Wayfinding Intervention and Long-Term Memory

Virtual Reality Interventions to Stimulate Capabilities for Learning and Retrieval of High-Fidelity Memory

Sponsors

Lead Sponsor: University of California, San Francisco

Source University of California, San Francisco
Brief 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). Interventions capable of sustaining improved learning and flexible association of new information into long-term memory (LTM) have shown promising pilot results, and further development is expected to find treatments 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 further development of a cognitive training intervention that targets sustained improvement in capabilities for long-term memory (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. Research in 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 significance of this project includes functionality for remote training procedures (i.e., at home). The availability for participants to complete some of the experiment procedures at home will expand enrollment opportunities and prove the practicality of the intervention outside of a clinical setting. The Labyrinth spatial wayfinding game uses 3D and 2.5D computer graphics tools to present dozens of levels of adaptive challenge and deliver a dynamic, engaging experience for participants throughout the training regimen. In this project, participants will effect game movement using hand controllers while playing the game in a seated position. For each participant, pre- and post-training assessments will occur promptly before and after their 15 to 20-hour training regimen. Cognitive outcome measures will assess capabilities for high-fidelity LTM retrieval and control of sustained visual attention, and some measures will include collection of associated functional MRI (fMRI) and structural MRI data. Effectiveness of the wayfinding game intervention will be evidenced by post-training improvements in retrieval of high-fidelity LTM and 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.

Overall Status Recruiting
Start Date 2023-02-01
Completion Date 2025-05-31
Primary Completion Date 2025-05-31
Phase N/A
Study Type Interventional
Primary Outcome
Measure Time Frame
MDT change in mnemonic discrimination baseline immediately before (T1) and post-assessment immediately after training regimen is completed (T2) providing for a composite score T2-T1
TOUR change in recall baseline immediately before (T1) and post-assessment immediately after training regimen is completed (T2) providing for a composite score T2-T1
Volumetric-based brain morphometry for gray and white matter collected in association with Outcome 1, at baseline immediately before (T1) and post-assessment immediately after training regimen is completed (T2)
Task-based cortical functional connectivity associated with mnemonic discrimination capability and in control of sustained visual attention collected in association with Outcome 1, at baseline immediately before (T1) and post-assessment immediately after training regimen is completed (T2)
Secondary Outcome
Measure Time Frame
Remote Cognitive Module (RCM) baseline immediately before training regimen begins
Enrollment 200
Condition
Intervention

Intervention Type: Behavioral

Intervention Name: LabyrinthVR software

Description: Head-mounted display virtual reality game designed to induce environmental enrichment in an adaptive, highly engaging regimen of wayfinding in novel urban and village neighborhoods.

Arm Group Label: LabyrinthVR Scoot

Intervention Type: Behavioral

Intervention Name: Placebo Games software

Description: Commercially-available, narrative computer games marketed as cognitively enriching. Can be tablet-based or wireless VR headset-based.

Arm Group Label: Placebo Controls

Intervention Type: Behavioral

Intervention Name: Labyrinth Tablet software

Description: Tablet computer playing Labyrinth spatial wayfinding game in 2.5D

Arm Group Label: Labyrinth Tablet

Intervention Type: Behavioral

Intervention Name: Labyrinth VR wireless

Description: Wireless head-mounted display virtual reality game designed to induce environmental enrichment in an adaptive, engaging regimen of wayfinding in novel urban and village neighborhoods.

Arm Group Label: Labyrinth VR wireless

Eligibility

Criteria:

Inclusion Criteria: - fluent speakers of English - completed 12 or more years of education - normal or corrected-to-normal vision - dexterity to comfortably operate the scanner-compatible response box - freedom from physical and neurological conditions contra-indicated for fMRI - must confirm physical stamina and comfort for semi-weekly brisk 30-minute walks on level ground Exclusion Criteria: - use of psychotropic medications - history of concussions or dizziness, vestibular or balance problems - significant discomfort with virtual reality experiences

Gender:

All

Minimum Age:

60 Years

Maximum Age:

85 Years

Healthy Volunteers:

Accepts Healthy Volunteers

Overall Official
Last Name Role Affiliation
Peter E Wais, PhD Principal Investigator Neuroscape, Department of Neurology
Overall Contact

Last Name: Melissa Arioli

Phone: 415-502-7321

Email: [email protected]

Location
Facility: Status: Contact: Investigator: UCSF Mission Bay Melissa Arioli 415-502-7321 [email protected] Peter E Wais, PhD Principal Investigator
Location Countries

United States

Verification Date

2022-11-01

Responsible Party

Type: Sponsor

Keywords
Has Expanded Access No
Condition Browse
Number Of Arms 4
Arm Group

Label: LabyrinthVR Scoot

Type: Experimental

Description: 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.

Label: Placebo Controls

Type: Placebo Comparator

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

Label: Labyrinth Tablet

Type: Experimental

Description: 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.

Label: Labyrinth VR wireless

Type: Experimental

Description: 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.

Acronym LABYR Tablet
Patient Data No
Study Design Info

Allocation: Randomized

Intervention Model: Parallel Assignment

Primary Purpose: Basic Science

Masking: Double (Participant, Outcomes Assessor)

Masking Description: After recruitment, participants are randomly assigned to treatment arms. Participants and experimenters with whom participants interact during the experiments are blind to the purpose of the randomly-assigned arm. First-level analysis performed blind to participant's treatment arm.

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