There and Back Again

Virtual reality tests for diagnosing early Alzheimer’s disease

Dr Dennis Chan

Department of Clinical Neurosciences

Why do we need a new approach?

We need to improve:

Diagnostic utility

Ecological validity

Trial outcome measures

Scientific understanding

Why do we need a new approach?

We need to improve:

Diagnostic utility

Ecological validity

Trial outcome measures

Scientific understanding

Cheap and simple but inaccurate

PET brain scanning Lumbar puncture

Accurate but expensive and unpleasant

Why do we need a new approach?

We need to improve:

Diagnostic utility

Ecological validity

Trial outcome measures

Scientific understanding

Bedside cognitive tests

Why do we need a new approach?

We need to improve:

Diagnostic utility

Ecological validity

Trial outcome measures

Scientific understanding

How we test new drugs

In animal models

In humans

Why do we need a new approach?

We need to improve:

Diagnostic utility

Ecological validity

Trial outcome measures

Scientific understanding

A new approach

The progression of AD changes across the brain

Hippocampal place cells

Work by John O’Keefe (UCL) in 1971; Nobel Prize in Medicine 2014

Which

picture

shows the

same place?

The 4

Mountains Test

Spatial memory testing correlates with dementia risk

score in PREVENT

The entorhinal cortex:

Ground Zero in AD

place cell

head direction cell

grid cell

border cell

Hippocampus

Entorhinal

cortex

VR navigation task

Howett et al. (2018) submitted

Howett et al. (2018) submitted

Distance error scatterplot: controls

Distance error scatterplot: MCI -ve

Distance error scatterplot: MCI +ve

VR navigation testing provides

Diagnostic utility 👍

Ecological validity 👍

Trial outcome measures 👍

Scientific understanding 👍

Next steps

VR in PREVENT

Navigation testing

from virtual reality to ….reality

Acknowledgments

David Howett

Zoe Adler

John O’Brien

Julija Krupic

Tereza Vargova

Ruth Wood

Neil Burgess

John King

Andrea Castegnaro

John O’Keefe