Immersive virtual reality has become increasingly popular to improve the assessment and treatment of health problems. This rising popularity is likely to be facilitated by the availability of affordable headsets that deliver high quality immersive experiences. As many health problems are more prevalent in older adults, who are less technology experienced, it is important to know whether they are willing to use immersive virtual reality. In this study, we assessed the initial attitude towards head-mounted immersive virtual reality in 76 older adults who had never used virtual reality before. Furthermore, we assessed changes in attitude as well as self-reported cybersickness after a first exposure to immersive virtual reality relative to exposure to time-lapse videos. Attitudes towards immersive virtual reality changed from neutral to positive after a first exposure to immersive virtual reality, but not after exposure to time-lapse videos. Moreover, self-reported cybersickness was minimal and had no association with exposure to immersive virtual reality. These results imply that the contribution of VR applications to health in older adults will neither be hindered by negative attitudes nor by cybersickness.

Immersive virtual reality (IVR) may boost neglect recovery, as it can provide an engaging experience in a 3D environment. We designed an IVR rehabilitation game for neglect patients using the Oculus Rift.Multisensory cues were presented in the neglected visual field in a patient-tailored way. We acquired pilot data in 15 neurologically healthy controls and 7 stroke patients. First, we compared cybersickness before and after VR exposure. Second, we assessed the user experience through a questionnaire. Third, we tested whether neglect symptoms corresponded between the VR game and a computerized cancellation task. Fourth, we evaluated the effect of the multisensory cueing on target discrimination.Last, we tested two algorithms to tailor the game to the characteristics of the neglected visual field.Cybersickness significantly reduced after VR exposure in six stroke patients and was low in healthy controls. Patients rated the user experience neutral to positive. In addition, neglect symptoms were consistent between a computerized cancellation and VR rehabilitation task. The multisensory cue positively affected target discrimination in the game and we successfully presented sensory stimulation to the neglected visual field in a patient-tailored way. Our results show that it is promising to use gamified patient-tailored immersive VR for neglect rehabilitation.

The Oxford Cognitive Screen (OCS) is a screening tool specifically designed for acute stroke patients, assessing 5 domains: attention and executive functions, language, praxis, numeric cognition and memory. Here we present norms for the Dutch version of the OCS (OCS-NL). We evaluated whether age and socio-economic status were linked to OCS-NL performance, since stroke prevalence and recovery are associated to these characteristics. We acquired normative data of the OCS-NL version A in 246 neurologically healthy participants and a subset of 179 participants also completed parallel version B. Socio-economic status was measured using three indicators: education, income and occupation. Data were analyzed in a Bayesian way and we report credible intervals of effect sizes. There were no systematic differences in OCS-NL global performance between low, middle and high income groups, nor between manual and non-manual workers. There were small differences between low and middle and between low and high education groups, and the association of education and OCS-NL performance did not vary across subtests. The association of age and OCS-NL performance varied across subtests. The naming, praxis, verbal memory and executive task had the strongest association with age. These data suggest that normative data for the OCS-NL do not need to be stratified on income and occupation, that age-specific cut-off scores are especially recommended for the naming, praxis, executive function and verbal memory tasks and that education must be considered when interpreting OCS-NL test scores.

Despite the proliferation of research on immersive virtual reality (IVR) technologies for older adults, comprehensive guidelines on designing immersive and engaging VR for older adults remain sparse. Therefore, we first compounded 67 guidelines based on published literature. Next, to empirically ground these design recommendations, we provided 37 older adults of diverse ages, education levels, and cognitive abilities with a first VR experience. Analyzing interviews with the 37 older adults via the Laddering method, we found that they generally reported positive experiences with their first VR exposure. With these deepened insights, we reflect on, nuance, and contextualize existing design guidelines, and formulate points to bear in mind when designing accessible and engaging VR experiences for older persons.

Shape perception is intrinsically holistic: combinations of features give rise to configurations with emergent properties that are different from the sum of the parts. The current study investigated neural markers of holistic shape representations learned by means of categorization training. We used the EEG frequency tagging technique, where two parts of a shape stimulus were 'tagged' by modifying their contrast at different temporal frequencies. Signals from both parts are integrated and, as a result, emergent frequency components (so-called, intermodulation responses, IMs), caused by nonlinear interaction of two frequency signals, are observed in the EEG spectrum. First, participants were trained in 4 sessions to discriminate highly similar, unfamiliar shapes into two categories, defined based on the combination of features. After training, EEG was recorded while frequency-tagged shapes from either the trained or the untrained shape family were presented. For all IMs combined, no learning effects were detected, but post hoc analyses of higher-order IMs revealed stronger occipital and occipito-temporal IMs for both trained and untrained exemplars of the trained shape family as compared to the untrained shape family. In line with recent findings, we suggest that the higher-order IMs may reflect high-level visual computations, like holistic shape categorization, resulting from a cascade of non-linear operations. Higher order frequency responses are relatively low in power, hence results should be interpreted cautiously and future research is needed to confirm these effects. In general, these findings are, to our knowledge, the first to show IMs as a neural correlate of perceptual learning.

No abstract

No abstract