Objective: To develop a novel video game (VG) prototype that can effectively detect mild cognitive impairment (MCI) in Parkinson’s disease (PD) patients.

Background: MCI is a common non-motor deficit in PD (PD-MCI). However, there is limited testing for PD-MCI. That said, identifying PD-MCI has enormous psychological and physiological implications. Affected patients may easily be distracted and inadvertently harm themselves via falls, traffic accidents, and other injuries. Early identification of cognitive limitations may allow for psychosocial and physical intervention. Traditional cognitive screenings are time-consuming and disengaging. VG is an excellent modality to analyze and follow cognitive function with increased efficiency.

Method: A randomized validation study. A total of 42 participants (31 PD and 11 non-PD). A VG prototype was developed involving a moving platform and target recognition. A total score was generated using positive scoring for correct target selection. Four cognitive performance domains were assessed using the VG: attention/working memory, executive function, memory, and visuospatial function. Participants’ cognitive status was evaluated using the Montreal Cognitive Assessment (MoCA). MoCA scores < 26 and > 21 were considered diagnostic for MCI. All participants completed anxiety and depression questionnaires. Those with PD were assessed using the UPDRS. Participants with VG scores above a set threshold did not have MCI, while those with scores below the threshold were considered to have MCI.

Results: A VG score threshold of 4200 was chosen after multiple trial scorings to maximize the sensitivity, accuracy, and specificity of the test. Among the 41 study participants (PD and non-PD), VG had a sensitivity of 84.62%, accuracy of 82.93%, and specificity of 80.0% for identifying MCI. Among the 31 participants in the PD group, a VG score threshold of 3900 was selected to produce a sensitivity of 85.71%, accuracy of 80.65%, and specificity of 70.0% for identifying MCI.

Conclusion: Our VG prototype showed comparable performance to MoCA in identifying PD-MCI. The high sensitivity and accuracy values indicate the test can reliably detect MCI with few false negatives. In addition to identification, the platform can longitudinally follow an individual’s cognitive status. A larger population investigation using a second-generation version of the VG platform is underway.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-investigation-of-a-novel-video-game-for-identifying-mild-cognitive-impairment-in-individuals-with-parkinsons-disease/