Virtual Reality-Based Cognitive Training Enhances Bilateral Hippocampal Functional Connectivity
Poster No:
84
Submission Type:
Abstract Submission
Authors:
Eek-Sung Lee1, Seunghee Na2
Institutions:
1Soonchunhyang University Bucheon Hospital, Bucheon, Korea, Republic of, 2Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea, Republic of
First Author:
Co-Author:
Seunghee Na
Incheon St. Mary’s Hospital, The Catholic University of Korea
Incheon, Korea, Republic of
Incheon St. Mary’s Hospital, The Catholic University of Korea
Incheon, Korea, Republic of
Introduction:
Recent studies have demonstrated that multimodal cognitive training can effectively prevent cognitive decline in at-risk populations. However, despite various cognitive training approaches being studied, the neural mechanisms underlying their effectiveness remain unclear. Therefore, this study investigated how a virtual reality (VR)-based multimodal cognitive training program affects functional brain connectivity and cognitive performance in mild cognitive impairment (MCI) patients.
Methods:
This study included 32 participants from the Precision Medicine Platform for MCI study, a prospective community-based cohort. Participants were diagnosed with MCI according to Petersen's criteria using the Korean version of the Clinical and Neuropsychological Assessment Battery (CERAD-K). The criteria included: memory complaint, objective memory impairment (1.5 standard deviations below age/education/sex norms on CERAD-K memory tests), normal general cognitive function, normal activities of daily living, and absence of dementia. Exclusion criteria included major psychiatric disorders, uncontrolled medical conditions, MRI contraindications, and significant brain injury history. The study was approved by the Institutional Review Board of Soonchunhyang University Bucheon Hospital. The VR cognitive intervention consisted of a 12-week program with twice-weekly 50-minute sessions using a Pico NEO 3 Eye VR system. Each session included cognitive stimulation (30 minutes), physical exercise (16 minutes), and meditation (2 minutes). Outcomes were assessed at baseline and post-intervention using the Seoul Cognitive Status Test (SCST), which evaluates five cognitive domains: attention, language, visuospatial function, memory, and executive function. The SCST provides standardized scores (0-100) with domain-specific weights. Additional assessments included depression (Geriatric Depression Scale), anxiety (Geriatric Anxiety Inventory), quality of life, dizziness (UCLA-DQ), and simulator sickness (SSQ). Caregivers evaluated daily living activities (K-IADL) and neuropsychiatric symptoms. Resting-state fMRI scans were performed at baseline and post-intervention using a 3T Magnetom Skyra system. Functional connectivity analysis used the CONN toolbox with standard preprocessing steps and the Harvard-Oxford atlas (132 ROIs). ROI-to-ROI analysis was conducted using threshold-free cluster enhancement (TFCE) with family-wise error correction (p < 0.05, 1,000 permutations). Statistical analysis employed Wilcoxon signed-rank tests for neuropsychological scores and Mann-Whitney tests for SSQ comparisons between first and final weeks.
Results:
Twenty-eight of 32 enrolled MCI patients completed the 12-week VR-based cognitive training program (87.5% females; mean age 73.21 ± 4.20 years; education 8.61 ± 4.55 years). Four participants withdrew due to poor vision (n=1) or withdrew consent (n=3). Primary cognitive outcomes showed significant improvements in SCST scores. The total composite score increased from 49.04 ± 9.15 to 52.96 ± 9.53 (p < 0.0001), and the memory-composite score improved from 51.36 ± 35.98 to 66.44 ± 31.40 (p = 0.0037). Secondary outcomes, including depression, anxiety, neuropsychiatric symptoms, and daily living activities, showed no significant changes. While UCLA-DQ scores remained stable (p > 0.05), SSQ scores significantly decreased from the first to the twelfth week, indicating improved tolerance to VR. Functional connectivity analysis revealed significantly increased connectivity (TFCE = 95.77; p-FWE = 0.032) in a cluster encompassing bilateral hippocampus, parahippocampal gyrus, posterior cerebellum, and amygdala regions, areas crucial for episodic memory processing (figure).
·Figure. Increased functional connectivity post-cognitive training
Conclusions:
In conclusion, our study provides evidence that VR-based multimodal cognitive training can enhance both cognitive performance and functional connectivity in memory-related brain regions in MCI patients.
Brain Stimulation:
Non-Invasive Stimulation Methods Other 2
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 1
Keywords:
Aging
FUNCTIONAL MRI
Memory
1|2Indicates the priority used for review
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Provide references using APA citation style.
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