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基于沉浸式虚拟现实的平台用于情绪或精神障碍患者现实生活场景认知训练的可行性及效果:一项随机对照概念验证研究。

Feasibility and effect of an immersive virtual reality-based platform for cognitive training in real-life scenarios in patients with mood - or psychotic disorders: A randomized, controlled proof-of-concept study.

作者信息

Jespersen Andreas E, Røen Isabella S, Lumbye Anders, Nordentoft Merete, Glenthøj Louise B, Miskowiak Kamilla W

机构信息

Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet Blegdamsvej 9, DK-2100, Copenhagen, Denmark.

Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353, Copenhagen, Denmark.

出版信息

Neurosci Appl. 2023 Feb 4;2:101120. doi: 10.1016/j.nsa.2023.101120. eCollection 2023.

Abstract

OBJECTIVES

Cognitive impairment is common across mood disorders (MD) and psychosis-spectrum disorders (PSD) but there is a lack of real-life pro-cognitive training programmes. Fully immersive virtual reality (VR) has the potential to ensure motivating, engaging cognition training directly relevant to patients' daily lives. This randomized, controlled proof-of-concept study investigated the feasibility and cognitive benefits of short-term VR-assisted training.

METHODS

Forty patients with MD or PSD were randomized to one week of VR-assisted training (n ​= ​20) or treatment as usual (TAU; n ​= ​20). They were assessed at baseline and after one week with a VR cognition test, neuropsychological tests, and questionnaires regarding user experience. Patients in the training group underwent two VR training sessions in a kitchen environment that involved solving tasks related to planning and cooking a meal using various cognitive strategies. They also completed two home assignments during which they applied the acquired strategies.

RESULTS

The completion rate was 100%. Patients reported high enjoyment and moderate-to-high presence in the VR environment and minimal motion sickness. VR training improved the global VR-based cognitive composite score with a large effect size compared with TAU ((1, 38) ​= ​11,29,  ​= ​.002,  ​= ​0.23). Posthoc assessments of VR subtests showed that this improvement was driven primarily by a large effect on psychomotor speed ((1, 38) ​= ​22.78,  ​< ​.001,  ​= ​0.39), but no effects were observed on other VR subtests or on traditional neuropsychological tests.

CONCLUSION

VR-assisted cognition training showed high feasibility and improved aspects of cognition after only one week. We therefore plan a larger trial to investigate the cognitive benefits of four-weeks VR-assisted cognition training.

摘要

目的

认知障碍在情绪障碍(MD)和精神病性谱系障碍(PSD)中很常见,但缺乏现实生活中的促认知训练项目。完全沉浸式虚拟现实(VR)有潜力确保提供与患者日常生活直接相关的、激励性且引人入胜的认知训练。这项随机对照概念验证研究调查了短期VR辅助训练的可行性和认知益处。

方法

40名患有MD或PSD的患者被随机分为接受为期一周的VR辅助训练组(n = 20)或常规治疗组(TAU;n = 20)。在基线和一周后,使用VR认知测试、神经心理学测试和关于用户体验的问卷对他们进行评估。训练组的患者在厨房环境中进行了两次VR训练课程,其中涉及使用各种认知策略解决与计划和烹饪一顿饭相关的任务。他们还完成了两项家庭作业,在此期间应用所学策略。

结果

完成率为100%。患者报告在VR环境中高度愉悦且存在感为中度至高度,晕动病症状轻微。与TAU相比,VR训练使基于VR的整体认知综合得分得到改善,效应量较大((1, 38) = 11.29,p = .002,d = 0.23)。VR子测试的事后评估表明,这种改善主要是由对心理运动速度的较大影响驱动的((1, 38) = 22.78,p < .001,d = 0.39),但在其他VR子测试或传统神经心理学测试中未观察到影响。

结论

VR辅助认知训练显示出高可行性,并且仅在一周后就改善了认知方面。因此,我们计划进行一项更大规模的试验,以研究为期四周的VR辅助认知训练的认知益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd72/12244015/c4686d0b6033/gr1.jpg

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