Can a novel computerized cognitive screening test provide additional information for early detection of Alzheimer's disease?

BACKGROUND: Virtual reality testing of everyday activities is a novel type of computerized assessment that measures cognitive, executive, and motor performance as a screening tool for early dementia. This study used a virtual reality day-out task (VR-DOT) environment to evaluate its predictive value in patients with mild cognitive impairment (MCI). METHODS: One hundred thirty-four patients with MCI were selected and compared with 75 healthy control subjects. Participants received an initial assessment that included VR-DOT, a neuropsychological evaluation, magnetic resonance imaging (MRI) scan, and event-related potentials (ERPs). After 12 months, participants were assessed again with MRI, ERP, VR-DOT, and neuropsychological tests. RESULTS: At the end of the study, we differentiated two subgroups of patients with MCI according to their clinical evolution from baseline to follow-up: 56 MCI progressors and 78 MCI nonprogressors. VR-DOT performance profiles correlated strongly with existing predictive biomarkers, especially the ERP and MRI biomarkers of cortical thickness. CONCLUSIONS: Compared with ERP, MRI, or neuropsychological tests alone, the VR-DOT could provide additional predictive information in a low-cost, computerized, and noninvasive way.

Glucocorticoids enhance in vivo exposure-based therapy outcome in spider phobia

BACKGROUND: Preclinical and clinical studies indicate that the administration of glucocorticoids may promote fear extinction processes. In particular, it has been shown that glucocorticoids enhance virtual reality based exposure therapy of fear of heights. Here, we investigate whether glucocorticoids enhance the outcome of in vivo exposure-based group therapy of spider phobia. METHODS: In a double blind, block-randomized, placebo-controlled, between-subject study design, 22 patients with specific phobia of spiders were treated with two sessions of in vivo exposure-based group therapy. Cortisol (20 mg) or placebo was orally administered 1 hr before each therapy session. Patients returned for a follow-up assessment one month after therapy. RESULTS: Exposure-based group therapy led to a significant decrease in phobic symptoms as assessed with the Fear of Spiders Questionnaire (FSQ) from pretreatment to immediate posttreatment and to follow-up. The administration of cortisol to exposure therapy resulted in increased salivary cortisol concentrations and a significantly greater reduction in fear of spiders (FSQ) as compared to placebo at follow-up, but not immediately posttreatment. Furthermore, cortisol-treated patients reported significantly less anxiety during standardized exposure to living spiders at follow-up than placebo-treated subjects. Notably, groups did not differ in phobia-unrelated state-anxiety before and after the exposure sessions and at follow-up. CONCLUSIONS: These findings indicate that adding cortisol to in vivo exposure-based group therapy of spider phobia enhances treatment outcome.

Modulating presence and impulsiveness by external stimulation of the brain

BACKGROUND "The feeling of being there" is one possible way to describe the phenomenon of feeling present in a virtual environment and to act as if this environment is real. One brain area, which is hypothesized to be critically involved in modulating this feeling (also called presence) is the dorso-lateral prefrontal cortex (dlPFC), an area also associated with the control of impulsive behavior. METHODS In our experiment we applied transcranial direct current stimulation (tDCS) to the right dlPFC in order to modulate the experience of presence while watching a virtual roller coaster ride. During the ride we also registered electro-dermal activity. Subjects also performed a test measuring impulsiveness and answered a questionnaire about their presence feeling while they were exposed to the virtual roller coaster scenario. RESULTS Application of cathodal tDCS to the right dlPFC while subjects were exposed to a virtual roller coaster scenario modulates the electrodermal response to the virtual reality stimulus. In addition, measures reflecting impulsiveness were also modulated by application of cathodal tDCS to the right dlPFC. CONCLUSION Modulating the activation with the right dlPFC results in substantial changes in responses of the vegetative nervous system and changed impulsiveness. The effects can be explained by theories discussing the top-down influence of the right dlPFC on the "impulsive system".

Auditive und visuelle Perzeption bei Abseitsentscheidungen im Fussball

Einleitung Die hohe Quote von fehlerhaften Abseitsentscheidungen im Fußball (ca. 26%, Helsen et al., 2006) könnte dadurch erklärt werden, dass Schiedsrichterassistenten zum Zeitpunkt des Passes die Abseitslinie fixieren und den Moment des Passes nur peripher wahr-nehmen (Catteeuw et al., 2009). Diese Annahme wurde geprüft, indem in einem Virtual-Reality-Setting systematisch visuelle (Spielerpositionen) und akustische (Passgeräusch) Informationen manipuliert wurden. Methode In Experiment 1 hatten 28 Teilnehmer die Aufgabe, Abseitsentscheidungen aus der Per-spektive des Schiedsrichterassistenten zu treffen. Dabei wurde das Passgeräusch mani-puliert (Geräusch bei Ballabgabe: 100 ms zu früh, 100 ms zu spät, ohne). Erwartet wurde, dass die Entscheidungsrichtigkeit bei asynchronen Geräuschen sinkt. In Experiment 2 wurde in drei Gruppen die (1) Distanz zum Assistent, (2) Exzentrizität des Passgebers (Winkel zwischen Passgeber und Abseitslinie) oder (3) der zu fixierende Spieler (letzter Verteidiger oder Passgeber) manipuliert. Je Gruppe hatten 20 Teilnehmer die Aufgabe, den Moment des Passes per Knopfdruck anzugeben und Abseitsentscheidungen zu tref-fen. Zu fixierende Orte wurden instruiert und durch Eyetracking geprüft. Prädiziert wurde, dass (1) große Exzentrizitäten und (2) große Entfernungen des Passgebers die Präzision der Passwahrnehmung und die Entscheidungsrichtigkeit senken und (3) der Passmo-ment bei Fixation des Passgebers präziser erkannt wird als bei Fixation des letzten Ver-teidigers. Ergebnisse Die bisher vorliegenden Ergebnisse aus Experiment 1 zeigen, dass die akustische Wahrnehmung des Passes die Entscheidungsrichtigkeit beeinflusst, F(2, 54)= 7.44, p = .01, ηp2 = .22, indem verzögerte Ballgeräusche die Zahl der „Flag-Errors“ (fälschlicher-weise auf Abseits entschieden) erhöht und die der „Non-Flag-Errors“ (Abseits nicht er-kannt) senkt. Experiment 2 wird zeigen, welche Rolle hierbei periphere visuelle Informa-tionen spielen. Diskussion Die vermutete Rückführung von fehlerhaften Abseitsentscheidungen auf periphere (vi-suelle) Wahrnehmungsaspekte konnte bestätigt werden. Der relative Einfluss auditiver und visueller Informationen auf die Fehlerquote gilt es weiter zu untersuchen. Literatur Catteeuw, P., Helsen, W., Gilis, B., Van Roie, E., & Wagemans, J. (2009). Visual scan patterns and decision-making skills of expert assistant referees in offside situations. Journal of Sport & Exercise Psychol-ogy, 31, 786-797. Helsen, W., Gilis, B., & Weston, M. (2006). Errors in judging “offside” in association football: Test of the optical error versus the perceptual flash-lag hypothesis. Journal of Sports Sciences, 24, 521–528.

On the comparison of a novel serious game and electroencephalography biomarkers for early dementia screening

Patients with amnestic mild cognitive impairment are at high risk for developing Alzheimer's disease. Besides episodic memory dysfunction they show deficits in accessing contextual knowledge that further specifies a general spatial navigation task or an executive function (EF) virtual action planning. Virtual reality (VR) environments have already been successfully used in cognitive rehabilitation and show increased potential for use in neuropsychological evaluation allowing for greater ecological validity while being more engaging and user friendly. In our study we employed the in-house platform of virtual action planning museum (VAP-M) and a sample of 25 MCI and 25 controls, in order to investigate deficits in spatial navigation, prospective memory, and executive function. In addition, we used the morphology of late components in event-related potential (ERP) responses, as a marker for cognitive dysfunction. The related measurements were fed to a common classification scheme facilitating the direct comparison of both approaches. Our results indicate that both the VAP-M and ERP averages were able to differentiate between healthy elders and patients with amnestic mild cognitive impairment and agree with the findings of the virtual action planning supermarket (VAP-S). The sensitivity (specificity) was 100% (98%) for the VAP-M data and 87% (90%) for the ERP responses. Considering that ERPs have proven to advance the early detection and diagnosis of "presymptomatic AD," the suggested VAP-M platform appears as an appealing alternative.

Car Design and Road Crossing Behaviour

Humans possess a highly developed sensitivity for facial features. This sensitivity is also deployed to non-human beings and inanimate objects such as cars. In the present study we aimed to investigate whether car design has a bearing on the behaviour of pedestrians. Methods: An immersive virtual reality environment with a zebra crossing was used to determine a) whether the minimum accepted distance for crossing the street is bigger for cars with dominant appearance than for cars with friendly appearance (Block 1) and b) whether the speed of dominant cars are overestimated compared to friendly cars (Block 2). In Block 1, the participant's task was to cross the road in front of an approaching car at the latest moment. The point of time when entering and leaving the street was measured. In Block 2 they were asked to estimate the speed of each passing car. An independent sample rated dominant cars as being more dominant, angry and hostile than friendly cars. Results: None of the predictions regarding the car design was confirmed. Instead, there was an effect of starting position: From the centre island, participants entered the road significantly later (smaller accepted distance) and left the road later than when starting from the pavement. Consistently, the speed of the cars was estimated significantly lower when standing on the centre island compared to the pavement. When entering the visual size of the cars as factor (instead of dominance), we found that participants started to cross the road significantly later in front of small cars compared to big cars and that the speed of smaller cars was overestimated compared to big cars (size-speed bias). Conclusions: Car size and starting position, not car design seem to have an influence on road crossing behaviour.

Street crossing behavior in younger and older pedestrians: an eye- and head-tracking study

BACKGROUND: Crossing a street can be a very difficult task for older pedestrians. With increased age and potential cognitive decline, older people take the decision to cross a street primarily based on vehicles' distance, and not on their speed. Furthermore, older pedestrians tend to overestimate their own walking speed, and could not adapt it according to the traffic conditions. Pedestrians' behavior is often tested using virtual reality. Virtual reality presents the advantage of being safe, cost-effective, and allows using standardized test conditions. METHODS: This paper describes an observational study with older and younger adults. Street crossing behavior was investigated in 18 healthy, younger and 18 older subjects by using a virtual reality setting. The aim of the study was to measure behavioral data (such as eye and head movements) and to assess how the two age groups differ in terms of number of safe street crossings, virtual crashes, and missed street crossing opportunities. Street crossing behavior, eye and head movements, in older and younger subjects, were compared with non-parametric tests. RESULTS: The results showed that younger pedestrians behaved in a more secure manner while crossing a street, as compared to older people. The eye and head movements analysis revealed that older people looked more at the ground and less at the other side of the street to cross. CONCLUSIONS: The less secure behavior in street crossing found in older pedestrians could be explained by their reduced cognitive and visual abilities, which, in turn, resulted in difficulties in the decision-making process, especially under time pressure. Decisions to cross a street are based on the distance of the oncoming cars, rather than their speed, for both groups. Older pedestrians look more at their feet, probably because of their need of more time to plan precise stepping movement and, in turn, pay less attention to the traffic. This might help to set up guidelines for improving senior pedestrians' safety, in terms of speed limits, road design, and mixed physical-cognitive trainings.

Real-time computer-based visual feedback improves visual acuity in downbeat nystagmus - a pilot study.

BACKGROUND Patients with downbeat nystagmus syndrome suffer from oscillopsia, which leads to an unstable visual perception and therefore impaired visual acuity. The aim of this study was to use real-time computer-based visual feedback to compensate for the destabilizing slow phase eye movements. METHODS The patients were sitting in front of a computer screen with the head fixed on a chin rest. The eye movements were recorded by an eye tracking system (EyeSeeCam®). We tested the visual acuity with a fixed Landolt C (static) and during real-time feedback driven condition (dynamic) in gaze straight ahead and (20°) sideward gaze. In the dynamic condition, the Landolt C moved according to the slow phase eye velocity of the downbeat nystagmus. The Shapiro-Wilk test was used to test for normal distribution and one-way ANOVA for comparison. RESULTS Ten patients with downbeat nystagmus were included in the study. Median age was 76 years and the median duration of symptoms was 6.3 years (SD +/- 3.1y). The mean slow phase velocity was moderate during gaze straight ahead (1.44°/s, SD +/- 1.18°/s) and increased significantly in sideward gaze (mean left 3.36°/s; right 3.58°/s). In gaze straight ahead, we found no difference between the static and feedback driven condition. In sideward gaze, visual acuity improved in five out of ten subjects during the feedback-driven condition (p = 0.043). CONCLUSIONS This study provides proof of concept that non-invasive real-time computer-based visual feedback compensates for the SPV in DBN. Therefore, real-time visual feedback may be a promising aid for patients suffering from oscillopsia and impaired text reading on screen. Recent technological advances in the area of virtual reality displays might soon render this approach feasible in fully mobile settings.

A multimodal tablet-based interface for designing and reviewing 3D engineering models

The ability to view and interact with 3D models has been happening for a long time. However, vision-based 3D modeling has only seen limited success in applications, as it faces many technical challenges. Hand-held mobile devices have changed the way we interact with virtual reality environments. Their high mobility and technical features, such as inertial sensors, cameras and fast processors, are especially attractive for advancing the state of the art in virtual reality systems. Also, their ubiquity and fast Internet connection open a path to distributed and collaborative development. However, such path has not been fully explored in many domains. VR systems for real world engineering contexts are still difficult to use, especially when geographically dispersed engineering teams need to collaboratively visualize and review 3D CAD models. Another challenge is the ability to rendering these environments at the required interactive rates and with high fidelity. In this document it is presented a virtual reality system mobile for visualization, navigation and reviewing large scale 3D CAD models, held under the CEDAR (Collaborative Engineering Design and Review) project. It’s focused on interaction using different navigation modes. The system uses the mobile device's inertial sensors and camera to allow users to navigate through large scale models. IT professionals, architects, civil engineers and oil industry experts were involved in a qualitative assessment of the CEDAR system, in the form of direct user interaction with the prototypes and audio-recorded interviews about the prototypes. The lessons learned are valuable and are presented on this document. Subsequently it was prepared a quantitative study on the different navigation modes to analyze the best mode to use it in a given situation.

Metadata Visualization of Cultural Heritage Information within a Collaborative Environment

Cultural content on the Web is available in various domains (cultural objects, datasets, geospatial data, moving images, scholarly texts and visual resources), concerns various topics, is written in different languages, targeted to both laymen and experts, and provided by different communities (libraries, archives museums and information industry) and individuals (Figure 1). The integration of information technologies and cultural heritage content on the Web is expected to have an impact on everyday life from the point of view of institutions, communities and individuals. In particular, collaborative environment scan recreate 3D navigable worlds that can offer new insights into our cultural heritage (Chan 2007). However, the main barrier is to find and relate cultural heritage information by end-users of cultural contents, as well as by organisations and communities managing and producing them. In this paper, we explore several visualisation techniques for supporting cultural interfaces, where the role of metadata is essential for supporting the search and communication among end-users (Figure 2). A conceptual framework was developed to integrate the data, purpose, technology, impact, and form components of a collaborative environment, Our preliminary results show that collaborative environments can help with cultural heritage information sharing and communication tasks because of the way in which they provide a visual context to end-users. They can be regarded as distributed virtual reality systems that offer graphically realised, potentially infinite, digital information landscapes. Moreover, collaborative environments also provide a new way of interaction between an end-user and a cultural heritage data set. Finally, the visualisation of metadata of a dataset plays an important role in helping end-users in their search for heritage contents on the Web.

IDT-3D: Identification and tracking in controlled environments using a 3D unified user interface

Identification and tracking of objects in specific environments such as harbors or security areas is a matter of great importance nowadays. With this purpose, numerous systems based on different technologies have been developed, resulting in a great amount of gathered data displayed through a variety of interfaces. Such amount of information has to be evaluated by human operators in order to take the correct decisions, sometimes under highly critical situations demanding both speed and accuracy. In order to face this problem we describe IDT-3D, a platform for identification and tracking of vessels in a harbour environment able to represent fused information in real time using a Virtual Reality application. The effectiveness of using IDT-3D as an integrated surveillance system is currently under evaluation. Preliminary results point to a significant decrease in the times of reaction and decision making of operators facing up a critical situation. Although the current application focus of IDT-3D is quite specific, the results of this research could be extended to the identification and tracking of targets in other controlled environments of interest as coastlines, borders or even urban areas.

Fast Correction of Tiled Display Systems on Planar Surfaces

A method for fast colour and geometric correction of a tiled display system is presented in this paper. Such kind of displays are a common choice for virtual reality applications and simulators, where a high resolution image is required. They are the cheapest and more flexible alternative for large image generation but they require a precise geometric and colour correction. The purpose of the proposed method is to correct the projection system as fast as possible so in case the system needs to be recalibrated it doesn’t interfere with the normal operation of the simulator or virtual reality application. This technique makes use of a single conventional webcam for both geometric and photometric correction. Some previous assumptions are made, like planar projection surface and negligibleintra-projector colour variation and black-offset levels. If these assumptions hold true, geometric and photometric seamlessness can be achievedfor this kind of display systems. The method described in this paper is scalable for an undefined number of projectors and completely automatic.

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

Purpose: Surgical simulators are currently essential within any laparoscopic training program because they provide a low-stakes, reproducible and reliable environment to acquire basic skills. The purpose of this study is to determine the training learning curve based on different metrics corresponding to five tasks included in SINERGIA laparoscopic virtual reality simulator. Methods: Thirty medical students without surgical experience participated in the study. Five tasks of SINERGIA were included: Coordination, Navigation, Navigation and touch, Accurate grasping and Coordinated pulling. Each participant was trained in SINERGIA. This training consisted of eight sessions (R1–R8) of the five mentioned tasks and was carried out in two consecutive days with four sessions per day. A statistical analysis was made, and the results of R1, R4 and R8 were pair-wise compared with Wilcoxon signed-rank test. Significance is considered at P value <0.005. Results: In total, 84.38% of the metrics provided by SINERGIA and included in this study show significant differences when comparing R1 and R8. Metrics are mostly improved in the first session of training (75.00% when R1 and R4 are compared vs. 37.50% when R4 and R8 are compared). In tasks Coordination and Navigation and touch, all metrics are improved. On the other hand, Navigation just improves 60% of the analyzed metrics. Most learning curves show an improvement with better results in the fulfillment of the different tasks. Conclusions: Learning curves of metrics that assess the basic psychomotor laparoscopic skills acquired in SINERGIA virtual reality simulator show a faster learning rate during the first part of the training. Nevertheless, eight repetitions of the tasks are not enough to acquire all psychomotor skills that can be trained in SINERGIA. Therefore, and based on these results together with previous works, SINERGIA could be used as training tool with a properly designed training program.

Mozarabic Chant anechoic recordings for auralization purposes

The Hispanic Rite is the liturgy celebrated by Christians of the Iberian Peninsula before the imposition of the Roman Rite in the mid-eleventh century. As in other early Christian liturgies, music was the core of the Hispanic Rite. This music, known as Mozarabic Chant is one of the richest musical repertoires of the Middle Ages. Currently, a research project is underway involving the restoration of the Hispanic Rite sound, using techniques of acoustic virtual reality. The project aims to perform the auralization of the sound of Mozarabic Chant in his primitive environment, that is, taking into account the acoustic characteristics of the pre-Romanesque churches in their original state. For this purpose, anechoic recordings were made for a number of musical pieces representative of the Mozarabic Chant repertoire. In total eight (8) musical pieces have been recorded and interpreted, each of one, by six (6) different singers. The recordings were made using a spherical array composed by 32 microphones. This paper describes the more relevant aspects related to the recorded musical material, the technical specifications and installation details of the recording equipment, the data processing, and a summary of the results.

Experimental Prototype Merging Stereo Panoramic Video and Interactive 3D Content in a 5-sided CAVETM

Immersion and interaction have been identified as key factors influencing the quality of experience in stereoscopic video systems. An experimental prototype designed to explore the influence of these factors in 3D video applications is described here1. The focus is on the real-time insertion algorithm of new 3D models into the original video streams. Using this algorithm, our prototype is aimed to explore a new interaction paradigm ? similar to the augmented reality approach ? with 3D video applications.