Cognitive Exercising for Patients with MCI Using Serious Games: Design of a Pilot Study

Cognitive Exercising for Patients with MCI Using Serious Games: Design of a Pilot Study

Ioannis Tarnanas (Gerontechnology and Rehabilitation Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Switzerland), Apostolis Tsolakis (Aristotle University of Thessaloniki, Polytechnic School, Thessaloniki, Greece) and Magda Tsolaki (3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki, Greece)
DOI: 10.4018/978-1-4666-8234-4.ch005
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In this chapter we demonstrate how older adults can benefit from novel technologies. One hundred and fourteen patients with MCI according to the revised Petersen criteria (Petersen, 2006), aged between 65 and 88 years, were recruited to participate in a Serious Game training (SG) and an Active Control group (AC). They benefited from neuropsychological testing and electroencephalography before and after the intervention. Our results showed that the SG group improved performance in specific cognitive functions such as working memory, dual task performance and visual conjunction search. The performance improvement was also supported only at the SG group by increased amplitude of the Event Related Potentials extracted from the electroencephalography measures.The results from our study suggest that older adults do not need to be technologically savvy to benefit from virtual reality training.
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Individuals With Mild Cognitive Impairment

The concept of Mild Cognitive Impairment (MCI) was derived from milder cases of dementia and not Alzheimer’s disease (AD). MCI encompasses patients with and without memory impairment. Of those with memory loss, some have memory impairment as their only deficit [amnestic MCI single domain (aMCIs)], whereas others have impairments of memory loss plus changes in other cognitive domains [amnestic MCI multiple domain (aMCImd) (Petersen et al., 1999). Multiple-domain MCI is more common than pure amnestic type MCI and is characterized by slight impairment in more than one cognitive domain but of insufficient severity to constitute dementia (Gauthier et al., 2006). Of those without any memory loss, some patients have deficits in one domain only, such as executive functions, apraxia or aphasia. Or they may have deficits in several domains, excluding memory (Petersen, 2004). These prodromal states may progress to non-AD dementias, such as vascular dementia, frontotemporal dementia, Lewy body dementia, primary progressive aphasia, or corticobasal degeneration (Winblad et al., 2004).

Key Terms in this Chapter

LORETA (Low Resolution Brain Electromagnetic Tomography): Is a technique for functional imaging of the human brain that computes the three dimensional distribution of electric neuronal activity (throughout cortical grey matter) from non-invasive measurements of scalp electric potential differences (EEG: electroencephalogram), with high time resolution in the millisecond range.

Executive Functions (EF): Is an umbrella term for the management (regulation, control) of cognitive processes, including working memory, reasoning, task flexibility and problem solving as well as planning and execution.

Serious Games (SG): Are simulations of real-world events or processes designed for the purpose of solving a problem.

Electroencephalography (EEG): Is the recording of voltage fluctuations resulting from ionic current flows within the neurons of the brain.

Event-Related Potentials (ERPs): Is the measured brain response that is the direct result of a specific sensory, cognitive or motor event.

Virtual Reality (VR): Sometimes referred to as immersive multimedia, is a computer simulated environment that can simulate physical presence in places in the real world or imagined worlds.

Cognitive Stimulation (CS): Is a reinforced cognitive intervention that strengthens the cognitive functions.

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