Neuropsychology from paper-and-pencil to technology. Advancing cognitive rehabilitation

Abstract

Patients with acquired brain injury (ABI) often experience cognitive impairment, such as forgetfulness or difficulties concentrating. Cognitive impairment can be one of the most devastating consequences of a brain injury, as it may interfere with activities of daily living, relationships, leisure and work. Cognitive rehabilitation focuses on learning how to deal with cognitive impairment. Cognitive rehabilitation starts with a thorough neuropsychological assessment, which mostly consists of paper-and-pencil tests to assess cognitive function. One drawback is that paper-and-pencil tests do not relate to the dynamics and complexity of daily life. As a result, paper-and-pencil tests sometimes fail to capture mild cognitive impairment, and test results do not translate easily to daily life. We investigated the feasibility, user-experience and the added value of three novel instruments: an inventory to systematically assess cognitive complaints in daily life, a digital neuropsychological assessment (in collaboration with Philips Research) and virtual reality (in collaboration with Atoms2Bits). The Cognitive Complaints – Participation (CoCo-P) inventory was developed with clinicians, researchers and patients to assess cognitive complaints in daily life. A digital neuropsychological assessment allows neuropsychologists to assess cognitive disorders, that are not observed or captured with paper-and-pencil tests. Finally, virtual reality seemed highly feasible in patients with ABI. We additionally showed the added value of virtual reality to assess mild cognitive impairment in a simulated daily environment. This dissertation only describes the first steps, but we are moving forward in assessing, understanding and treating cognitive difficulties patients encounter in daily life.