Patient-Centered Serious Games for Remote Cognitive Training in Older Adults with Mild Cognitive Impairment

项目总结/摘要 轻度认知障碍（MCI）的特征是认知能力下降大于正常衰老的预期， 这还没有显著地干扰日常生活活动的表现。治疗目标 对MCI的作用是减缓病程进展，减轻临床症状的影响。那里 也特别强调非药物干预，因为它们可以减缓疾病 并且成本低、非侵入性、安全且无不良副作用。 严肃的游戏作为一种有前途的、低成本的、非暴力的游戏，已经引起了研究人员和临床医生的极大兴趣。 药物干预工具，可以帮助评估和训练患者的认知功能，在各种 环境（例如，（在诊所外）。医疗保健领域的严肃游戏代表着专注于 通过利用视频的娱乐成分来教育、告知和增强患者的健康 平板电脑设备.然而，目前可用的解决方案需要训练有素的护理人员的大量参与， 临床医生激励患者遵守干预方案，这是治疗的关键障碍。 广泛实施严肃的基于游戏的干预措施。 为了弥合这些差距，该项目旨在开发一种移动健康（mHealth）技术， 在MCI患者中使用严肃的基于游戏的训练，从而最大限度地提高依从性 在诊所外面。我们计划采用基于平板电脑的应用程序-即神经世界-由六个严重的 游戏旨在刺激工作记忆和选择性注意力，这是由我们的研究团队开发的。 工业合作伙伴。充分利用该系统的能力，提供与患者相关的有临床意义的见解， 来自他们的游戏过程的认知表现、他们随时间的进展、以及他们的顺从行为（例如，使用 频率和持续时间），这是我们的最终研究目标，开发一个最佳的，以人为本的严重游戏 平台，可以激励患者更好地坚持技术方案。 为了实现这一研究目标，Aim 1将重点评估我们的严肃游戏的初步功效 作为提高认知功能的训练工具。我们将进行一项小型单盲随机对照试验 50名MCI患者随机分为干预组和对照组。在目标2中， 我们将开发基于机器学习的算法，以获得有关认知的临床有意义的信息， 从游戏的性能。目标3最终将研究移动健康系统的最佳设计， 通过以人为本的设计方法，最大限度地提高患者对基于游戏的严肃训练的依从性。 我们相信，该项目的成果将打开一扇新的大门，通往以前未探索的数据集， 了解患者与技术的互动，以促进积极的行为改变， 管理，严重的游戏为基础的认知训练，这可以形成广泛的未来的基础 偏瘫康复和个性化疾病管理的研究。

Project Summary/Abstract Mild Cognitive Impairment (MCI) is characterized by cognitive decline greater than expected from normal aging, which does not yet significantly interfere with the performance of activities of daily living. The therapeutic goal for MCI is to slow down the course of the disease progress and reduce the impact of clinical symptoms. There has also been a particular emphasis on non-pharmacological interventions because they can slow disease progression and are low cost, non-invasive, safe, and have no adverse side effects. Serious games have received great interests among researchers and clinicians as a promising, low-cost, non- pharmacological intervention tool that can help assess and train patients’ cognitive function in a variety of environments (e.g., in/outside the clinic). Serious games in healthcare represent digital applications focusing on educating, informing, and enhancing patients’ health by leveraging the entertainment components of video games. However, currently available solutions require substantial involvement of trained caregivers and clinicians to motivate patients to adhere to the intervention protocol, which acts as the key barrier to the widespread implementations of serious game-based interventions. To bridge these gaps, this project aims to develop a mobile-health (mHealth) technology designed to encourage the use of, and thereby maximizing the compliance to, serious game-based training in individuals with MCI outside the clinic. We plan to employ a tablet-based application – namely Neuro-World – composed of six serious games designed to stimulate working memory and selective attention, which is developed by our research team’s industrial partner. Fully leveraging the system’s ability to provide clinically meaningful insights related to patients’ cognitive performance from their gameplays, their progress over time, and their compliance behaviors (e.g., use frequency and duration), it is our ultimate research goal to develop an optimal, human-centered serious game platform that can motivate patients’ to better adhere to the technological regimen. To accomplish this research goal, Aim 1 will focus on evaluating the preliminary efficacy of our serious games as a training tool to improve cognitive function. We will perform a small single-blind randomized controlled trial in 50 individuals with MCI who will be randomized either to the intervention group or the control group. In Aim 2, we will develop machine learning-based algorithms to derive clinically meaningful information regarding cognitive function from the game performance. Aim 3 will finally investigate the optimal design of the mHealth system to maximize patients’ compliance with serious game-based training via human-centered design approaches. We believe that outcomes of this project will open a new door leading to previously unexplored datasets and understanding of patient-technology interactions to promote positive behavior changes to enable self- administered, serious game-based cognitive training, which can form the basis of a wide range of future investigations of hemiparesis rehabilitation and personalized disease management.