The Study of Evaluation and Rehabilitation of Patients With Different Cognitive Impairment Phases Based on Virtual Reality and EEG

2018 
The evaluation and rehabilitation (EAR) of patients with different cognitive impairment phases (PDCIP), including subjective cognitive decline (SCD) (Jessen et al., 2014; Innes et al., 2016a,b, 2017), mild cognitive impairment (MCI) (Weniger et al., 2011) and Alzheimer's disease (AD) (Serino et al., 2015), become a rapidly growing research field. Virtual reality (VR) has been reported to re-activate and/or improve multiple cortical functions (Baumann et al., 2003; Lin et al., 2008; Schedlbauer et al., 2014; Carrieri et al., 2016) and help optimize the coding efficiency of the sensory cortex (Ansuini et al., 2006; Keller et al., 2012; Ravassard et al., 2013; Schindler and Bartels, 2013; Sofroniew et al., 2015). Therefore, many researchers have started applying the VR technology to the EAR of PDCIP (Buss, 2009), including spatial memory (Allison et al., 2016), episodic memory (Valladares-Rodriguez et al., 2017), activities of daily living (Seo et al., 2017), language (Montenegro and Argyriou, 2017), executive function (Tost et al., 2014), short-term and working memory (Burdea et al., 2013), attention (Kalova et al., 2005), movement and balance (McEwen et al., 2014), and outdoor activities (Van Schaik et al., 2008). For EAR of PDCIP, the advantages of using VR over conventional approaches, such as electroencephalogram (EEG), functional magnetic resonance imaging (fMRI), and neuropsychological tasks, have been reported (Tarnanas et al., 2014a,b, 2015a). However, these studies did not record EEG during the course of evaluation and training within a VR environment, nor took full advantages of the EEG recordings to objectively explore the brain states of PDCIP in (near) real time, despite the combination of VR and EEG has been used in the EAR of other diseases, including stroke (I Badia et al., 2013; Lechner et al., 2014; Vourvopoulos and I Badia, 2016), paraplegic (Donati et al., 2016), autism (Amaral et al., 2017), attention deficit hyperactivity disorder (Rohani and Puthusserypady, 2015) and so on. The neuroimaging research for the EAR of PDCIP within a VR environment is still in its infancy, and more works need to be done before conclusions can be confidently drawn. This study will review the literature related to the EAR of PDCIP from the perspectives of VR and EEG, and discuss the potential advantages of the combined use of VR and EEG. It is expected that the analysis may provide useful suggestions to the field of the EAR of PDCIP.
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