Project

Virtual Reality based Evaluation of Mental Disorders – VRMIND

Goal: El proyecto “Virtual Reality based Evaluation of Mental Disorders – VRMIND”. Es un proyecto europeo que ha sido concedido a Nesplora. Este proyecto es cofinanciado por la Unión Europea bajo el programa H2020-SMEInst-2016-2017, dentro del Topic SMEInst-01-2016-2017 (GA: 733901). Duración: Septiembre 2016 – Agosto 2018

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MOTIVATION FOR THE STUDY It is an acclaimed necessity that performance tests in any domain include an integrated performance validity subtest as suboptimal effort is a stumbling block to accurate assessment, especially in compensation-seeking individuals (Bashem, 2022). As has been advocated for the past two decades, the use of psychometric indicators is the most valid approach to identify neuropsychological response validity, as well as independent effort measures and embedded validity indicators (EVI). Employing an EVI constructed by the test authors, or by the owners of the commercial operation, rather than relying on external validators, represents a methodological advance, as it reduces the level of inference involved in determining the validity of a given test score (Erdodi, 2014). Analysing patterns of performance within the instrument to establish the credibility of the response set seems to be a logical approach in assessing performance validity, although for more demanding domains highly sensitive measures may be needed in addition to the embedded ones (Bussé, 2012).
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Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is highly prevalent in children and adolescents, with estimated prevalence ranges from 5.9 to 7.1% globally and 1 to 6.8% in Spain. This has commonly been associated with deficits in attention threads and executive functions. This paper aims to study the cognitive-executive performance of adolescents between the ages of 17 and 23 with an ADHD diagnosis, relative to a control group. The total sample consisted of 120 male participants who were given the Nesplora Aquarium test. Dual execution tasks assessed attention, response speed, and inhibition capability. When comparing the experimental and control groups, statistically significant differences were detected in processing speed, selective attention, and cognitive inhibition [general execution (T_correct_n) (p ¼ 0.008), attention arousal (T_omission_n) (p ¼ 0.008), and processing speed (T_correctreactime_mean) (p ¼ 0.008)]. We demonstrate that a new virtual reality tool, designed to measure attention in people over the age of 16 years, is effective at measuring attention and working memory. In addition, item difficulty and discrimination values were also acceptable.
NESPLORA AQUARIUM: Through different Continuous Performance Test (CPT) paradigms, Nesplora Aquarium collects in 20 minutes reliable information about: sustained and selective attention, visual and auditory attention, working memory, inhibitory control, switching and perseveration, reaction time and motor activity. In addition to its usefulness for the detection of ADHD in adults, Nesplora Aquarium provides relevant information for a multitude of pathologies such as depression, acquired brain injury and other pathologies of mental health in adults, since it is an extremely sensitive test to the attentional processes of any nature. Nesplora Aquarium provides the opportunity to measure attentional processes within sensory modality as in hearing, and seeing, and across sensory modality, hearing and seeing, or seeing and hearing.
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El objetivo de este estudio es analizar la estructura factorial de la prueba Nesplora Aquarium. 882 personas entre las edades de 16 y 60 fueron evaluadas. Se trata de un Test de Ejecución Continua (CPT) de tres tareas: una tarea AX y dos tareas XNO Dual donde se presentan estímulos visuales y auditivos. Sólo se tuvieron en cuenta algunas de las principales variables. La solución explicó el 68% de la varianza y se componía de tres factores: arousal atencional, velocidad de respuesta y consistencia, y control inhibitorio y capacidad de switching. El análisis posterior se ha llevado a cabo con una muestra compuesta por 1425 personas entre las edades de 16 y 90 años (M=44,4; DT=20,7; mujeres: 57,5%). Se han analizado las principales medidas de ambas tareas de evaluación de ejecución dual (omisiones, comisiones, tiempo de reacción, desviación estándar del tiempo de reacción y switching), lo que explica el 76,3% de la varianza. Se observan tres factores: arousal atencional y switching, atención sostenida y control inhibitorio. Los resultados de este estudio respaldan la evidencia de que Nesplora Aquarium puede evaluar la atención y sus diferentes componentes.
Los objetivos principales de este estudio son verificar la utilidad de la prueba Nesplora Aquarium para discernir entre personas con diagnóstico de trastorno por déficit de atención con/sin hiperactividad (TDAH) y sin él y, analizar el perfil atencional de ambos grupos. La muestra está compuesta por 47 personas, 25 con diagnóstico de TDAH y 22 controles. A todos los participantes se les administró el test Nesplora Aquarium para evaluación de la atención y memoria de trabajo en adultos. Los resultados muestran que existe un rendimiento del grupo clínico significativamente más bajo en comparación con el grupo control en la variable indicadora de inatención. Por otro lado se ha observado que en la tarea Xno el tiempo de reacción (TR) en comisiones del grupo clínico es más lento que el grupo control. Esto indica que las comisiones realizadas durante la prueba se deben a inatención y no a impulsividad. En la tarea Xno + i existe una diferencia significativa en la calidad del foco atencional. El grupo clínico tiene peor calidad del foco atencional, es decir, aun con el foco bien dirigido a los estímulos visuales, cometen más errores, puede ser indicador de inatención por estímulos internos de la personas.
The main objectives of this study are to verify the usefulness of the Nesplora Aquarium test for discerning between people with and without attention deficit disorder with/without hyperactivity (ADHD), and to analyse the attentional profile of both groups. The sample is made up of 47 people, 25 with ADHD diagnosis and 22 controls. All participants were administered the Nesplora Aquarium test for evaluation of attention and working memory in adults. The results show that there is a significantly lower clinical group performance compared to the control group in the inattention indicator variable. On the other hand it has been observed that in task Xno the reaction time (TR) in commissions of the clinical group is slower than the control group. This indicates that the commissions performed during the test are due to inattention and not impulsivity. In the Xno + i task there is a significant difference in the quality of the attention focus. The clinical group has worse quality of the attention focus, that is to say, even with the focus well directed to the visual stimuli, they commit more errors, it can be an indicator of inattention by internal stimuli of the people.
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Attentional and working memory processes undergo significant changes during different stages of development. However, currently there are not many Continuous Performance tools based on Virtual Reality (VR) for measuring attentional capacity in adults. The present study aimed to obtain normative data for the Nesplora Aquarium VR test in a Spanish population, looking at sex and age variables. In addition, this study also aimed to analyze the psychometric properties of the tool such as scale, internal consistency and item difficulty and discrimination indices. A total of 1469 participants from different regions of Spain (57.6% female) with ages ranging from 16 to 90 years old took part in this normative study. Nesplora Aquarium was developed in order to support clinicians in the assessment of attentional processes and WM in adults over 16 years old. It is an 18-minute individual test performed through a virtual reality (VR) system. The system provides better visual and auditory immersion in the task than computerized CPTs. This study revealed that the new VR tool, designed to measure adult attention and working memory levels, exhibited good psychometric properties related to reliability and internal consistency. In addition, item difficulty and discrimination values were also acceptable.
La valoración de las funciones ejecutivas es un aspecto central de la evaluación neuropsicológica. De cara a una evaluación fiable, la estrategia tradicionalmente seguida para la evaluación de las funciones ejecutivas ha sido su atomización en diferentes subprocesos cognitivos. No obstante, en la práctica clínica, frecuentemente resulta artificiosa la disgregación de un proceso cognitivo global y complejo como éste en infinidad de subcomponentes relacionados. Así, a menudo, las pruebas diseñadas de acuerdo con este paradigma resultan de poco valor para procedimientos clínicos (diagnóstico, diseño de la rehabilitación) por la pobre correspondencia con la realidad clínica del sujeto o paciente. Los objetivos del presente trabajo son revisar el concepto de validez ecológica aplicado a la evaluación de las funciones ejecutivas y hacer una revisión crítica de la valoración de las funciones ejecutivas mediante paradigmas de multitarea como medio de incrementar la validez ecológica y valor predictivo del desempeño funcional del sujeto. Tras un recorrido histórico por la (escasa) validez ecológica de los tests monotarea y la apuesta por un paradigma multitarea para la evaluación de las funciones ejecutivas, se recogen minuciosamente los tests multitarea existentes hasta la fecha (con sus respectivas ventajas e inconvenientes). Se concluye con recomendaciones concretas sobre cómo desarrollar tests multitarea en el futuro, atendiendo a parámetros concretos relacionados con entorno, tareas, objetivos, reglas y puntuaciones.
Miguel Mejías
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Objective assessment of attentional processes has been a problem since lacking of sensitive neuropsychological measures in clinical adult population. Virtual Reality (VR) offers an opportunity to reproduce tested laboratory paradigms into a real simulated situation, providing better ecological validity to the measures collected. In order to integrate a Continuous Performance Test (CPT) in a realistic situation, we created a virtual aquarium, where the subject should perform different “fish-control” tasks in his/her first working day at the aquarium. Visual stimuli consist on fishes which pass through two rocks of the main fish tank, and auditory stimuli are fish names said by the voice-over supervising the task. Pilot studies guided our team to create a task with visual and auditory stimuli where an AX learning paradigm and two Dual Execution assessment tasks are performed, all them integrated into a virtual aquarium. The test provides a complete attentional profile, including switching capacity, working memory and visual/auditory performance. VR technology provides the chance to measure motor activity during the task and the effect of environmental distractors in patient’s performance. Norms for Spanish population from 16 to 90 years old have already been collected (1486 subjects). Studies with depression, anxiety disorders, adult ADHD and schizophrenia patients are currently being performed in order to stablish the clinical validity of the tool.
Introduction The prevalence of mental disorders is estimated at 20% worldwide. The VRMIND project, co-founded by the Horizon 2020 program of the European Union, addresses the evaluation of these disorders. Objectives The objective of this project is to create a platform for neuropsychological evaluation tools in Virtual Reality (VR), both for children and adults. Method With the developed tools, three types of studies are carried out: (1) The Field Trials seek to identify errors in design, usability and measurement of the variables; (2) Normative studies, which establish the normal execution curve for each age group and gender; (3) The objective of clinical studies is to determine the sensitivity and specificity of the tests in different pathologies. The sample is collected and analyzed by Nesplora and by independent collaborators who participate in the project and represent three regions: Europe, Latin America and the United States. Results Within this project, 4 neuropsychological evaluation tools in RV will be developed Nesplora Aula School: it provides reliable and objective information on the attentional profile of schoolchildren between 6 and 16 years old. The report includes psycho-pedagogical guidelines based on the profile. Nesplora Aquarium: evaluates attention and working memory in people over 16 years of age through continuous execution tasks based on XnoDual paradigms. Nesplora Ice Cream is a test that is performed by the executive in adults. Finally, Nesplora Suite evaluates memory and learning processes.
943 309 497 INTRODUCCIÓN Y OBJETIVOS Nesplora Aquarium es un CPT (Continuous Performance Test) en realidad virtual que evalúa atención y memoria de trabajo en adultos. El objetivo es comprobar si existen diferencias significativas en las tareas entre sujetos bilingües y monolingües. MÉTODO La muestra se compone de 1015 personas (57% mujeres) de entre 16 y 91 años con una edad media de 45 años (DT=20,9), de los cuales el 50,3% son monolingües, sin diferencias significativas por edad y nivel educativo entre ambos grupos. Nesplora Aquarium se divide en tres subtareas: un paradigma AX y otras dos XnoDual. RESULTADOS Se ha llevado a cabo una comparación de medias no paramétricas de las principales puntuaciones de la prueba entre ambos grupos. Los resultados indican que no hay diferencias significativas entre la ejecución de los monolingües y los bilingües. CONCLUSIONES Estos resultados están en la línea de investigaciones recientes 1 que no encuentran una ventaja en los bilingües en este tipo de tareas. No obstante, es necesario profundizar en estos resultados. 1. Usabilidad y entrenamiento en realidad virtual: Invita a explorar el entorno para entender el funcionamiento de la realidad virtual y los dispositivos. 2. Tarea 1 paradigma "AX": Se debe responder ante el estímulo diana siempre que vaya precedido por otro estímulo concreto. 3. Tareas 2 y 3 paradigmas "XnoDual": Se debe responder ante todos los estímulos excepto a un visual y auditivo concreto. En la tarea 3 se invierten los estímulos diana. • Respuestas correctas • Omisiones-Inatención • Comisiones-Impulsividad • Tiempo de reacción (TR) • Variabilidad del TR-Fatiga • Memoria de trabajo (Agenda visoespacial + Bucle fonológico) • Switching + perseveración-Adaptación al cambio de tarea
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El proyecto “Virtual Reality based Evaluation of Mental Disorders – VRMIND”. Es un proyecto europeo que ha sido concedido a Nesplora. Este proyecto es cofinanciado por la Unión Europea bajo el programa H2020-SMEInst-2016-2017, dentro del Topic SMEInst-01-2016-2017 (GA: 733901). Duración: Septiembre 2016 – Agosto 2018