This clinical trial aims to assess the effectiveness of a telerehabilitation program
combined with a virtual reality (VR) app in enhancing cognitive performance and social
skills in individuals with Subjective Cognitive Decline (SCD) and Mild Cognitive
Impairment (MCI).
Study Rationale SCD and MCI are considered critical stages in identifying individuals at
risk for dementia. Both conditions are associated with cognitive and social impairments,
as well as neurophysiological changes observable through advanced neuroimaging and EEG
markers. While traditional cognitive rehabilitation has shown benefits, emerging evidence
suggests that telerehabilitation combined with VR may offer enhanced outcomes through its
interactive, engaging, and scalable nature.
Primary Objective Evaluate the potential efficacy of a telerehabilitation plus VR
intervention in improving cognitive performance and social cognition skills in patients
with SCD and MCI.
Secondary Objectives Assess neurophysiological changes (EEG and MRI biomarkers) following
the intervention.
Evaluate gait patterns and eye movement parameters. Investigate the usability and patient
compliance of the VR app-based intervention.
Study Design Type: Randomized Clinical Trial (RCT) Duration: 6 weeks intervention, with
follow-up assessments at baseline (T0), post-intervention (T1), and 3 months after
intervention (T2).
Population: Individuals aged 40-80 with SCD or MCI (AD and PD subtypes).
Intervention Groups:
Experimental Group (EG): Participants will use two non-immersive VR apps ("NeuroNation"
and "The Sims Mobile") on smartphones/tablets for cognitive and socio-emotional skill
training. Training will occur 3 times per week, 30 minutes per session, guided remotely
by therapists.
Active Control Group (aCG): Participants will follow a traditional cognitive
rehabilitation program using paper-based exercises targeting cognitive domains.
Assessment Tools:
Neuropsychological Assessment: MMSE, MoCA, FAB, Stroop Test, RAVLT, Trail Making Test
(TMT-A/B), and more.
Neurophysiological Assessment: EEG and MRI scans for brain activity and structural
analysis.
Gait Analysis: Timed Up and Go (TUG) Test with BTS G-WALK®. Eye Movement Analysis: Using
an eye-tracking system for fixation, saccades, antisaccades, and smooth pursuit eye
movements.
Usability Assessment: System Usability Scale (SUS).
Expected Outcomes:
Improved cognitive and social cognition performance in the experimental group compared to
the control group.
Observable changes in EEG and MRI biomarkers correlating with cognitive improvements.
Enhanced usability and acceptance of VR-based telerehabilitation tools among
participants.
Significance of the Study:
This trial seeks to bridge the gap between traditional cognitive rehabilitation and
innovative, scalable, and cost-effective digital health interventions. Positive outcomes
could establish telerehabilitation with VR as a standard intervention for cognitive and
social rehabilitation in at-risk populations.
The study adheres to ethical principles outlined in the Declaration of Helsinki, and
informed consent will be obtained from all participants before enrollment