Impaired spatial orientation and navigation as an early sign of Alzheimer’s disease: diagnosis using virtual reality technologies

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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