Virtual reality for the assessment of frontotemporal dementia, a feasibility study

Abstract

Purpose: Behavioral variant frontotemporal dementia (bvFTD) is a non-Alzheimer dementia characterized by difficulty in documenting social-emotional changes. Few investigations have used virtual reality (VR) for documentation and rehabilitation of non-Alzheimer dementias. Methods: Five bvFTD patients underwent insight interviews while immersed in a virtual environment. They were interviewed by avatars, their answers were recorded, and their heart rates were monitored. They were asked to give ratings of their stress immediately at the beginning and at the end of the session. Results: The patients tolerated the head-mounted display and VR without nausea or disorientation, heart rate changes, or worsening stress ratings. Their insight responses were comparable to real world interviews. All bvFTD patients showed their presence in the VR environment as they moved their heads to face and respond to each avatar’s questions. The bvFTD patients tended to greater verbal elaboration of answers with larger mean length of utterances compared to their real world interviews. Conclusions: VR is feasible and well-tolerated in bvFTD. These patients may have VR responses comparable to real world performance and they may display a presence in the virtual environment which could even facilitate assessment. Further research can explore the promise of VR for the evaluation and rehabilitation of dementias beyond Alzheimer's disease.

Implications for Rehabilitation

• Clinicians need effective evaluation and rehabilitation strategies for dementia, a neurological syndrome of epidemic proportions and a leading cause of disability.

• Memory and cognitive deficits are the major disabilities and targets for rehabilitation in Alzheimer's disease, the most common dementia.

• In contrast, social and emotional disturbances are the major disabilities and targets for rehabilitation in behavioral variant frontotemporal dementia (bvFTD), an incompletely understood non-Alzheimer dementia.

• Virtual reality is a technology that holds great promise for the evaluation and rehabilitation of patients with bvFTD and other non-Alzheimer dementias, and preliminary evidence suggests that this technology is feasible in patients with bvFTD.

Keywords:

• Frontotemporal dementia
• insight
• virtual reality

Acknowledgements

Authors thank Michelle Mather for her assistance in conducting this project.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article. This work was supported by NIH funding from NIA #R01AG034499-04.