出潜力。行走轨迹分析表明，AD患者和aMCI患者四处徘徊，而不是直接走向隐藏物体。
