Axe 3 / Axis 3

Axis 3. Neurocognitive Training and Cognitive Cybertherapy



To improve the diagnosis and the characterization of the neuropsychological profile of patients (perverved/impaired balance), studies can take advantage of new technologies used to develop paradigms that are able to detect functional changes in cognitive abilities in conditions that resemble daily life (Rizzo et al., 2004; Plancher & Piolino, 2016). Moreover, some behavioral and interventional approaches are able to enhance brain functions and memory performances in both aging and neuro-psychiatric disorders, fostering brain plasticity (Cotman & Berchtold, 2002; Lustig et al., 2009; Park & Bischof, 2011). Among these, virtual reality (VR), namely the immersion in a three-dimensional computer-generated environment with multi-sensory stimulation close to real life, is a promising behavioural approach that allows the early diagnosis of different diseases and the readaptation of cognitive functions.

Our innovative research project will contribute to developing new therapeutic methods for patients:  In particular, child populations with epilepsia (I Jambaqué), autism and genetic diseases (N Angeard), domain of schizophrenia (P Piolino, coll Sainte Anne hospital), traumatic brain injury and Alzheimer’s disease (V La Corte, Coll IM2A Salpétrière hospital).

Our innovative research project will contribute to developing new therapeutic methods for patients to enhance memory encoding, remembering the past and anticipating the future, executive functions and metacognition in child populations with epilepsia, autism or genetic diseases, domain of schizophrenia, traumatic brain injury and Alzheimer’s disease. Moreover, we will use immersion in a virtual environment to reactivate autobiographical memory (from scenarios, landmarks, music encountered during navigation) and projection into the future. This kind of VR reminiscence and prospection tools could facilitate the evocation of autobiographical memories (Lalanne et al., 2014) and stimulate projection as oneself into the future, thus improving the sense of identity and temporal continuity in patients (application of the findings from ANR TEMPORALITY in the domain of cognitive training in aging). 

Yet, we have planned a series of “pre/post” program comparison (and in some studies, compared to groups with as usual remediation program) in prodromal and early stage of Alzheimer’s disease (REVALZ Serious Game, PI. V. La Corte & P. Piolino, collaboration with IM2A, Salpêtrière Hospital, Dr Michon and Pr Dubois, pending France Alzheimer’s New Technology call), traumatic brain injury (V. La Corte & P Piolino, collaboration with Salpêtrière Hospital and Garches Hospital, Pr P. Pradat and Pr P. Azouvi, grants from the SOFMER/FTC), and schizophrenia (the Mathurin Serious Game, I. Amado & P. Piolino, preliminary pilot published, PHRC PLANI-REV). 

We will also take avantage of the properties of VR to enlarge the spectrum of targeted functions generally associated with alteration of memory. For instance, we will use virtual reality cognitive flexibility training in preschool children in order to stimulate self-distancing (from one’s egocentric perspective to allocentric perspective) and thus executive functions and theory of mind capacity in Autism Spectrum Disorders and patients with Myotonic Dystrophy type 1 (N. Angeard). In the same line, we will add elements of affective and social cognition training (e.g., theory of mind, ability to deal with the emotional signals of others, empathy, knowledge of social conventions and moral rules) in VR programs in order to assess and remediate these skills in Alzheimer’s disease and other neuropsychiatric pathologies (P. Narme in collaboration with N. Ehrlé, CHU of Reims, EA4072 PSITEC University of Lille 3).

Finally, we will combine virtual reality with new neurocognitive therapies, such as neurostimulation or neurofeedback training (S Blanchet) and biofeedback training (M Sperduti), which offers new avenues for alleviating cognitive and behavioural functions in healthy population and disorders. Such combined approaches may thus significantly inform on the optimal factors of the neuro-rehabilitation programs aiming ultimately to improve the quality of life and well-being of the targeted clinical populations. Othervise, virtual reality will be combined with behavioral activities known to stimulate brain plasticity and attention, i.e., aerobic training (S Blanchet), and meditation training (M Sperduti).