Overall findings provide further support for the use of VR cognitive training applications in neuropsychological rehabilitation. Implications for Rehabilitation Improvements in memory and attention functions following a virtual reality-based serious games intervention. Training of daily-life activities using a virtual reality application. Accessibility to training contents.

Background The consequences of alcohol dependence are severe and may range from physical disease to neuropsychological deficits in several cognitive domains. Alcohol abuse has also been related to brain dysfunction specifically in the prefrontal cortex. Conventional neuropsychological interventions (paper-and-pencil cognitive stimulation training) have a positive effect but are time-consuming, costly, and not motivating for patients. Objective Our goal was to test the cognitive effects of a novel approach to neuropsychological intervention, using mobile technology and serious games, on patients with alcohol dependence. Methods The trial design consisted of a two-arm study assessing the cognitive outcomes of neuropsychological intervention with mobile serious games (mHealth) versus control (treatment-as-usual with no neuropsychological intervention) in patients undergoing treatment for alcohol dependence syndrome. Sixty-eight patients were recruited from an alcohol-rehab clinic and randomly assigned to the mHealth (n=33) or control condition (n=35). The intervention on the experimental group consisted of a therapist-assisted cognitive stimulation therapy for 4 weeks on a 2-3 days/week basis. Results Fourteen patients dropped out of the study. The results of the neuropsychological assessments with the remaining 54 patients showed an overall increase ( P <.05) of general cognitive abilities, mental flexibility, psychomotor processing speed, and attentional ability in both experimental (n=26) and control groups (n=28). However, there was a more pronounced improvement ( P =.01) specifically in frontal lobe functions from baseline (mean 13.89, SE 0.58) to follow-up (mean 15.50, SE 0.46) in the experimental group but not in the control group. Conclusions The overall increase in general cognitive function for both experimental and control groups supports the beneficial role of existing alcohol treatment protocols aimed at minimizing withdrawal symptoms, but the differential improvements observed in frontal lobe functioning supports the use of mobile serious games for neuropsychological stimulation to overcome executive dysfunction in patients with alcohol dependence. This trial was negative on two neuropsychological/cognitive tests, and positive on one. Trial Registration ClinicalTrials.gov NCT01942954; http://www.clinicaltrials.gov/ct2/show/NCT01942954 (Archived by WebCite at http://www.webcitation.org/6OYDqHLwB).

This study aims at assessing an online portal where patients with traumatic brain injury (TBI) can carry on memory and attention exercises outside clinic premises. The training took place in a virtual reality (VR) setup where one TBI patient had to complete a set of 10 online VR sessions. The neuropsychological evaluation was carried out with the PASAT (Paced Auditory Serial Addition Task) at pre-, during and post-treatment assessments. The results showed an increase in working memory and attention levels from the fi rst to the fi nal assessment, which can suggest that VR applications may promote the autonomy and increase in overall quality of life of these patients. The average time for task conclusion was 5 min.

The advantages of using naturalistic virtual reality (VR) environments based on everyday life tasks for cognitive intervention in the elderly are not yet well understood. The literature suggests that the similarity of such exercises with real life activities may improve generalizability by extending the transfer of gains of training to everyday living. This study aimed to investigate the gains associated with this ecologically-oriented virtual reality cognitive stimulation (VR-CS) versus standard cognitive stimulation in the elderly. Forty-three healthy older adults were divided into two groups: an experimental group underwent a VR-based cognitive stimulation and an active control group underwent a paper-and-pencil cognitive stimulation. The outcomes assessed at the pre-treatment and posttreatment assessment consisted in well-established tests for cognitive and executive functioning, depression, subjective well-being, and functionality. The results showed positive outcomes on dimensions of general cognition, executive functioning, attention, and visual memory in the group that underwent VR-CS. Improvements in executive functioning in this group was supported by consistent evidence of increases in attention abilities but little evidence of increases in memory abilities. Both effects may have contributed to improvements in general cognition. Further studies are needed to test whether these effects may extend to well-being and functionality in cognitively impaired older adults.

As the demographic structure in western societies ages, the prevalence and impact of cognitive decline rises. Thus, new solutions to tackle this problem are required. The use of Information and Communication Technologies (ICT)-based cognitive exercises has emerged in the last few decades, though with inconsistent results. Hence, we conducted a pre-post treatment study to further investigate this approach. We designed a set of virtual reality exercises that mimic activities of daily living by which the patient can train different cognitive domains. Twenty-five participants, ages 65-85, underwent 12 training sessions between the pre-treatment and post-treatment assessments. Significant increases were seen between the two assessments for some of the neuropsychological measures: visual memory, attention, and cognitive flexibility. Results also suggest that participants with lower baseline cognitive performance levels improved most after these sessions.

The results are promising but still require randomized control trials to determine the efficiency of this approach to cognitive rehabilitation programs for the cognitive recovery of heroin addicts.

The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.

Craving is a strong desire to consume that emerges in every case of substance addiction. Previous studies have shown that eliciting craving with an exposure cues protocol can be a useful option for the treatment of nicotine dependence. Thus, the main goal of this study was to develop a virtual platform in order to induce craving in smokers. Fifty-five undergraduate students were randomly assigned to two different virtual environments: high arousal contextual cues and low arousal contextual cues scenarios (17 smokers with low nicotine dependency were excluded). An eye-tracker system was used to evaluate attention toward these cues. Eye fixation on smoking-related cues differed between smokers and nonsmokers, indicating that smokers focused more often on smoking-related cues than nonsmokers. Self-reports of craving are in agreement with these results and suggest a significant increase in craving after exposure to smoking cues. In sum, these data support the use of virtual environments for eliciting craving.