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The Role of Virtual Reality in Neuropsychology: The Virtual Multiple Errands Test for the Assessment of Executive Functions in Parkinson’s Disease

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Abstract

In recent years, Virtual Reality technologies have emerged as assessment and treatment tools in neuropsychology. In this chapter, we will explore the possibility of using Virtual Reality to improve the traditional neuropsychological assessment of executive functions. First, we will discuss the advantages offered by Virtual Reality to more traditional approaches. Then, the chapter details the characteristics of the Virtual Multiple Errands Test (VMET), a virtual reality tool developed using NeuroVR (http://www.neurovr.org)—a free virtual reality platform useful for the assessment and neurorehabilitation. Specifically, the VMET is an assessment protocol of executive functions, where participants are invited to navigate a virtual supermarket, completing tasks that require certain rules. In the chapter, we will present the detailed description of its clinical rationale and its different phases. Furthermore, a systematic analysis of the results obtained in different studies using the VMET will be outlined. Finally, we will discuss the potentiality of the VMET for integrating the traditional neuropsychological evaluation of patients with Parkinson’s disease. Detection of early executive deficits in Parkinson’s disease could facilitate the identification of patients at risk to develop dementia, and could give the chance to develop early neurorehabilitation interventions.

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Abbreviations

VR:

Virtual reality

VE:

Virtual environment

MET:

Multiple errands test

VMET:

Virtual multiple errands test

3D:

Three-dimensional

PD:

Parkinson’s disease

OCD:

Obsessive-compulsive disorder

References

  1. Aarsland, D., Andersen, K., Larsen, J.P., Lolk, A., Kragh-Sorensen, P.: Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study. Arch. Neurol. 60(3), 387–392 (2003). doi:10.1001/archneur.60.3.387

    Article  Google Scholar 

  2. Aarsland, D., Larsen, J.P., Karlsen, K., Lim, N.G., Tandberg, E.: Mental symptoms in Parkinson’s disease are important contributors to caregiver distress. Int. J. Geriatr. Psychiatry 14(10), 866–874 (1999). doi:10.1002/(Sici)1099-1166(199910)14:10<866:Aid-Gps38>3.0.Co;2-Z

    Article  Google Scholar 

  3. Aarsland, D., Larsen, J.P., Tandberg, E., Laake, K.: Predictors of nursing home placement in Parkinson’s disease: a population-based, prospective study. J. Am. Geriatr. Soc. 48(8), 938–942 (2000)

    Google Scholar 

  4. Albani, G., Raspelli, S., Carelli, L., Priano, L., Pignatti, R., Morganti, F., Riva, G.: Sleep dysfunctions influence decision making in undemented Parkinson’s disease patients: a study in a virtual supermarket. Stud. Health. Technol. Inform. 163, 8–10 (2011)

    Google Scholar 

  5. Alderman, N., Burgess, P.W., Knight, C., Henman, C.: Ecological validity of a simplified version of the multiple errands shopping test. J. Int. Neuropsychol. Soc. 9(1), 31–44 (2003). doi:10.1017/S1355617703910046

    Article  Google Scholar 

  6. Azuma, T., Cruz, R.F., Bayles, K.A., Tomoeda, C.K., Montgomery, E.B.: A longitudinal study of neuropsychological change in individuals with Parkinson’s disease. Int. J. Geriatr. Psychiatry 18(11), 1043–1049 (2003). doi:10.1002/Gps.1015

    Article  Google Scholar 

  7. Bechara, A., Damasio, A.R., Damasio, H., Anderson, S.W.: Insensitivity to future consequences following damage to human prefrontal cortex. Cognition 50(1–3), 7–15 (1994). doi:10.1016/0010-0277(94)90018-3

    Article  Google Scholar 

  8. Bohil, C.J., Alicea, B., Biocca, F.A.: Virtual reality in neuroscience research and therapy. Nat. Rev. Neurosci. 12(12), 752–762 (2011). doi:10.1038/Nrn3122

    Google Scholar 

  9. Bosboom, J.L.W., Stoffers, D., Wolters, E.C.: Cognitive dysfunction and dementia in Parkinson’s disease. J. Neural Transm. 111(10–11), 1303–1315 (2004). doi:10.1007/s00702-004-0168-1

    Article  Google Scholar 

  10. Brooke, J.: SUS: A “quick and dirty” usability scale. In: Jordan, P.W., Thomas, B., Weerdmeester, B.A., McClelland, I.L. (eds.) Usability Evaluation in Industry, pp. 189–194. Taylor & Francis, London (1996)

    Google Scholar 

  11. Brooks, B.M., Rose, F.D.: The use of virtual reality in memory rehabilitation: current findings and future directions. Neurorehabilitation 18(2), 147–157 (2003)

    Google Scholar 

  12. Burgess, P.W., Alderman, N., Forbes, C., Costello, A., Coates, L.M.A., Dawson, D.R., Channon, S.: The case for the development and use of “ecologically valid” measures of executive function in experimental and clinical neuropsychology. J. Int. Neuropsychol. Soc. 12(2), 194–209 (2006). doi:10.1017/S135561770606310

    Article  Google Scholar 

  13. Burgess, P.W., Shallice, T.: Bizarre responses, rule detection and frontal lobe lesions. Cortex 32(2), 241–259 (1996)

    Article  Google Scholar 

  14. Burgess, P.W., Shallice, T.: Response suppression, initiation and strategy use following frontal lobe lesions. Neuropsychologia 34(4), 263–272 (1996). doi:10.1016/0028-3932(95)00104-2

    Article  Google Scholar 

  15. Burgess, P.W., Veitch, E., Costello, A.D., Shallice, T.: The cognitive and neuroanatomical correlates of multitasking. Neuropsychologia 38(6), 848–863 (2000). doi:10.1016/S0028-3932(99)00134-7

    Article  Google Scholar 

  16. Ceravolo, R., Pagni, C., Tognoni, G., Bonuccelli, U.: The epidemiology and clinical manifestations of dysexecutive syndrome in Parkinson’s disease. Front. Neurol. 3, 159 (2012). doi:10.3389/fneur.2012.00159

    Article  Google Scholar 

  17. Chan, R.C., Shum, D., Toulopoulou, T., Chen, E.Y.: Assessment of executive functions: review of instruments and identification of critical issues. Arch. Clin. Neuropsychol. 23(2), 201–216 (2008). doi:10.1016/j.acn.2007.08.010

    Article  Google Scholar 

  18. Chaytor, N., Schmitter-Edgecombe, M.: The ecological validity of neuropsychological tests: a review of the literature on everyday cognitive skills. Neuropsychol. Rev. 13(4), 181–197 (2003)

    Article  Google Scholar 

  19. Chen, E.Y., Shapleske, J., Luque, R., McKenna, P.J., Hodges, J.R., Calloway, S.P., Berrios, G.E.: The Cambridge neurological inventory: a clinical instrument for assessment of soft neurological signs in psychiatric patients. Psychiatry Res. 56(2), 183–204 (1995)

    Article  Google Scholar 

  20. Cipresso, P., Paglia, F.L., Cascia, C.L., Riva, G., Albani, G., La Barbera, D.: Break in volition: a virtual reality study in patients with obsessive-compulsive disorder. Exp. Brain Res. (2013). doi:10.1007/s00221-013-3471-y

    Google Scholar 

  21. Cipresso, P., Serino, S., Pedroli, E., Albani, G., Riva, G.: Psychometric reliability of the NeuroVR-based virtual version of the multiple errands test. Paper presented at the 7th international conference on pervasive computing technologies for healthcare, Venice (2013)

    Google Scholar 

  22. Dubois, B., Burn, D., Goetz, C., Aarsland, D., Brown, R.G., Broe, G.A., Emre, M.: Diagnostic procedures for Parkinson’s disease dementia: recommendations from the movement disorder society task force. Mov. Disord. 22(16), 2314–2324 (2007). doi:10.1002/Mds.21844

    Article  Google Scholar 

  23. Foltynie, T., Brayne, C.E., Robbins, T.W., Barker, R.A.: The cognitive ability of an incident cohort of Parkinson’s patients in the UK. The CamPaIGN study. Brain 127(Pt 3), 550–560 (2004). doi:10.1093/brain/awh067

    Google Scholar 

  24. Goel, V., Grafman, J., Tajik, J., Gana, S., Danto, D.: A study of the performance of patients with frontal lobe lesions in a financial planning task. Brain 120, 1805–1822 (1997). doi:10.1093/brain/120.10.1805

    Article  Google Scholar 

  25. Goldstein, G.: Functional considerations in neuropsychology. In: Sbordone, R.J., Long, C.J. (eds.) Ecological validity of neuropsychological testing, pp. 75–89. GR Press/St. Lucie Press, Delray Beach, FL (1996)

    Google Scholar 

  26. Grafman, J., Litvan, I.: Importance of deficits in executive functions. Lancet 354(9194), 1921–1923 (1999). doi:10.1016/S0140-6736(99)90438-5

    Article  Google Scholar 

  27. Hely, M.A., Reid, W.G.J., Adena, M.A., Halliday, G.A., Morris, J.G.L.: The Sydney multicenter study of Parkinson’s disease: the inevitability of dementia at 20 years. Mov. Disord. 23(6), 837–844 (2008). doi:10.1002/Mds.21956

    Article  Google Scholar 

  28. Humes, G.E., Welsh, M.C., Retzlaff, P., Cookson, N.: Towers of Hanoi and London: reliability and validity of two executive function tasks. Assessment 4(3), 249–257 (1997)

    Google Scholar 

  29. Janvin, C.C., Aarsland, D., Larsen, J.P.: Cognitive predictors of dementia in Parkinson’s disease: a community-based, 4-year longitudinal study. J. Geriatr. Psychiatry Neurol. 18(3), 149–154 (2005). doi:10.1177/0891988705277540

    Article  Google Scholar 

  30. Janvin, C.C., Larsen, J.P., Aarsland, D., Hugdahl, K.: Subtypes of mild cognitive impairment in Parkinson’s disease: progression to dementia. Mov. Disord. 21(9), 1343–1349 (2006). doi:10.1002/Mds.20974

    Article  Google Scholar 

  31. Jones-Gotman, M., Milner, B.: Design fluency: the invention of nonsense drawings after focal cortical lesions. Neuropsychologia 15(4–5), 653–674 (1977)

    Article  Google Scholar 

  32. Kehagia, A.A., Barker, R.A., Robbins, T.W.: Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson’s disease. Lancet Neurol. 9(12), 1200–1213 (2010). doi:10.1016/S1474-4422(10)70212-X

    Article  Google Scholar 

  33. Knight, C., Alderman, N., Burgess, P.W.: Development of a simplified version of the multiple errands test for use in hospital settings. Neuropsychol. Rehabil. 12(3), 231–255 (2002). doi:10.1080/09602010244000039

    Article  Google Scholar 

  34. Lange, B., Chang, C.Y., Suma, E., Newman, B., Rizzo, A.S., Bolas, M.: Development and evaluation of low cost game-based balance rehabilitation tool using the Microsoft Kinect sensor. In: Conference proceedings of IEEE engineering medical biology society, Aug 30–Sep 3, pp. 1831–1834 (2011)

    Google Scholar 

  35. La Paglia, F., La Cascia, C., Rizzo, R., Riva, G., La Barbera, D.: Assessment of executive functions in patients with obsessive compulsive disorder by NeuroVR. Stud. Health Technol. Inform. 181, 98–102 (2012)

    Google Scholar 

  36. Levy, G., Jacobs, D.M., Tang, M.X., Cote, L.J., Louis, E.D., Alfaro, B., Marder, K.: Memory and executive function impairment predict dementia in Parkinson’s disease. Mov. Disord. 17(6), 1221–1226 (2002). doi:10.1002/mds.10280

    Article  Google Scholar 

  37. Litvan, I., Aarsland, D., Adler, C.H., Goldman, J.G., Kulisevsky, J., Mollenhauer, B., Weintraub, D.: MDS task force on mild cognitive impairment in Parkinson’s Disease: critical review of PD-MCI. Mov. Disord. 26(10), 1814–1824 (2011). doi:10.1002/Mds.23823

    Article  Google Scholar 

  38. Litvan, I., Goldman, J.G., Troster, A.I., Schmand, B.A., Weintraub, D., Petersen, R.C., Emre, M.: Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement disorder society task force guidelines. Mov. Disord. 27(3), 349–356 (2012). doi:10.1002/Mds.24893

    Article  Google Scholar 

  39. McKinlay, A., Grace, R.C., Dalrymple-Alford, J.C., Roger, D.: Characteristics of executive function impairment in Parkinson’s disease patients without dementia. J. Int. Neuropsychol. Soc. 16(2), 268–277 (2010). doi:10.1017/S1355617709991299

    Article  Google Scholar 

  40. Muslimovic, D., Post, B., Speelman, J.D., Schmand, B.: Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 65(8), 1239–1245 (2005). doi:10.1212/01.wnl.0000180516.69442.95

    Article  Google Scholar 

  41. Parkinson, J.: An essay on the Shaking Palsy. Whittingham and Rowland, London (1817)

    Google Scholar 

  42. Pedroli, E., Cipresso, P., Serino, S., Albani G., Riva, G.: A virtual reality test for the assessment of cognitive deficits: usability and perspectives. Paper presented at the 7th international conference on pervasive computing technologies for healthcare, Venice (2013)

    Google Scholar 

  43. Rand, D., Katz, N., Kizony, R., Shahar, M., Weiss, P.L.: The virtual mall: a functional virtual environment for stroke rehabilitation. Cyberpsychology Behav. 8(4), 369–370 (2005)

    Google Scholar 

  44. Rand, D., Katz, N., Weiss, P.L.: Evaluation of virtual shopping in the VMall: comparison of post-stroke participants to healthy control groups. Disabil. Rehabil. 29(22), 1710–1719 (2007). doi:10.1080/09638280601107450

    Article  Google Scholar 

  45. Rand, D., Rukan, S.B.A., Weiss, P.L., Katz, N.: Validation of the Virtual MET as an assessment tool for executive functions. Neuropsychol. Rehabil. 19(4), 583–602 (2009). doi:10.1080/09602010802469074

    Article  Google Scholar 

  46. Raspelli, S., Pallavicini, F., Carelli, L., Morganti, F., Poletti, B., Corra, B., Riva, G.: Validation of a neuro virtual reality-based version of the multiple errands test for the assessment of executive functions. Stud. Health Technol. Inform. 167, 92–97 (2011)

    Google Scholar 

  47. Riva, G.: Applications of virtual environments in medicine. Methods Inf. Med. 42(5), 524–534 (2003)

    Google Scholar 

  48. Riva, G.: Virtual reality: an experiential tool for clinical psychology. British J. Guidance Counselling 37(3), 337–345 (2009). doi:10.1080/03069880902957056

    Article  Google Scholar 

  49. Riva, G., Castelnuovo, G., Mantovani, F.: Transformation of flow in rehabilitation: the role of advanced communication technologies. Behav. Res. Methods 38(2), 237–244 (2006)

    Article  Google Scholar 

  50. Riva, G., Gaggioli, A.: Rehabilitation as empowerment: the role of advanced technologies. In: Gaggioli, A., Keshner, E.A., Weiss, P.L., Riva, G. (eds.) Technologies in Rehabilitation: Empowering Cognitive, Physical, Social and Communicative Skills through Virtual Reality, Robots, Wearable Systems and Brain-Computer Interfaces Advanced, vol. 145, pp. 3–22. IOS Press, Amsterdam (2009)

    Google Scholar 

  51. Riva, G., Gaggioli, A.: Rehabilitation as empowerment: the role of advanced technologies. In: Advanced Technologies in Rehabilitation: Empowering Cognitive, Physical, Social and Communicative Skills through Virtual Reality, Robots, Wearable Systems and Brain-Computer Interfaces, vol. 145, pp. 3–22 (2009b). doi: 10.3233/978-1-60750-018-6-3

  52. Riva, G., Gaggioli, A., Grassi, A., Raspelli, S., Cipresso, P., Pallavicini, F., Donvito, G.: NeuroVR 2–a free virtual reality platform for the assessment and treatment in behavioral health care. Stud. Health Technol. Inform. 163, 493–495 (2011)

    Google Scholar 

  53. Riva, G., Mantovani, F., Gaggioli, A.: Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology. J. Neuroeng. Rehabil. 1(1), 9 (2004). doi:10.1186/1743-0003-1-9

    Article  Google Scholar 

  54. Riva, G., Vigna, C., Grassi, A., Raspelli, S., Cipresso, P., Pallavicini, F., Serino, S., Gaggioli, A.: Learning Island: the development of a virtual reality system for the experiential training of stress management. Stud. Health Technol. Inform. 173, 369–371 (2012)

    Google Scholar 

  55. Robertson, I.H., Manly, T., Andrade, J., Baddeley, B.T., Yiend, J.: ‘Oops!’: performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia 35(6), 747–758 (1997). doi:10.1016/S0028-3932(97)00015-8

    Article  Google Scholar 

  56. Rogers, R.D., Sahakian, B.J., Hodges, J.R., Polkey, C.E., Kennard, C., Robbins, T.W.: Dissociating executive mechanisms of task control following frontal lobe damage and Parkinson’s disease. Brain 121, 815–842 (1998). doi:10.1093/brain/121.5.815

    Article  Google Scholar 

  57. Rose, F.D., Brooks, B.M., Rizzo, A.A.: Virtual reality in brain damage rehabilitation: review. Cyberpsychology Behav. 8(3), 241–262 (2005). doi:10.1089/cpb.2005.8.241

    Article  Google Scholar 

  58. Rowe, J., Stephan, K.E., Friston, K., Frackowiak, R., Lees, A., Passingham, R.: Attention to action in Parkinson’s disease—impaired effective connectivity among frontal cortical regions. Brain 125, 276–289 (2002). doi:10.1093/Brain/Awf036

    Article  Google Scholar 

  59. Schrag, A., Jahanshahi, M., Quinn, N.: What contributes to quality of life in patients with Parkinson’s disease? J. Neurol. Neurosurg. Psychiatry 69(3), 308–312 (2000). doi:10.1136/jnnp.69.3.308

    Article  Google Scholar 

  60. Schultheis, M.T., Rizzo, A.A.: The application of virtual reality technology in rehabilitation. Rehabil. Psychol. 46(3), 296–311 (2001). doi:10.1037/0090-5550.46.3.296

    Article  Google Scholar 

  61. Shallice, T.: Specific impairments of planning. Philos. Trans. R. Soc. Lond. B Biol. Sci. 298(1089), 199–209 (1982). doi:10.1098/rstb.1982.0082

    Article  Google Scholar 

  62. Shallice, T.: From Neuropsychology to Mental Structure. Cambridge University Press, Cambridge (1988)

    Book  Google Scholar 

  63. Shallice, T., Burgess, P.W.: Deficits in strategy application following frontal-lobe damage in man. Brain 114, 727–741 (1991). doi:10.1093/brain/114.2.727

    Article  Google Scholar 

  64. Stuss, D.T., Benson, D.F.: The frontal lobes. Raven Press, New York (1986)

    Google Scholar 

  65. Stuss, D.T., Shallice, T., Alexander, M.P., Picton, T.W.: A multidisciplinary approach to anterior attentional functions. Ann. N. Y. Acad. Sci. 769, 191–211 (1995)

    Article  Google Scholar 

  66. Troster, A.I.: Neuropsychological characteristics of dementia with Lewy bodies and Parkinson’s disease with dementia: differentiation, early detection, and implications for “mild cognitive impairment” and biomarkers. Neuropsychol. Rev. 18(1), 103–119 (2008). doi:10.1007/s11065-008-9055-0

    Article  MathSciNet  Google Scholar 

  67. Verleden, S., Vingerhoets, G., Santens, P.: Heterogeneity of cognitive dysfunction in Parkinson’s disease: a cohort study. Eur. Neurol. 58(1), 34–40 (2007). doi:10.1159/000102164

    Article  Google Scholar 

  68. Vingerhoets, G., Verleden, S., Santens, P., Miatton, M., De Reuck, J.: Predictors of cognitive impairment in advanced Parkinson’s disease. J. Neurol. Neurosurg. Psychiatry 74(6), 793–796 (2003)

    Article  Google Scholar 

  69. Williams-Gray, C.H., Evans, J.R., Goris, A., Foltynie, T., Ban, M., Robbins, T.W., Barker, R.A.: The distinct cognitive syndromes of Parkinson’s disease: 5 year follow-up of the CamPaIGN cohort. (Research Support, Non-U.S. Gov’t). Brain 132(Pt 11), 2958–2969 (2009). doi: 10.1093/brain/awp245

  70. Wilson, B.A., Alderman, N., Burgess, P.W., Emslie, H., Evans, J.J.: Behavioural assessment of the dysexecutive syndrome (1996)

    Google Scholar 

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Acknowledgments

This work was supported by the Italian funded project “VRehab. Virtual Reality in the Assessment and TeleRehabilitation of Parkinson’s Disease and Post-Stroke Disabilities” - RF-2009-1472190.

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Correspondence to Silvia Serino .

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Serino, S. et al. (2014). The Role of Virtual Reality in Neuropsychology: The Virtual Multiple Errands Test for the Assessment of Executive Functions in Parkinson’s Disease. In: Ma, M., Jain, L., Anderson, P. (eds) Virtual, Augmented Reality and Serious Games for Healthcare 1. Intelligent Systems Reference Library, vol 68. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54816-1_14

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