Wayfinding Intervention in High-Fidelity Long-Term Memory
Condition: Long-Term Memory Decline; Mild Cognitive Impairment
MeSH terms: Cognitive Dysfunction
Study type: Interventional

Summary: 
      Therapeutic treatment is yet available for declining memory, which is an impairment affecting
      the quality of life for many older adults and patients with cognitive impairment. Cognitive
      training with an immersive video game promises to drive hippocampal-cortical plasticity and
      associated gains that can restore memory capability or provide therapeutic treatment for
      memory deficits.
    

Detailed description: 
      A hallmark of higher cognition is the capability for flexible association of diverse bits of
      information stored in memory, such that experiences can be remembered in detailed and
      distinct terms (i.e., high-fidelity long-term memory (LTM)). Interventions capable of
      sustaining improved learning and flexible association of new information into LTM remain
      elusive. Interventions have yet to be developed to attenuate the decline of high-fidelity LTM
      in normal aging or provide therapeutic treatment for patients with cognitive impairment
      without dementia (i.e., MCI).

      This project applies a translational neuroscience approach in development of a cognitive
      training intervention that targets sustained improvement in capabilities for LTM and
      cognitive control. Treatments use commercially available head-mounted display Virtual Reality
      (VR) technology and tablet computers to present a deeply immersive spatial wayfinding video
      game. Based on preliminary results, the hypothesis is that immersion in a game to navigate
      errands through unfamiliar, visually complex neighborhoods (i.e., wayfinding) will be an
      effective means to environmental enrichment, which refers to a process whereby new and
      complex experiences bring change to brain and behavior.

      The significance of this platform is from the effects in brain and behavior arising from
      cognitive training, which can generalize to improvements in untrained capability for
      high-fidelity LTM. Research in rodents and humans shows that learning a new, enriched
      environment spurs the healthy function of the hippocampus and supports lifelong neurogenesis.
      Adult-borne hippocampal neurogenesis has been linked as the neurobiological basis for the
      formation of new, high-fidelity memories.

      The Labyrinth spatial wayfinding game was developed in-house to incorporate full scientific
      rigor, as with procedures in any properly controlled behavioral experiment. The game uses 3D
      and 2.5D computer graphics tools, as well as numerous levels of adaptive challenge, to
      deliver a dynamic, engaging experience for participants throughout the training regimen.
      Training can be administered with and without participant ambulation in movement through
      wayfinding runs.

      A participant's pre- and post-training assessments will occur promptly before and after their
      15 to 20-hour training regimen, including collection of functional MRI (fMRI) and structural
      MRI data. Cognitive outcome measures will assess capabilities for high-fidelity LTM
      retrieval.

      The a priori hypothesis is that effectiveness of the wayfinding game intervention would be
      evidenced by post-training improvements in retrieval of high-fidelity LTM and associated
      cognitive control capabilities. FMRI results associated with the measured cognitive
      improvements will localize changes in functional brain networks that support gains in memory
      capabilities. Structural MRI measures will assess morphometric and volumetric changes from
      pre- to post-training assessments.
    

Intervention name(s): LabyrinthVR; Placebo Games; Coherence; Tablet
Intervention type(s): Device; Device; Device; Device
Intervention description(s): Head-mounted display virtual reality game designed to induce environmental enrichment in an adaptive, immersive regimen of wayfinding in novel urban and village neighborhoods.; Commercially-available, narrative computer games marketed as cognitively enriching.; Head-mounted display virtual reality game designed to present an adaptive rhythm training routine.; Tablet computer playing Labyrinth VR game but in 2.5D
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Basic Science
Keywords: amnestic MCI without dementia; cognitive training