Background: Cognitive training can potentially prevent cognitive decline. However, the results of recent studies using semi-immersive virtual reality (VR)-assisted cognitive training are inconsistent. Objective: We aimed to examine the hypothesis that cognitive training using fully immersive VR, which may facilitate visuospatial processes, could improve visuospatial functioning, comprehensive neuropsychological functioning, psychiatric symptoms, and functional connectivity in the visual brain network in predementia. Methods: Participants over 60 years old with subjective cognitive decline or mild cognitive impairment from a memory clinic were randomly allocated to the VR (n=23) or the control (n=18) group. The VR group participants received multidomain and neuropsychologist-assisted cognitive training in a fully immersive VR environment twice a week for 1 month. The control group participants did not undergo any additional intervention except for their usual therapy such as pharmacotherapy. Participants of both groups were evaluated for cognitive function using face-to-face comprehensive neuropsychological tests, including the Rey-Osterrieth Complex Figure Test (RCFT) copy task; for psychiatric symptoms such as depression, apathy, affect, and quality of life; as well as resting-state functional magnetic resonance imaging (rsfMRI) at baseline and after training. Repeated-measures analysis of variance was used to compare the effect of cognitive training between groups. Seed-to-voxel–based analyses were used to identify the cognitive improvement–related functional connectivity in the visual network of the brain. Results: After VR cognitive training, significant improvement was found in the total score (F1,39=14.69, P=.001) and basic components score of the RCFT copy task (F1,39=9.27, P=.005) compared with those of the control group. The VR group also showed improvements, albeit not significant, in naming ability (F1,39=3.55, P=.07), verbal memory delayed recall (F1,39=3.03, P=.09), and phonemic fluency (F1,39=3.08, P=.09). Improvements in psychiatric symptoms such as apathy (F1,39=7.02, P=.01), affect (F1,39=14.40, P=.001 for positive affect; F1,39=4.23, P=.047 for negative affect), and quality of life (F1,39=4.49, P=.04) were found in the VR group compared to the control group. Improvement in the RCFT copy task was associated with a frontal-occipital functional connectivity increase revealed by rsfMRI in the VR group compared to the control group. Conclusions: Fully immersive VR cognitive training had positive effects on the visuospatial function, apathy, affect, quality of life, and increased frontal-occipital functional connectivity in older people in a predementia state. Future trials using VR cognitive training with larger sample sizes and more sophisticated designs over a longer duration may reveal greater improvements in cognition, psychiatric symptoms, and brain functional connectivity. Trial Registration: Clinical Research Information Service KCT0005243; https://tinyurl.com/2a4kfasa

This is the abstract only. Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.

中文翻译：

---

完全沉浸式虚拟现实中的认知训练对痴呆症前期视觉空间功能和额枕部功能连接的影响：随机对照试验

背景：认知训练可以潜在地防止认知能力下降。然而，最近使用半沉浸式虚拟现实 (VR) 辅助认知训练的研究结果并不一致。目的：我们旨在检验使用完全沉浸式 VR 进行认知训练的假设，这可能会促进视觉空间过程，可以改善视觉空间功能、综合神经心理功能、精神症状和痴呆前期视觉大脑网络的功能连接。方法：来自记忆诊所的 60 岁以上患有主观认知能力下降或轻度认知障碍的参与者被随机分配到 VR（n=23）或对照组（n=18）。VR 组参与者在完全沉浸式 VR 环境中接受多领域和神经心理学家辅助的认知训练，每周两次，持续 1 个月。对照组参与者除了药物治疗等常规治疗外，没有接受任何额外的干预。使用面对面的综合神经心理学测试对两组参与者的认知功能进行评估，包括 Rey-Osterrieth 复杂图形测试 (RCFT) 复制任务；精神症状，如抑郁、冷漠、情感和生活质量；以及基线和训练后的静息状态功能磁共振成像 (rsfMRI)。重复测量方差分析用于比较组间认知训练的效果。基于种子到体素的分析用于识别大脑视觉网络中与认知改善相关的功能连接。结果：经过VR认知训练后，RCFT复制任务的总分（F1,39=14.69，P=.001）和基本成分得分（F1,39=9.27，P=.005）均显着提高。对照组的那些。VR 组在命名能力 (F1,39=3.55, P=.07)、言语记忆延迟回忆 (F1,39=3.03, P=.09) 和音素流畅性 (F1, 39=3.08，P=.09）。精神症状的改善，例如冷漠 (F1,39=7.02, P=.01)、情感（F1,39=14.40, P=.001 表示积极情感；F1,39=4.23, P=.047 表示消极情感）和生活质量 (F1,39=4.49, P=.04) 在 VR 组中发现与对照组相比。与对照组相比，VR 组中 rsfMRI 显示的 RCFT 复制任务的改进与额枕部功能连接性增加有关。结论：完全沉浸式 VR 认知训练对处于痴呆前期状态的老年人的视觉空间功能、冷漠、情感、生活质量和增加的额枕部功能连接具有积极影响。未来在更长时间内使用更大样本量和更复杂设计的 VR 认知训练的试验可能会揭示认知、精神症状和大脑功能连接的更大改善。试验注册：临床研究信息服务 KCT0005243；https://tinyurl.com/2a4kfasa 并且增加了处于痴呆前期状态的老年人的额枕部功能连接。未来在更长时间内使用更大样本量和更复杂设计的 VR 认知训练的试验可能会揭示认知、精神症状和大脑功能连接的更大改善。试验注册：临床研究信息服务 KCT0005243；https://tinyurl.com/2a4kfasa 并且增加了处于痴呆前期状态的老年人的额枕部功能连接。未来在更长时间内使用更大样本量和更复杂设计的 VR 认知训练的试验可能会揭示认知、精神症状和大脑功能连接的更大改善。试验注册：临床研究信息服务 KCT0005243；https://tinyurl.com/2a4kfasa

这只是摘要。阅读 JMIR 网站上的完整文章。JMIR 是互联网时代电子健康和医疗保健领域领先的开放获取期刊。