Virtual reality (VR) represents a key technology of the 21st century, attracting substantial interest from a wide range of scientific disciplines. With regard to clinical neuropsychology, a multitude of new VR applications are being developed to overcome the limitations of classical paradigms. Consequently, researchers increasingly face the challenge of systematically evaluating the characteristics and quality of VR applications to design the optimal paradigm for their specific research question and study population. However, the multifaceted character of contemporary VR is not adequately captured by the traditional quality criteria (ie, objectivity, reliability, validity), highlighting the need for an extended paradigm evaluation framework. To address this gap, we propose a multidimensional evaluation framework for VR applications in clinical neuropsychology, summarized as an easy-to-use checklist (VR-Check). This framework rests on 10 main evaluation dimensions encompassing cognitive domain specificity, ecological relevance, technical feasibility, user feasibility, user motivation, task adaptability, performance quantification, immersive capacities, training feasibility, and predictable pitfalls. We show how VR-Check enables systematic and comparative paradigm optimization by illustrating its application in an exemplary research project on the assessment of spatial cognition and executive functions with immersive VR. This application furthermore demonstrates how the framework allows researchers to identify across-domain trade-offs, makes deliberate design decisions explicit, and optimizes the allocation of study resources. Complementing recent approaches to standardize clinical VR studies, the VR-Check framework enables systematic and project-specific paradigm optimization for behavioral and cognitive research in neuropsychology.
1 August 2003 in International Journal of Psychology
Successful prospective remembering (PR) comprises at least two components: one retrospective component that refers to the encoding and retrieval of the content of the intention and a second prospective component that involves the retrieval of the intended action at the appropriate moment. Whereas the retrospective component is very similar to memory skills like learning and retention of new information, the prospective component is thought to rely mainly on executive function. Head injuries can disturb PR during both of these stages. To disentangle the relative impact of executive functions and retrospective memory processes on PR we embedded a PR task in a 2‐back verbal working memory paradigm. Fifty‐six neurological patients with brain damage of various aetiologies were divided pre‐experimentally into four groups on the basis of their delayed recall Index in the Wechsler Memory Scale‐Revised (WMS‐R, indicating absence or presence of deficits in retrospective memory functions) and their age‐corrected score in the Behavioural Assessment of the Dysexecutive Syndrome (BADS, indicating absence or presence of deficits in executive functions). Additionally, 19 controls matched for age and education were examined. We found that patients with deficits in executive functions detected fewer cues than any other group irrespective of their retrospective memory performance. However, eight patients with severe anterograde memory deficits could retain neither the intention nor its content. Thus, intactness of the retrospective component seems to be a necessary but not sufficient prerequisite for successful prospective remembering. For the execution of the intended action itself executive functions play a critical role.
This study introduces a 3-week group program designed for patients with neurocognitive post-COVID-19 syndrome (PCS). The program represents a combination of evidence-based components of neurorehabilitation and cognitive behavioral therapy (CBT). Following a detailed assessment, we develop a personalized bio-psycho-social model that integrates perceived complaints and identifies modifiable and influencing factors. We employed physiotherapeutic, cognitive, and communicative training methods to improve patients’ awareness of energy limits and implement compensatory strategies, including pacing and mindfulness techniques. N = 33 patients completed the program between June 2021 and November 2022. A pre-post comparison of questionnaire-based self-assessments revealed significant positive effects on mood, self-efficacy, and participation but not on fatigue symptoms. The study provides recommendations for the neuropsychological treatment of patients with PCS.
The WHO Dementia Global Action Plan states that rehabilitation services for dementia are required to promote health, reduce disability, and maintain quality of life for those living with dementia. Current services, however, are scarce, particularly for people with young-onset dementia (YOD). This article, written by an international group of multidisciplinary dementia specialists, offers a three-part overview to promote the development of rehabilitation services for YOD. Firstly, we provide a synthesis of knowledge on current evidence-based rehabilitative therapies for early-onset Alzheimer’s disease (EOAD), behavioural variant frontotemporal dementia (bvFTD), primary progressive aphasia (PPA), and posterior cortical atrophy (PCA). Secondly, we discuss the characteristics of rehabilitation services for YOD, providing examples across three continents for how these services can be embedded in existing settings and the different roles of the rehabilitation multidisciplinary team. Lastly, we conclude by highlighting the potential of telehealth in making rehabilitation services more accessible for people with YOD. Overall, with this paper, we aim to encourage clinical leads to begin introducing at least some rehabilitation into their services, leveraging existing resources and finding support in the collective expertise of the broader multidisciplinary dementia professional community.
1 January 2010 in Zeitschrift für Neuropsychologie
Die wichtigsten Empfehlungen auf einen Blick Diagnostik: Die Untersuchung von Gedächtnisstörungen erfordert mindestens ein Verfahren zur Erfassung der Gedächtnisspanne und des Arbeitsgedächtnisses sowie je ein Verfahren zur Untersuchung der unmittelbaren und verzögerten Reproduktion verbaler und figuraler Informationen. Darüber hinaus wird eine Untersuchung des Lernprozesses im Rahmen eines Lernparadigmas (z. B. Wortlisten-Lernen) empfohlen (A). Für die Untersuchung des für den Alltag so relevanten prospektiven Gedächtnisses sind vor allem die Verhaltensbeobachtung und die systematische Befragung z. B. mit Hilfe von Fragebögen von Bedeutung (B). Therapie: (1) Am Anfang der Therapie in der Frühphase steht häufig das Orientierungstraining. (2) Bei Patienten, bei denen die Diagnostik Hinweise auf eine erhaltene Konsolidierung gibt und bei denen der Rehabilitationsverlauf noch offen ist, wird empfohlen, internale Gedächtnisstrategien intensiv zu üben, um die Enkodierungsleistung zu verbessern (A). Für die Wirkung eines übenden Funktionstrainings, bei dem möglichst viele Informationen «auswendig gelernt» werden müssen, gibt es hingegen keine Evidenz. (3) Darüber hinaus ist die Behandlung der Gedächtnisstörung an den Alltagsanforderungen des Patienten zu orientieren und für spezifische gedächtnisrelevante Situationen sind Kompensationsstrategien zu erarbeiten (A). Ob die Patienten lediglich lernen können, auf externe Hilfen, die sie von Angehörigen oder Pflegepersonen erhalten, adäquat zu reagieren, oder ob sie diese selbstständig nutzen können, muss im Einzelfall im Therapieverlauf entschieden werden.
1 September 2022 in Zeitschrift für Neuropsychologie
Zusammenfassung: Die vorliegende Arbeit untersucht die aktuelle wissenschaftliche Evidenz zur Diagnostik und Therapie neuropsychologischer Störungen nach Hirnschädigung, wie sie bis 2020 in Leitlin... Guideline-Based Standards for the Structural and Process Quality of Neuropsychological Diagnostics and Therapy Recent years have seen the establishment of evidence-based guidelines for ne...