INS NYC 2024 Program

Poster	Poster Session 04 Program Schedule 02/15/2024 12:00 pm - 01:15 pm Room: Shubert Complex (Posters 1-60) Poster Session 04: Neuroimaging \| Neurostimulation/Neuromodulation \| Teleneuropsychology/Technology Final Abstract #36 Immediate and Delayed Recall Comparisons of Virtual Kitchen Protocol to Existing Neuropsychological Memory Tests for Neurocognitive Disorder Diagnosis Matthew Fontanese, The University of Texas at Tyler, Tyler, United States Harrison Boynton, The University of Texas at Tyler, Tyler, United States Kellee Bishop, The University of Texas at Tyler, Tyler, United States Chris López, The University of Texas at Tyler, Tyler, United States Joel Zamora, The University of Texas at Tyler, Tyler, United States Lutavious Boone, The University of Texas at Tyler, Tyler, United States Erin Hulsman, The University of Texas at Tyler, Tyler, United States Leticia Cossi de Souza, The University of Texas at Tyler, Tyler, United States Michael Barnett, The University of Texas at Tyler, Tyler, United States Category: Memory Functions/Amnesia Keyword 1: neuropsychological assessment Keyword 2: test development Keyword 3: technology Objective: The ecological validity and extrapolative uses of extant paper-and-pencil neuropsychological assessment techniques have been challenged since the conception of the field. The use of virtual reality in neuropsychological assessment aims to ameliorate this threat by creating more realistic assessment tasks and testing environments. The purpose of this study was to compare the diagnosis discrimination ability of a novel virtual reality kitchen protocol compared to two existing paper-and-pencil tests. Participants and Methods: Older adult patients (N = 99) participated in a full neuropsychological evaluation including paper-and-pencil tests and a virtual reality assessment tool. Older adults with [n = 17 (17.2%); age 71.0 ± 0.75] and without a neurocognitive diagnosis [n = 82 (82.8%), age 75.1 ± 2.01] were not significantly different in age, sex, education level, or race. Immediate and delayed recall paper and pencil assessments included the California Verbal Learning Test – Second Edition (CVLT-II) and the Wechsler Memory Scale – Fourth Edition Visual Reproduction subtests (WMS-IV- VR I & II). The Virtual Kitchen Protocol for Learning and Memory (VKP: LM) is a virtual reality test that measures immediate (VKP: LM IR) and delayed recall (VKP: LM DR) for meal preparation tasks. The VKP: LM was administered using an HTC Vive Pro headset and Job Simulator (Schwartz, 2016). Results: Data were analyzed using SPSS version 29.0.0.0 (SPSS Inc., USA). A binomial logistic regression revealed a significant model between all study variables, χ²(6) = 72.39, p < .001.VKP: LM DR was shown to be an independent significant predictor of neurocognitive disorders irrespective of other variables (b =12.59, SE = 6.07, p = .038). Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated. The VKP: LM DR (AUC = .978), CVLT-II delayed (AUC = .965), VKP: LM IR (AUC = .950), and CVLT-II immediate (AUC = .950), all showed excellent discrimination ability, while the WMS-IV VR II (AUC = .876) and WMS-IV VR I (AUC = .833) showed slightly weaker diagnosis discernability. Under nonparametric assumptions, a Mann-Whitney U-test for equality was used to compare the AUCs. The VKP: LM DR (p = .013), VKP: LM IR (p = .035), and the CVLT-II delayed (p = .012) demonstrated significantly better discrimination than the WMS-IV LM I. A multilevel perceptron analysis (MLP) was then conducted to confirm each test’s discrimination accuracy. The VKP: LM DR, CVLT-II delayed, and VKP: LM IR each yielded diagnostic accuracies of 96.8%. When all tests were factored together, the MLP analysis indicated that the VKP: LM DR test was the most important factor for discerning a diagnosis (Importance = .381). Conclusions: The VKP: LM has proven to be an excellent tool for discrimination, performing similarly to the CVLT-II and better than the WMS-IV VR I. Future application of the VKP: LM and other virtual reality neuropsychological assessment has the potential to redevelop the field with increased ecological validity and enhanced diagnostic predictive ability.

Poster

02/15/2024
12:00 pm - 01:15 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology

Final Abstract #36

Immediate and Delayed Recall Comparisons of Virtual Kitchen Protocol to Existing Neuropsychological Memory Tests for Neurocognitive Disorder Diagnosis

Matthew Fontanese, The University of Texas at Tyler, Tyler, United States
Harrison Boynton, The University of Texas at Tyler, Tyler, United States
Kellee Bishop, The University of Texas at Tyler, Tyler, United States
Chris López, The University of Texas at Tyler, Tyler, United States
Joel Zamora, The University of Texas at Tyler, Tyler, United States
Lutavious Boone, The University of Texas at Tyler, Tyler, United States
Erin Hulsman, The University of Texas at Tyler, Tyler, United States
Leticia Cossi de Souza, The University of Texas at Tyler, Tyler, United States
Michael Barnett, The University of Texas at Tyler, Tyler, United States

Category: Memory Functions/Amnesia

Keyword 1: neuropsychological assessment
Keyword 2: test development
Keyword 3: technology

Objective:

The ecological validity and extrapolative uses of extant paper-and-pencil neuropsychological assessment techniques have been challenged since the conception of the field. The use of virtual reality in neuropsychological assessment aims to ameliorate this threat by creating more realistic assessment tasks and testing environments. The purpose of this study was to compare the diagnosis discrimination ability of a novel virtual reality kitchen protocol compared to two existing paper-and-pencil tests.

Participants and Methods:

Older adult patients (N = 99) participated in a full neuropsychological evaluation including paper-and-pencil tests and a virtual reality assessment tool. Older adults with [n = 17 (17.2%); age 71.0 ± 0.75] and without a neurocognitive diagnosis [n = 82 (82.8%), age 75.1 ± 2.01] were not significantly different in age, sex, education level, or race. Immediate and delayed recall paper and pencil assessments included the California Verbal Learning Test – Second Edition (CVLT-II) and the Wechsler Memory Scale – Fourth Edition Visual Reproduction subtests (WMS-IV- VR I & II). The Virtual Kitchen Protocol for Learning and Memory (VKP: LM) is a virtual reality test that measures immediate (VKP: LM IR) and delayed recall (VKP: LM DR) for meal preparation tasks. The VKP: LM was administered using an HTC Vive Pro headset and Job Simulator (Schwartz, 2016).

Results:

Data were analyzed using SPSS version 29.0.0.0 (SPSS Inc., USA). A binomial logistic regression revealed a significant model between all study variables, χ²(6) = 72.39, p < .001.VKP: LM DR was shown to be an independent significant predictor of neurocognitive disorders irrespective of other variables (b =12.59, SE = 6.07, p = .038). Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated. The VKP: LM DR (AUC = .978), CVLT-II delayed (AUC = .965), VKP: LM IR (AUC = .950), and CVLT-II immediate (AUC = .950), all showed excellent discrimination ability, while the WMS-IV VR II (AUC = .876) and WMS-IV VR I (AUC = .833) showed slightly weaker diagnosis discernability. Under nonparametric assumptions, a Mann-Whitney U-test for equality was used to compare the AUCs. The VKP: LM DR (p = .013), VKP: LM IR (p = .035), and the CVLT-II delayed (p = .012) demonstrated significantly better discrimination than the WMS-IV LM I. A multilevel perceptron analysis (MLP) was then conducted to confirm each test’s discrimination accuracy. The VKP: LM DR, CVLT-II delayed, and VKP: LM IR each yielded diagnostic accuracies of 96.8%. When all tests were factored together, the MLP analysis indicated that the VKP: LM DR test was the most important factor for discerning a diagnosis (Importance = .381).

Conclusions:

The VKP: LM has proven to be an excellent tool for discrimination, performing similarly to the CVLT-II and better than the WMS-IV VR I. Future application of the VKP: LM and other virtual reality neuropsychological assessment has the potential to redevelop the field with increased ecological validity and enhanced diagnostic predictive ability.