What is the role of visual-haptic intervention in cognitive assessment, modifications and restraining?

Updated: Aug 20, 2019
  • Author: Morris Steffin, MD; Chief Editor: Jonathan P Miller, MD  more...
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Theoretically, neuroplasticity can extend into sensorimotor performance and into cognitive realms. Application of virtual reality (VR) techniques can be useful in providing standardization for neuropsychological testing and in developing more encompassing environments for retraining.

Moreover, the immersive environments that can be generated with VR allow development of neuropsychological test tasks that emulate necessary behavioral and cognitive performance requirements in the real world with greater fidelity than currently provided by available instruments. Such approaches should allow a high degree of interexamination standardization.

As a result of these unique capabilities, VR is finding a therapeutic role in several cognitive disorders. At present, the long-term effect of visuomotor interventions on cognitive systems remains, to a great extent, unexplored territory. Some attempts have been made to influence task-related performance, for example, in patients with traumatic brain injury; results, however, remain uncertain.

The exact extent to which the motor component, as distinct from the sensory component, of the VR milieu can alter behavior is in the early stages of investigation. Some interactions will be determined by closing the VR-patient loop. Independent, objective measurements of patient attention are needed to assess the cognitive effects of VR intervention and to provide feedback for modification of stimulation characteristics. Increasing the richness and versatility of stimulation modes and measurement responses will involve interaction of haptic and sensory modalities, hopefully with enhanced patient motivation.

Evaluations of cognitive performance based on overt performance and measurements such as event-related potentials (ERPs) are likely to form the basis for training feedback systems. Assessment of attention and motivation, aided by such measures, will determine at least some of the parameters of the haptic interaction of VR training systems with patients. Following is a survey of some of these cognitive measures, including ERPs and functional MRI (fMRI), and some likely directions their evolution will take in the context of VR interventions for the treatment of cognitive disorders.

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