Immersive Video Games for Cognitive Impairment

(Quest-Tablet Trial)

Overseen By Melissa Arioli

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, San Francisco

Must not be taking: Psychotropic medications

Disqualifiers: Concussions, Dizziness, Balance problems, others

Compensation: Varies

Number of Visits: 2

200 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether immersive video games can improve memory in older adults and those with cognitive impairments. Participants will engage in a special video game, the Wayfinding Intervention, designed to challenge and potentially enhance brain function related to memory. The trial includes various game setups, such as virtual reality and tablet versions, to determine which is most effective. Individuals who have experienced memory issues affecting daily life and feel comfortable using virtual reality or tablets might be suitable for this study. As an unphased study, this trial offers a unique opportunity to explore innovative, non-drug interventions for memory improvement.

Will I have to stop taking my current medications?

If you are taking psychotropic medications (drugs that affect your mind, emotions, or behavior), you will need to stop taking them to participate in this trial.

What prior data suggests that the Wayfinding Intervention is safe for cognitive training?

Research shows that virtual reality (VR) games like LabyrinthVR can improve memory in older adults. These games are designed to enhance brain functions. In past studies, participants who played these VR games experienced better memory without major safety issues. The game was easy to use, and no serious problems were reported.

A tablet version of the Labyrinth game also exists. Studies indicate it helps users improve their navigation skills. This version is safe and easy to use, with no serious side effects noted.

For the wireless VR version, research confirms its safety and effectiveness in improving memory, with no major negative effects reported by users.

In summary, all versions of the Labyrinth game, whether VR or tablet, have been well-received in previous studies and are considered safe for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the innovative approach of using immersive video games to address cognitive impairment. Unlike traditional methods that often involve medication or simple cognitive exercises, these interventions utilize virtual reality (VR) and tablet-based games to create engaging spatial wayfinding challenges. The LabyrinthVR Scoot and Labyrinth VR wireless treatments offer high-resolution, adaptive VR experiences with handheld controllers, which can immerse users in a more interactive way compared to standard therapies. Meanwhile, the Labyrinth Tablet provides a 2.5D gaming experience on a tablet, making it accessible for those who might not have access to VR equipment. This novel use of technology could potentially enhance cognitive engagement and improvement, offering a fresh avenue for treatment that's both fun and effective.

What evidence suggests that this trial's treatments could be effective for cognitive impairment?

Research has shown that immersive video games, like those tested in this trial, may help improve memory in older adults. Participants in this trial may receive the LabyrinthVR Scoot, Labyrinth Tablet, or Labyrinth VR wireless interventions. Studies indicate that playing LabyrinthVR can enhance long-term memory by helping the brain adapt and reorganize, improving memory to levels similar to those of younger adults. Additionally, the Labyrinth Tablet version has improved older adults' ability to navigate spaces, which is important for everyday tasks. These findings suggest that using Labyrinth games could be a promising way to address memory issues. ^{1 3 6 7 8}

Who Is on the Research Team?

Peter E Wais, PhD

Principal Investigator

Neuroscape, Department of Neurology

Are You a Good Fit for This Trial?

This trial is for older adults with memory issues or mild cognitive impairment. Participants must have good vision (with glasses if needed), be fluent in English, have completed at least 12 years of education, and be able to operate a response box. They should also be physically able to take brisk walks and not have conditions that make fMRI scans unsafe.

Inclusion Criteria

Fluent speakers of English

Dexterity to comfortably operate the scanner-compatible response box

Completed 12 or more years of education

Exclusion Criteria

I am taking medication for my mental health.

Significant discomfort with virtual reality experiences

I have had concussions or issues with dizziness and balance.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants undergo a 15 to 20-hour training regimen using virtual reality and tablet-based cognitive interventions

2-3 weeks

Remote training sessions

Post-training Assessment

Pre- and post-training assessments to evaluate cognitive improvements and collect MRI data

1 week

2 visits (in-person)

Follow-up

Participants are monitored for sustained cognitive improvements and any long-term effects

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Wayfinding Intervention

Trial Overview The study tests whether immersive video games can improve memory by changing brain activity. It uses LabyrinthVR software and other similar tools compared against placebo games to see if they can help restore memory functions or provide therapeutic benefits.

How Is the Trial Designed?

Group I: LabyrinthVR Scoot Experimental Treatment 1 Intervention

Multi-session cognitive intervention with VIVE high-resolution head-mounted display virtual reality computer game that presents an adaptive spatial wayfinding challenge. Game movement via handheld controllers.

Group II: Labyrinth VR wireless Experimental Treatment 1 Intervention

Multi-session cognitive intervention with QUEST head-mounted display virtual reality computer game using wireless technology to present an adaptive spatial wayfinding challenge. Game movement via handheld controllers.

Group III: Labyrinth Tablet Experimental Treatment 1 Intervention

Multi-session cognitive intervention with tablet computer, displaying 2.5D version of Labyrinth game in an adaptive spatial wayfinding challenge. Game movement via on-screen control buttons.

Group IV: Placebo Controls Placebo Group 1 Intervention

Multi-session cognitive intervention with handheld tablet or wireless virtual reality headset presentation of commercially available, narrative computer games.

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials

2,636

Recruited

19,080,000+

Published Research Related to This Trial

A study involving 11 neurologic patients with spatial disorientation and 11 healthy controls showed that a VR-based passive navigation training program significantly improved route finding abilities over five training sessions.

Both neurologic patients and healthy controls demonstrated enhanced general spatial cognition after the VR training, suggesting that this method could be effective for rehabilitating spatial deficits caused by brain damage.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality in neurologic rehabilitation of spatial disorientation. Kober, SE., Wood, G., Hofer, D., et al.[2021]

Virtual reality (VR) testing of navigation skills closely correlates with real-world navigation performance in older adults and those with early Alzheimer's disease, indicating that VR can be a valid assessment tool.

Both aging and Alzheimer's disease patients exhibit similar difficulties in self-orientation and scene localization, with Alzheimer's patients also facing challenges in verbal recall, highlighting the risks associated with navigational deficits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Detecting navigational deficits in cognitive aging and Alzheimer disease using virtual reality. Cushman, LA., Stein, K., Duffy, CJ.[2022]

A virtual reality (VR) spatial wayfinding game called Labyrinth-VR was tested on 48 older adults (average age 68.7 years) and showed significant improvements in long-term memory (LTM) capabilities after 12 hours of gameplay over four weeks.

Participants who played Labyrinth-VR achieved memory performance levels comparable to younger adults, indicating that this VR intervention can enhance LTM in older adults and may benefit hippocampal-dependent memory functions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality video game improves high-fidelity memory in older adults. Wais, PE., Arioli, M., Anguera-Singla, R., et al.[2021]

A novel mediated reality wayfinding system was developed to assist individuals with Topographical Disorientation (TD) by providing different types of positional information for indoor navigation.

Among the evaluated tools, the locator and minimap were preferred by users, as they offered the most relevant navigation information while also reducing energy expenditure during navigation tasks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Navigation in smart environments using mediated reality tools. Torres-Solis, J., Guan, M., Biddiss, E., et al.[2009]

A collaborative design approach involving 7 individuals with dementia/MCI, exercise professionals, and game designers led to the creation of a VR exergame called 'Seas the Day', which promotes physical activity tailored for this population.

The study highlights that involving multiple stakeholders in the design process results in more effective and engaging VR games that meet the specific needs of persons living with dementia, demonstrating the potential for personalized health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Immersive Virtual Reality Exergames for Persons Living With Dementia: User-Centered Design Study as a Multistakeholder Team During the COVID-19 Pandemic. Muñoz, J., Mehrabi, S., Li, Y., et al.[2022]

A case study of a man with early Alzheimer's disease showed that he could successfully learn to navigate in a virtual reality environment, indicating potential for cognitive training in AD.

Feedback from his caregiver suggested that this training not only improved his navigation skills in the virtual setting but also translated to real-life benefits, such as better driving skills and overall cognitive improvement at home.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neurocognitive Treatment for a Patient with Alzheimer's Disease Using a Virtual Reality Navigational Environment. White, PJ., Moussavi, Z.[2020]

A virtual reality (VR) technique was developed to assess spatial orientation, showing significant differences in performance between individuals with mild Alzheimer's disease (AD) and those with mild cognitive impairment (MCI), based on a study of 93 participants.

The results indicate that this VR localization method could serve as a quick and effective diagnostic tool to differentiate early stages of AD from MCI, with longitudinal tracking of patients supporting its potential clinical utility.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Egocentric spatial orientation differences between Alzheimer's disease at early stages and mild cognitive impairment: a diagnostic aid. Moussavi, Z., Kimura, K., Lithgow, B.[2022]

Virtual reality (VR) tools can significantly enhance cognitive rehabilitation for individuals with mild cognitive impairment (MCI) and early-stage Alzheimer's disease, addressing the growing need for effective support services for the elderly population.

The immersive and interactive nature of VR technology offers unique advantages in improving daily life activities for those affected by cognitive impairments, suggesting a promising avenue for healthcare and caregiver assistance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using virtual reality for cognitive training of the elderly. García-Betances, RI., Jiménez-Mixco, V., Arredondo, MT., et al.[2022]

Individuals with Alzheimer's disease (AD) or mild cognitive impairment (MCI) showed significantly impaired wayfinding abilities compared to older adults without cognitive impairments, highlighting the challenges they face in navigation.

Using salient cues (like colorful and memorable markers) in a virtual reality simulation improved wayfinding performance for all participants, suggesting that enhancing environments with such cues can help those with AD and MCI navigate more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Salient Cues and Wayfinding in Alzheimer's Disease within a Virtual Senior Residence. Davis, R., Ohman, JM., Weisbeck, C.[2019]

The pilot study involved 27 low-active adults aged 45 to 62 years who participated in a 10-week trial, showing that iPad-enhanced aerobic exercise improved wayfinding self-efficacy, indicating increased confidence in navigation skills.

While the experimental group did not show significant differences in behavioral wayfinding tasks compared to the control group, they performed better on an attentional-control cognitive assessment, suggesting potential cognitive benefits from the virtual reality component of the exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Traditional vs. iPad-Enhanced Aerobic Exercise on Wayfinding Efficacy and Cognition: A Pilot Randomized Controlled Trial. Palac, D., Bullard, T., Cohen, JD., et al.[2020]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05625425

Wayfinding Intervention and Long-Term Memory Multi-session cognitive intervention with tablet computer, displaying 2.5D version of Labyrinth game in an adaptive spatial wayfinding challenge. Game movement ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7844043/

Virtual reality video game improves high-fidelity memory in ... A virtual reality game improved high-fidelity memory in older adults, reaching levels attained by younger adults in another experiment.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC9302894/

Leveraging technology to personalize cognitive ... The results from an intervention trial of Labyrinth showed that healthy OA increased their spatial wayfinding abilities in the game, but more ...

4. aging.jmir.org aging.jmir.org/2023/1/e46177/

Tablet-Based Puzzle Game Intervention for Cognitive Function ... This study aims to investigate the benefits of dynamic adaptive casual puzzle games on cognitive function and well-being in healthy adults and older people.

5. sciencedirect.com sciencedirect.com/science/article/pii/S0747563224002176

Detecting cognitive impairment through an age-friendly ... SPACE is a novel iPad serious game designed to identify differences in spatial ability indicative of early signs of cognitive impairment.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12466985/

Immersive Technologies Targeting Spatial Memory Decline Enhancing spatial navigation skills in mild cognitive impairment patients: A usability study of a new version of ANTaging software. Front ...

7. trialfinder.panfoundation.org trialfinder.panfoundation.org/en-US/trial/listing/369575

Wayfinding Intervention and Long-Term Memory Cognitive training with an immersive video game promises to drive hippocampal-cortical plasticity and associated gains that can restore memory ...

8. clinicaltrials.gov clinicaltrials.gov/study/NCT05468424

Effect of Tablet-Based Games on Executive Functions in ... The purpose of this study is to examine the use of tablet-based (iPad or android) video games as a means of improving executive functions in older adults with ...