Authors :
Presenting Author: Noah Okada, BS – California Institute of Technology
Yousef Rajeh, BS – Emory University; Tommy Skodje, BS – Emory University; Evan Brady, BS – Neurology – Emory University; Taylor Shade, BS – Emory University; Kruthik Ravikanti, BS – Georgia Institute of Technology; Keith Adams, Visual Effects Supervisor – SpinVFX; Nigel Pedersen, MBBS, FAES, FANA – Associate Professor and Vice Chair of Research, Neurology, University of California Davis School of Medicine; Daniel Drane, Ph.D., ABPP(CN) – Associate Professor, Neurology and Pediatrics, Emory University School of Medicine
Rationale:
The utilization of minimally invasive technologies in temporal lobe epilepsy (TLE) surgery has significantly advanced our understanding of the effects of surgical interventions on memory circuitry. These advancements have revealed a range of cognitive functions in TLE patients that are vulnerable during epilepsy surgery but often go unnoticed by traditional cognitive assessments. These functions encompass processes such as the integration of multi-sensory experiences with linguistic, semantic, and autobiographical, which are challenging to assess accurately using standard static cognitive tests. In recent years technological innovations have facilitated the development of interactive cognitive assessments that immerse patients in gamified environments, resembling real-world interactions and memory functions. Leveraging these technologies, we developed a gamified assessment to study critical aspects of memory across multiple modalities at risk in epilepsy surgery.
Methods:
Using the Unity Game Engine, we developed a stand-alone application to administer a multimodal memory assessment. The task consisted of two blocks: a learning block and delayed recall block. During the learning block, participants are immersed in a gamified town environment where they can view a series of ten videos that display actors conducting daily living activities. In each video, the actors introduce novel information (faces, names, locations, and objects) which can be used to assess memory across multiple modalities. The delayed recall block consists of an interactive user interface which allows participants to respond to several questions designed to evaluate participants' capacity to integrate this information effectively and accurately identify contextual features embedded within the videos. To ensure robustness in data collection, the framework is designed to be compatible with peripheral monitoring devices such as eye-tracking devices and EEG amplifiers.
Results:
We have successfully developed and validated this gamified framework for use in patients with epilepsy. Preliminary results indicate that this assessment can effectively measure participants' ability to successfully recall and integrate visuospatial, semantic, and episodic information. These results show promise that this game-based framework will enable the development of cognitive assessments that advance our capacity to monitor and model critical cognitive deficits that may arise in epilepsy surgery.
Conclusions:
By leveraging technological innovations and interactive cognitive assessments, we can better understand the intricate relationship between epilepsy surgery and cognitive functions. This work highlights the value of incorporating gamified assessments into epilepsy surgery assessments to assess memory and cognitive deficits better. Cognitive assessments built upon this gamified framework hold the potential to aid in identifying and addressing cognitive vulnerabilities in TLE patients, ultimately contributing to the development of tailored interventions and improved patient outcomes.
Funding:
NIH/NINDS (R01 NS088748)
Quad Fellowship by Schmidt Futures
National Science Foundation Graduate Research Fellowship