Assessment of Attentional and Executive Disorders in Multiple Sclerosis Using Techniques of Virtual Reality
Condition: Relapsing-Remitting Multiple Sclerosis
MeSH terms: Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Sclerosis
Study type: Interventional

Summary: 
      Since many years cognitive disorders are a main topic of clinical research in Multiple
      Sclerosis (MS) as there could be observed early on in the disease and could induce with time
      in patients significant socio-professional burden. Today assessment of cognitive dysfunction
      in MS is still based on traditional pencil-paper task tests which are not able to give a true
      representation of functional burden observed in patients in real life situations. The
      development of new tools close to these "life situations", i.e. more ecological, are needed
      to better assess and take in charge cognitive impairment in MS patients. One way to reach
      this goal is Virtual Reality (VR). VR offers a new human-computer interface paradigm that
      simulates a realistic 3D environment where the user become immersed and interacts with it.
      These last ten years VR has known a rapid development in the health domain and has been
      applied with success to motor rehabilitation, psychiatry and neuropsychology. In this last
      domain, virtual environment (VE) reproducing activities of daily living have been used to
      evaluate executive and memory functions as well as attentional or visuospatial processes.
      Among main VE developed, driving assessment system, navigation skills, cooking behaviors,
      virtual supermarket have shown better sensitivity to detect functional consequences of
      cognitive impairment in various neurological and psychiatric disorders than traditional
      evaluations. In Caen University Hospital, investigators used VE driving system and developed
      the use of the Virtual Action Planning in a supermarket (VAP-S ; Klinger et al 2004) where a
      user move to select and buy groceries and other things inside an interactive virtual
      supermarket using a shopping cart. In a preliminary study investigators have used this
      virtual interactive tool to evaluate executive functioning in small group of Parkinson's
      disease and MS patients. Analysis of initial data shows the feasibility of the VAP-S for use
      with these two kinds of diseases. According to these results investigators planned a new
      study in Relapsing-Remitting(RR)- MS patients where they compare the use of VE (driving
      system and the VAP-S) to traditional attentional and executive evaluation for estimate their
      respective sensitivity to detect cognitive/functional impairment in MS patients.
      Investigators hope to shown that VR will demonstrate its interest to assess cognitive
      functions in MS and to develop cognitive rehabilitation.
    


Intervention name(s): Assessment of attentional functions by traditional tests; Assessment of attentional functions by virtual reality tests; Assessment of executive functions by traditional tests; Assessment of executive functions by virtual reality test; Evaluation of cognitive complaint, fatigue, anxiety and depression
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): For assessment of attentional functions, traditional tests include : Symbol Digit Modalities Test (SDMT), Test d'Evaluation de l'Attention (TEA), Attentional Network Test (ANT).; For assessment of attentional functions, virtual reality tests include : Monotonous task of driving on motorways, Task of city driving with accident scenarios, Monotonous driving task with divided attention test ; all tests realized on a driving simulator.; For assessment of executive functions, traditional tests include : Wisconsin Card Sorting Test (WCST), Task verbal fluencies, Sequence Numbers Letters subtest of the Wechsler Adult Intelligence Scale (WAIS) III, Commissions.; For assessment of executive functions, virtual reality test include : VAP-S.; The following questionnaires will be completed by the participant at the inclusion visit : cognitive complaint RBN-SEP questionnaire to assess cognitive complaint, EMIF-SEP to assess fatigue, STAI (State Trait Anxiety Inventory) to assess anxiety and MADRS to assess depression.
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Relapsing-Remitting MS; cognitive impairment; virtual reality