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. 2024;100(3):923-934.
doi: 10.3233/JAD-240200.

Embodied Spatial Navigation Training in Mild Cognitive Impairment: A Proof-of-Concept Trial

Cosimo Tuena  1   2 , Silvia Serino  3 , Elisa Pedroli  2   4 , Chiara Stramba-Badiale  1 , Karine Marie Goulene  4 , Marco Stramba-Badiale  4 , Giuseppe Riva  1   5
Affiliations

Embodied Spatial Navigation Training in Mild Cognitive Impairment: A Proof-of-Concept Trial

Cosimo Tuena et al. J Alzheimers Dis. 2024.

Abstract

Background: Egocentric and allocentric spatial memory impairments affect the navigation abilities of older adults with mild cognitive impairment (MCI). Embodied cognition research hints that specific aids can be implemented into virtual reality (VR) training to enhance spatial memory.

Objective: In this study, we preliminarily tested 'ANTaging', an embodied-based immersive VR training for egocentric and allocentric memory, compared to treatment as usual (TAU) spatial training in MCI.

Methods: MCI patients were recruited for this controlled trial. A cognitive battery was administered at pre-test, after ten sessions of ANTaging or TAU intervention, and at 3-month follow-up (FU). The primary outcomes were spatial cognition tests (Corsi supra-span, CSS; Manikin test, MT). VR egocentric and allocentric performance was also collected.

Results: We found that ANTaging significantly improved MT scores at FU compared to TAU. CSS slightly improved in both groups. Concerning secondary outcomes, auditory-verbal forgetting significantly improved at post-test in the ANTaging but not TAU group and significantly declined at FU in the TAU but not in the ANTaging group. Global cognition significantly improved at FU for TAU and remained stable for ANTaging. Other tests showed no improvement or deterioration. Clinical significance showed that ANTaging is effective for CSS. Virtual egocentric and allocentric memory performance improved across ANTaging sessions.

Conclusions: ANTaging holds the potential to be superior for improving spatial cognition in MCI compared to TAU. Embodied cognition research provides insights for designing effective spatial navigation rehabilitation in aging.

Keywords: Alzheimer’s disease; dementia; embodied cognition; mild cognitive impairment; rehabilitation; spatial cognition; virtual reality.

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Conflict of interest statement

The authors have no conflict of interest to report.

Figures

Fig. 1
Fig. 1
Encoding virtual environment.
Fig. 2
Fig. 2
Main results of the ANTaging intervention. Positive MT and CSS scores (primary outcomes) indicate improvement, whereas negative SR-F (secondary outcome) score indicates improvement. TAU, treatment as usual; MT, manikin test; CSS, Corsi supra-span test; SR-F, Story recall forgetting. *p<0.05; **p<0.01. Plot shows mean and 95% CI.
Fig. 3
Fig. 3
Intervention effect on egocentric and allocentric spatial memory. Gray shades show standard error.
See this image and copyright information in PMC

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