The Growing Use of Virtual Reality in Cognitive Rehabilitation: Fact, Fake or Vision? A Scoping Review

Maggio, Maria Grazia; Maresca, Giuseppa; Luca, Rosaria De; Stagnitti, Maria Chiara; Porcari, Bruno; Ferrera, Maria Cristina; Galletti, Francesco; Casella, Carmela; Manuli, Alfredo; Calabrò, Rocco Salvatore

doi:10.1016/j.jnma.2019.01.003

Cited by 112 publications

(68 citation statements)

References 40 publications

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“…Even though our results suggest that looking at nothing may be overestimated in previous 2D screen-based settings, we still found the effect of looking back to empty locations during mental imagery and visual memory, thereby confirming ecological validity of previous findings. Given the growing use of IVR in cognitive rehabilitation settings (Maggio et al 2019) looking at nothing could thus be used as control for task performance in memory assessment and rehabilitation. The finding creates a starting point for future research in order to gain a more conclusive understanding of perception and visual behavior in 3D space.…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Eye movements to absent objects during mental imagery and visual memory in immersive virtual reality

2020

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The role of eye movements in mental imagery and visual memory is typically investigated by presenting stimuli or scenes on a two-dimensional (2D) computer screen. When questioned about objects that had previously been presented on-screen, people gaze back to the location of the stimuli, even though those regions are blank during retrieval. It remains unclear whether this behavior is limited to a highly controlled experimental setting using 2D screens or whether it also occurs in a more naturalistic setting. The present study aims to overcome this shortcoming. Three-dimensional (3D) objects were presented along a circular path in an immersive virtual room. During retrieval, participants were given two tasks: to visualize the objects, which they had encoded before, and to evaluate a statement about visual details of the object. We observed longer fixation duration in the area, on which the object was previously displayed, when compared to other possible target locations. However, in 89% of the time, participants fixated none of the predefined areas. On the one hand, this shows that looking at nothing may be overestimated in 2D screen-based paradigm, on the other hand, the looking at nothing effect was still present in the 3D immersive virtual reality setting, and thus it extends external validity of previous findings. Eye movements during retrieval reinstate spatial information of previously inspected stimuli.

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Section: Limitations and Future Directionsmentioning

confidence: 99%

Eye movements to absent objects during mental imagery and visual memory in immersive virtual reality

2020

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“…It is possible that this issue is attenuated in computerized CBT, which may make fewer demands in terms of recognizing and communicating affect states and cognitions. [ 16 ] Virtual reality, due to the possibility of reproducing ecological environments, provides the patient with the psychological sensation of “being there” boosting the emotional processing. VR has been used for treating different mental disorders such as phobia, eating disorders and schizophrenia, but rarely in patients with neuropsychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

“…[ 11 – 15 ] The use of computerized training has been recently validated as a promising tool in the rehabilitation of brain injuries, including stroke, whereas growing evidence is demonstrating that the use of a semi-immersive virtual reality (VR) environment accelerates the rehabilitation process of compromised cognitive functions. [ 16 ] Regarding the efficacy of new technologies, several studies show that the use of advanced tools using VR, both immersive (such as BTS- Nirvana -BTS-N) and non-immersive (using the robotic devices Lokomat or Armeo-P), improves the effects of the ongoing conventional neurorehabilitation, so to be considered complementary treatments in post - stroke physical, cognitive and psychological recovery. [ 17 – 20 ] Moreover, VR treatments can increase patient's safety and self-efficacy, as well as coping strategies, eventually leading to an improvement in motivation and rehabilitation outcomes.…”

Section: Introductionmentioning

confidence: 99%

Can emerging technologies be effective in improving alexithymia due to brain lesion?

et al. 2020

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Introduction: About 66% of stroke survivors present with cognitive or physical consequences, which are often complicated by emotional instability. Alexithymia is defined as “a difficulty in identifying and describing feelings”, although there is no consensus on the exact diagnosis and treatment. Patient concerns: A 36-year-old right-handed man, affected by ischemic stroke (which occurred about 3 months before admission) involving the right hemisphere (ie, the fronto-parieto-temporal region) with left hemiparesis and behavioral abnormalities, came to our observation for intensive rehabilitation. He was treated unsuccessfully with a traditional and behavioral training. Diagnosis: Alexithymia due to ischemic stroke. Interventions: Then, a specific combined protocol using computerized emotional and virtual emotional training was applied in a semi-immersive virtual reality environment using the BTS-Nirvana device. Outcomes: At the end of this novel rehabilitation approach, the patient showed a significant improvement in emotional skills, cognitive performances, and coping strategies. Conclusions: Virtual reality, in addition to standard therapy, may be a valuable tool in improving emotional abnormalities due to brain lesions, such as alexithymia.

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“…This is proposed to occur by increasing the sense of presence/social presence experienced by the participant (as they experience emotionally engaging background narratives to enhance the affective experience and social interactions) [11,12]. Moreover, VR allows increased feedback to the central nervous system through intensive, repetitive and task-oriented exercises that are performed in a virtual environment, developing a knowledge of the results and the quality of the movements (i.e., knowledge of the performance), leading to "reinforcement learning" [13].…”

mentioning

confidence: 99%

“…Indeed, a better knowledge of the neurophysiological underpinnings of VR may allow tailoring the cognitive-motor training to patient's needs and goals. The main hypothesis is that VR may entrain the same neural pathways that are involved in motor learning and cognitive processes, thus reinforcing the neuroplasticity processes triggered by motor-cognitive rehabilitation that are fundamental for neural damage recovery [13]. Indeed, VR may magnify the effects of the assisted, intensive, and repetitive motor-cognitive tasks delivered within a rehabilitative setting by providing patients with task-oriented exercises (which are motivating and entraining) and with additional knowledge of performance and results [16,17].…”

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confidence: 99%

Understanding Social Cognition Using Virtual Reality: Are We still Nibbling around the Edges?

Calabrò

Naro

2019

Brain Sciences

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Virtual Reality (VR) has a variety of applications in various fields of study, including social work and human performance training. Useful information regarding the neurobiological underpinnings of social cognition (SC) has been obtained from the use of VR. This was mainly achieved by substituting the use of simple and static stimuli (that lack many of the potentially important aspects of real-world activities and social interactions) with fully interactive, three-dimensional computerized models of social situations that can be fully controlled by the experimenter, and can simulate a real-world setting as recently pointed out by Parsons et al. (Virtual Reality for Research in Social Neuroscience. Brain Sciences, 2017). As a consequence, the cognitive training in the field of SC and, broadly, social neuroscience, has greatly benefited from the use of VR. However, specific issues concerning the VR neurophysiological underpinnings remain to be clarified, as well as the social and cultural consequences of VR technologies focusing on the processing of social information and the consequences arising from the understanding of self and others. Notwithstanding, it is important to remark that VR-based social neuroscience scenarios can reliably enhance the affective experience and social interactions, whether added to or coupled with traditional cognitive behavioural therapy.

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The Growing Use of Virtual Reality in Cognitive Rehabilitation: Fact, Fake or Vision? A Scoping Review

Cited by 112 publications

References 40 publications

Eye movements to absent objects during mental imagery and visual memory in immersive virtual reality

Eye movements to absent objects during mental imagery and visual memory in immersive virtual reality

Can emerging technologies be effective in improving alexithymia due to brain lesion?

Understanding Social Cognition Using Virtual Reality: Are We still Nibbling around the Edges?

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