Effectiveness of Attention/executivefunctions Training on Prospective Memory Abilities of Parkinson's Disease Subjects with Mild Cognitive Impairment and Healthy Aged Individuals: a Placebo-controlled Study with a Combined Immersive Virtual Reality and Telemedicine Approach

The cognitive training involved a 4-week immersive virtual reality program to improve planning, cognitive flexibility, and information updating in patients with mild cognitive impairment related to Parkinson's disease. Over 12 sessions of 30 minutes each, participants trained in a virtual supermarket to strengthen attentional and executive skills. The planning task required creating and following a route to collect items while following rules, with increasing complexity. The cognitive flexibility task involved alternating between selecting items from different categories, with difficulty rising due to more categories and distractors. The updating task, set at a virtual checkout, challenged participants to memorize and recall items on a conveyor belt, with difficulty increasing based on sequence length and item count. Progression to higher levels required three successful trials, with feedback provided to support performance improvement

The active placebo used the same virtual environment, Oculus Go system, and telemedicine setup as the training group, but engaged in tasks with low cognitive demands, mimicking everyday activities. The placebo-planning task involved following a fixed shopping list order in a modified version of the Zoo Map Test. The placebo-shifting task required selecting items from shelves without alternating between categories, while the placebo-updating task involved recalling only the last item from a conveyor belt sequence. The sessions mirrored the training group's structure, with 12 sessions over 4 weeks (3 per week, 30 minutes each), maintaining the same frequency, duration, and levels than Training.