Due to COVID-19 restrictions, a group of neuroscientists at the University of Victoria decided to investigate if NeuroTrackerX could uphold the standards of the lab version used in their many years of research. As well as doing a feasibility study they also wanted to test the potential for remote clinical use for the assessment and rehabilitation of neurological impairments, such as concussions. Here we will look at a summary of the key findings.

The Advantages of Remote Research

Aside from the challenges that lockdowns placed research assessing brain health and performance, remote research offers the possibility of studies with much larger numbers of participants and at greatly reduced cost. Having more participants increases the statistical reliability of findings, as well as allowing a broader range of populations and health conditions to be included in a single study for comparative analyses. It also makes participating in research studies much more accessible, affording more efficient recruitment as well as removing geographical restrictions.

The research team also noted prior research indicating NeuroTracker's promising potential as therapeutic tool for brain injury survivors, and accordingly wanted to assess it's practicality as a telehealth solution.

What Was Studied

Specifically the team sought to test if the setup of the home-based version would produce variations inresults from the lab-based version. The key differences between them being the size of the display and the method used to stimulate the binocular stereo 3D required for the NeuroTracker exercise.

To do this they performed a head-to-head comparision study of two groups of participants performing 3 NeuroTracker sessions, two days per week, for 4–5 weeks. One group performed the training program in the lab, while the other group undertook a home-based program.

Both groups were volunteer participants, and were equal in age (av. 50 years old), cognitive health and gender distribution.

The lab setup used an active 3D system with a 52-inch 3DTV. This method utilizes specialized shutter glasses, which flicker from opaque to transparent 60 times per second, alternating between each eye. The shutter glasses are precisely synchronized with the 3DTV display, effectively allowing a rapid stream of different images to be delivered to each eye.

The home based setup used anaglyph 3D glasses, which separates a single stream of images via color filtering. This is done through lenses specially calibrated to the NeuroTrackerX software's video rendering. The key advantage is that stereo 3D can be achieved on an everyday computer or TV display, without the need for any specialized hardware. All at-home participants trained on a computer with a 22 inch monitor provided by the researchers.

For both groups clear instructions were provided on how to perform the training, including sitting the correct distance away from the 3DTV or computer screen so that the same field of view was achieved. However a key difference was that the lab group was supervised in person, while the home group performed the training unsupervised.

What Was Found

A feasibility assessment found volunteer participants had exceptionally high recruitment and retention rates. Specifically for the remote users, questionnaire assessments showed a high ease of use of the program, and training data established a 90% adherence rate for independently completing the 4-5 week program. The 10% of sessions which weren't completed included participants who had health issues, such as requiring surgery, or significant time constraints.

Both groups' training data was analyzed for individual session scores, learning rates between sessions, and overall improvement.

Other than a slightly higher starting point for the lab group, multiple statistical analysis methods found that performance in both groups was close to identical, with 95% confidence intervals.

In conclusion the researchers stated.

''NeuroTrackerX is a feasible method of at-home cognitive training for research. Under these conditions, this research suggests that the at-home version offers a very similar training environment as the in-lab version and can be used for research purposes.''

The study was funded by the Canadian Institutes of Health Research Strategy for Patient Oriented Research, a Canadian Institutes of Health Research Project Grant and a Canadian Institutes of Health Research Canada Graduate Scholarship.

The open-access study can be read here.

A Protocol for Remote Cognitive Training Developed for Use in Clinical Populations During the COVID-19 Pandemic

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