Park Jin-Hyuck
Department of Occupational Therapy, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea.
J Neuroeng Rehabil. 2025 Aug 9;22(1):176. doi: 10.1186/s12984-025-01714-9.
Executive dysfunction is commonly impaired in individuals with mild cognitive impairment (MCI). Traditional tools like the Stroop test are widely used to evaluate this domain but lack ecological validity. Virtual reality (VR)-based cognitive assessments, grounded in embodied cognition, may offer a more immersive and sensitive approach to detecting subtle executive dysfunction.
This study developed and validated a novel VR-based Stroop Test (VRST) that simulates a real-life clothing-sorting task involving incongruent word-color stimuli. A total of 413 older adults (224 healthy controls and 189 with MCI) completed the VRST using a hand-held controller. Behavioral metrics including task completion time, 3D(three-dimensional) trajectory length, and hesitation latency were collected. Participants also underwent traditional assessments: the Korean version of the Montreal Cognitive Assessment (MoCA-K), the paper-based Stroop test, and the Corsi Block Test (CBT). Receiver operating characteristic curves and Spearman correlations were used to analyze discriminant power and construct validity.
All VR-derived behavioral markers effectively differentiated older adults with MCI from HCs, with 3D trajectory length showing the highest area under the curve (0.981), followed by hesitation latency (0.967). These surpassed the MoCA-K (0.962). Significant correlations were observed between VRST outcomes and global cognition (MoCA-K), inhibition (Stroop), and working memory (CBT), supporting convergent validity. Importantly, baseline motor abilities did not significantly differ between groups, suggesting that executive function could contributed to performance differences.
The VRST provides a valid, reliable, and scalable means of detecting MCI-related executive dysfunction through embodied cognitive-motor interaction. Its ability to capture subtle behavioral changes in a realistic context suggests strong potential for use in both clinical and community-based cognitive screening settings.
This study was retrospectively registered in the Thai Clinical Trial Registration with identifier TCTR 20250625011.
在轻度认知障碍（MCI）患者中，执行功能障碍较为常见。像斯特鲁普测试这样的传统工具被广泛用于评估这一领域，但缺乏生态效度。基于虚拟现实（VR）的认知评估，以具身认知为基础，可能为检测细微的执行功能障碍提供一种更具沉浸感和敏感性的方法。
本研究开发并验证了一种基于VR的新型斯特鲁普测试（VRST），该测试模拟了一项涉及不一致文字 - 颜色刺激的现实生活衣物分类任务。共有413名老年人（224名健康对照者和189名MCI患者）使用手持控制器完成了VRST。收集了包括任务完成时间、三维轨迹长度和犹豫潜伏期在内的行为指标。参与者还接受了传统评估：韩国版蒙特利尔认知评估（MoCA - K）、纸质斯特鲁普测试和科西方块测试（CBT）。使用受试者工作特征曲线和斯皮尔曼相关性分析判别能力和结构效度。
所有源自VR的行为指标都能有效区分MCI老年人与健康对照者，三维轨迹长度的曲线下面积最高（0.981），其次是犹豫潜伏期（0.967）。这些指标超过了MoCA - K（0.962）。在VRST结果与整体认知（MoCA - K）、抑制功能（斯特鲁普测试）和工作记忆（CBT）之间观察到显著相关性，支持了聚合效度。重要的是，两组之间的基线运动能力没有显著差异，这表明执行功能可能导致了表现差异。
VRST通过具身认知 - 运动交互提供了一种有效、可靠且可扩展的检测与MCI相关的执行功能障碍的方法。它在现实情境中捕捉细微行为变化的能力表明其在临床和社区认知筛查环境中具有强大的应用潜力。
本研究在泰国临床试验注册中心进行了回顾性注册，标识符为TCTR 20250625011。
