Digital Marker for Early Screening of Mild Cognitive Impairment Through Hand and Eye Movement Analysis in Virtual Reality Using Machine Learning: First Validation Study

Author:

Kim Se YoungORCID,Park JinseokORCID,Choi HojinORCID,Loeser MartinORCID,Ryu HokyoungORCID,Seo KyoungwonORCID

Abstract

Background With the global rise in Alzheimer disease (AD), early screening for mild cognitive impairment (MCI), which is a preclinical stage of AD, is of paramount importance. Although biomarkers such as cerebrospinal fluid amyloid level and magnetic resonance imaging have been studied, they have limitations, such as high cost and invasiveness. Digital markers to assess cognitive impairment by analyzing behavioral data collected from digital devices in daily life can be a new alternative. In this context, we developed a “virtual kiosk test” for early screening of MCI by analyzing behavioral data collected when using a kiosk in a virtual environment. Objective We aimed to investigate key behavioral features collected from a virtual kiosk test that could distinguish patients with MCI from healthy controls with high statistical significance. Also, we focused on developing a machine learning model capable of early screening of MCI based on these behavioral features. Methods A total of 51 participants comprising 20 healthy controls and 31 patients with MCI were recruited by 2 neurologists from a university hospital. The participants performed a virtual kiosk test—developed by our group—where we recorded various behavioral data such as hand and eye movements. Based on these time series data, we computed the following 4 behavioral features: hand movement speed, proportion of fixation duration, time to completion, and the number of errors. To compare these behavioral features between healthy controls and patients with MCI, independent-samples 2-tailed t tests were used. Additionally, we used these behavioral features to train and validate a machine learning model for early screening of patients with MCI from healthy controls. Results In the virtual kiosk test, all 4 behavioral features showed statistically significant differences between patients with MCI and healthy controls. Compared with healthy controls, patients with MCI had slower hand movement speed (t49=3.45; P=.004), lower proportion of fixation duration (t49=2.69; P=.04), longer time to completion (t49=–3.44; P=.004), and a greater number of errors (t49=–3.77; P=.001). All 4 features were then used to train a support vector machine to distinguish between healthy controls and patients with MCI. Our machine learning model achieved 93.3% accuracy, 100% sensitivity, 83.3% specificity, 90% precision, and 94.7% F1-score. Conclusions Our research preliminarily suggests that analyzing hand and eye movements in the virtual kiosk test holds potential as a digital marker for early screening of MCI. In contrast to conventional biomarkers, this digital marker in virtual reality is advantageous as it can collect ecologically valid data at an affordable cost and in a short period (5-15 minutes), making it a suitable means for early screening of MCI. We call for further studies to confirm the reliability and validity of this approach.

Publisher

JMIR Publications Inc.

Subject

Health Informatics

Cited by 11 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Multimodal Machine Learning Model For MCI Detection Using EEG, MRI and VR Data;2024 International Technical Conference on Circuits/Systems, Computers, and Communications (ITC-CSCC);2024-07-02

2. Advancing Mild Cognitive Impairment Detection: Integrating VR, MRI, and Neuropsychological Insights for Comprehensive Diagnosis;2024 International Technical Conference on Circuits/Systems, Computers, and Communications (ITC-CSCC);2024-07-02

3. Exploring the Relationship between Behavioral and Neurological Impairments Due to Mild Cognitive Impairment: Correlation Study between Virtual Kiosk Test and EEG-SSVEP;Sensors;2024-05-30

4. Exploring the Multimodal Integration of VR and MRI Biomarkers for Enhanced Early Detection of Mild Cognitive Impairment;Extended Abstracts of the CHI Conference on Human Factors in Computing Systems;2024-05-11

5. Decoding Behavior: Utilizing Virtual Reality Digital Marker and Machine Learning for Early Detection of Mild Cognitive Impairment;Extended Abstracts of the CHI Conference on Human Factors in Computing Systems;2024-05-11

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