Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) in Parkinson’s Disease

Abstract

Background: Cognitive impairment is common in Parkinson’s disease (PD) and highly associated with loss of independence, caregiver burden, and assisted living placement. The need for cognitive functional capacity tools validated for use in PD clinical and research applications has thus been emphasized in the literature. The Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) is a tablet-based instrument that assesses proficiency for performing real world tasks in a highly realistic environment. Objective: The present study explored application of the VRFCAT-SL in clinical assessments of patients with PD. Specifically, we examined associations between VRFCAT-SL performance and measures of cognition, motor severity, and self-reported cognitive functioning. Methods: The VRFCAT-SL was completed by a sample of 29 PD patients seen in clinic for a comprehensive neuropsychological evaluation. Fifteen patients met Movement Disorders Society Task Force criteria for mild cognitive impairment (PD-MCI); no patients were diagnosed with dementia. Non-parametric correlations between VRFCAT-SL performance and standardized neuropsychological tests and clinical measures were examined. Results: VRFCAT-SL performance was moderately associated with global rank on neuropsychological testing and discriminated PD-MCI. Follow-up analyses found completion time was associated with visual memory, sustained attention, and set-switching, while errors were associated with psychomotor inhibition. No clinical or motor measures were associated with VRFCAT-SL performance. Self-report was not associated with VRFCAT-SL or neuropsychological test performance. Conclusion: The VRFCAT-SL appears to provide a useful measure of cognitive functional capacity that is not confounded by PD motor symptoms. Future studies will examine utility in PD dementia.

Systematic review of memory assessment in virtual reality: evaluating convergent and divergent validity with traditional neuropsychological measures

“…Through a thorough examination of the available literature, it emerges that VR tools that have been tested and proven to be reliable on older adults and have provided correlations with established neuropsychological assessments cover a wide array of memory areas such as episodic memory ( Plancher et al, 2010 ; Arvind Pala et al, 2014 ; Kempe et al, 2015 ; Zygouris et al, 2015 ; Sauzéon et al, 2016 ; Ouellet et al, 2018 ; Corriveau Lecavalier et al, 2020 ; Eraslan Boz et al, 2020 ; Limoncu et al, 2021 ; Turner et al, 2021 ; Bruni et al, 2022 ; Pieri et al, 2022 ), verbal memory ( Gottlieb et al, 2022 ), prospective memory ( Lecouvey et al, 2019 ; Hogan et al, 2023 ), and spatial memory ( Cushman et al, 2008 ; Tippett et al, 2009 ; Morganti et al, 2013 ; Lee et al, 2014 ; Serino et al, 2015 ; Mohammadi et al, 2018 ; Zhang et al, 2021 ; Da Costa et al, 2022 ; Rekers and Finke, 2023 ).…”

“…Similarly, in the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) ( Turner et al, 2021 ), a tool developed to measure functional capacity of subjective cognitive decline, participants engage in an exploratory activity within a kitchen environment to ascertain the available culinary resources for the recipe at hand. Subsequently, individuals employ a bus timetable to locate a suitable bus route that will transport them to a grocery store.…”

“…The supermarket of Limoncu et al (2021) correlated with memory, executive functions and visuo-spatial functions. The VRFCAT ( Turner et al, 2021 ) was correlated with neuropsychological assessment battery (NAB) and delayed recall. The VR-RAVLT ( Gottlieb et al, 2022 ) positively correlated with the standard RAVLT.…”

“…The demographic groups primarily subjected to examination through the utilization of VR tools for the purpose of memory assessment primarily consist of healthy older adults ( Cushman et al, 2008 ; Tippett et al, 2009 ; Plancher et al, 2010 ; Morganti et al, 2013 ; Arvind Pala et al, 2014 ; Lee et al, 2014 ; Kempe et al, 2015 ; Serino et al, 2015 ; Zygouris et al, 2015 ; Sauzéon et al, 2016 ; Mohammadi et al, 2018 ; Lecouvey et al, 2019 ; Corriveau Lecavalier et al, 2020 ; Eraslan Boz et al, 2020 ; Limoncu et al, 2021 ; Zhang et al, 2021 ; Bruni et al, 2022 ; Da Costa et al, 2022 ; Gottlieb et al, 2022 ; Pieri et al, 2022 ; Rekers and Finke, 2023 ), older adults with subjective cognitive decline ( Ouellet et al, 2018 ), individuals diagnosed with Mild Cognitive Impairment (MCI) ( Cushman et al, 2008 ; Tippett et al, 2009 ; Serino et al, 2015 ); MCI-single domain (SD) ( Lee et al, 2014 ; Serino et al, 2015 ; Zygouris et al, 2015 ; Mohammadi et al, 2018 ; Eraslan Boz et al, 2020 ), MCI-multiple domain (MD) ( Zygouris et al, 2015 ; Mohammadi et al, 2018 ), patients with Parkinson’s disease (PD) ( Turner et al, 2021 ), and PD-MCI ( Turner et al, 2021 ), cognitively normal individuals with small vessel disease (SVD) ( Limoncu et al, 2021 ), individuals with SVD with cognitive impairment ( Limoncu et al, 2021 ); patients with stroke ( Hogan et al, 2023 ), patients with AD ( Cushman et al, 2008 ; Morganti et al, 2013 ; Lee et al, 2014 ; Serino et al, 2015 ; Sauzéon et al, 2016 ; Mohammadi et al, 2018 ; Lecouvey et al, 2019 ). See Table 3 for descriptions of the samples.…”

Virtual reality and rehabilitation.

“…One of the most methodologically rigorous VR-based assessments found in the literature is the Virtual Reality Functional Capacity Assessment Tool (VRFCAT), a VR-based assessment of functional abilities (Ruse et al, 2014) developed and sold by NeuroCog Trials (NeuroCog, 2015). Specifically, the VRFCAT evaluates activities of daily living, including navigating to and from the grocery store via bus, shopping for and purchasing items at the store, and completing a recipe.…”