Non-invasive technologies for cognitive rehabilitation of Mild Cognitive Impairment in older adults

Título	Non-invasive technologies for cognitive rehabilitation of Mild Cognitive Impairment in older adults
Código	NAM23I0070
Palabras Clave	MILD COGNITIVE IMPAIRMENT; OLDER ADULTS; TRANSCRANIAL MAGNETIC STIMULATION; VIRTUAL REALITY
Carreras Relacionadas	Otra
Período	2023-2024
Financiamiento	FONDEF
Presupuesto	$42140000
Modalidad	Individual
Investigador Responsable	Izaskun Álvarez-Aguado
Coinvestigadores	Maryam Farhang, Miguel Roselló
Vinculación con el Medio	Sí

In Chile, Mild Cognitive Impairment (MCI) manifests in at least 10% of adults over 60 years of age. This percentage increases exponentially as the person ages. The annual conversion rate from MCI to dementia is estimated to be between 5 and 15%, and generally occurs within 3 years of MCI diagnosis. If the period between the onset of MCI and the diagnosis of dementia is taken advantage of, older adults could benefit from an effective intervention considering that the brain would still have the capacity to compensate for its deficits and support the acquisition and retention of cognitive functions. This proposal seeks to validate a new multi-method approach that acts on both neural-cognitive and behavioral-cognitive levels for MCI in older adults using Virtual Reality (VR) and Transcranial Magnetic Stimulation (TMS). The integration of VR and TMS has high-impact potential in cognitive rehabilitation because it combines neuropsychological and cognitive-behavioral techniques that facilitate more sensitive rehabilitation of cognitive symptoms while modulating impaired neural circuitry to provide a stronger beneficial effect. Recently, the efficacy of the joint application of VR and TMS for motor rehabilitation has been demonstrated. This has opened the possibility of analyzing the potential of this integrated method for cognitive rehabilitation, which, to our knowledge, has not been investigated. The crucial aspect for advancing in the development of this proposal is to achieve improvements in general cognitive, memory, visuospatial and particularly executive functioning, as well as in basic and instrumental activities of daily living for the elderly affected by MCI. To achieve this objective, it proposes exploratory research with a pre-test/post-test design. This proposal distinguishes three phases: pre-intervention, intervention, and post-intervention. During the pre-intervention stage, a neuropsychological evaluation will be carried out to determine the participants' scores on different cognitive abilities (pre-test). In the intervention stage, the proof of concept will be developed. After each TMS session, older adults will be immersed in a CAVE, a virtual cube the size of a room in which they will be exposed to two different environments: a virtual supermarket and a virtual city where they can move around thanks to an Xbox controller and 3-D glasses. The tasks will consist of selecting different products or looking for some objects according to precise rules, with increasing difficulty. A total of 2 weekly sessions (VR-TMS) of 45 minutes are estimated for 12 weeks. During the post-intervention stage, a second neuropsychological evaluation will be carried out (post-test). To make pre-test/post-test comparisons, the same diagnostic tests will be used as in the pre-intervention stage. An improvement of at least 3 points in each of the applied tests will be expected. The acceptability of the intervention will be estimated by the adherence of older adults to the sessions through semi-structured interviews after the last session. The expected result of the project is the design and validation, through pilot application, of a multimodal intervention model for the cognitive rehabilitation of MCI in older adults that integrates VR and TMS. After the execution of the proposal, the next steps would focus on obtaining more measurements; design new VR scenarios; and analyze its use for the rehabilitation of other brain diseases.