r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2024-29-6-4-14r-n-j-631Research ArticleОБЗОРЫREVIEWSНарушение способности к пространственной ориентации и навигации как ранний признак болезни Альцгеймера: диагностика с применением технологий виртуальной реальностиImpaired spatial orientation and navigation as an early sign of Alzheimer’s disease: diagnosis using virtual reality technologieshttps://orcid.org/0000-0002-6256-3429ГригорьеваВ. Н.GrigoryevaV. N.

Нижний Новгород

Nizhny Novgorod

vrgr@yandex.ruhttps://orcid.org/0009-0000-8309-9816СемакаМ. А.SemakaM. A.

Нижний Новгород

Nizhny Novgorod

marinasemaka7@gmail.comПриволжский исследовательский медицинский университетРоссияPrivolzhsky Research Medical UniversityRussian Federation202425012025296414Copyright © Григорьева В.Н., Семака М.А., 20252025Григорьева В.Н., Семака М.А.Grigoryeva V.N., Semaka M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/631

Нарушения зрительно-пространственной ориентации и навигации (ЗПОН) при болезни Альцгеймера (БА) могут возникать еще на додементной стадии и имеют важное диагностическое значение, отражая изменения тех зон головного мозга, которые при данном зааболевании страдают ранее всего. Однако выявить эти нарушения с помощью классических нейропсихологических тестов трудно, а исследования в реальной окружающей среде малодоступны. Преодолеть указанные ограничения позволяют исследования в виртуальной среде. Целью работы явилось обобщение научных данных по использованию технологий виртуальной реальности для ранней диагностики нарушений зрительно-пространственной ориентации и навигации при умеренном когнитивном расстройстве (УКР) разной природы и легкой деменции при БА. Проанализировано 16 опубликованных за последние 15 лет статей, посвященных применению технологий виртуальной реальности для оценки ЗПОН при УКР и БА. Из этого числа исследований 13 работ выявили нарушения пространственной ориентации и навигации уже на стадии УКР. Снижение ЗПОН было более выраженным при БА. Наибольшей чувствительностью в диагностике нарушений ЗПOН обладали тесты, требовавшие переключения между эгоцентрической и аллоцентрической системами пространственных представлений. Оценка ЗПОН, проводившаяся одновременно с нейрофизиологическими и нейровизуализационными исследованиями, позволила расширить представления о морфо-функциональных основах зрительно-пространственных расстройств. Раннее выявление расстройств ЗПОН с помощью технологий виртуальной реальности при БА требует разработки стандартизированных и легко воспроизводимых тестов, направленных на оценку различных компонентов этих нарушений у пациентов с поражением головного мозга.

In Alzheimer’s disease (AD), disturbances in spatial orientation and navigation occur even at the pre-dementia stage and can have important diagnostic significance, reflecting changes in those areas of the brain that suffer earlier than others in this pathology. However, it is difficult to identify such disorders using classical neuropsychological tests, and studies in the real environment are not readily available in routine practice. These difficulties can be overcome by researches in a virtual environment. The purpose was to summarize scientific data on the use of virtual reality computer technologies for early diagnosis. The article provides an overview of 16 papers published over the past 15 years on the use of virtual reality technologies for the assessment of visuospatial orientation and navigation in mild cognitive impairment (MCI) and mild dementia AD patients. 13 studies revealed deficit in spatial orientation and navigation already at the stage of MCI. The deterioration in in spatial orientation and navigation was more pronounced in patients with AD. The most sensitive tests for the diagnosis of orientation and navigation impairments were those that required switching between egocentric and allocentric spatial representations. Assessment of orientation in a virtual environment, carried out simultaneously with neurophysiological and neuroimaging studies of the brain, made it possible to expand the understanding of the morpho-functional basis of visuospatial disorders in humans. Early detection of deficit in spatial orientation and navigation using virtual reality technologies in Alzheimer’s disease requires the development of standardized tests aimed at assessing the various components of these disorders and their individual combinations in patients with brain damage.

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The authors declare that there are no conflicts of interest present.