Neuropsychology from paper-and-pencil to technology: Advancing cognitive rehabilitation

Patients with acquired brain injury (ABI) often experience cognitive impairment, such as forgetfulness or difficulties concentrating. Cognitive impairment can be one of the most devastating consequences of a brain injury, as it may interfere with activities of daily living, relationships, leisure and work. Cognitive rehabilitation focuses on learning how to deal with cognitive impairment. Cognitive rehabilitation starts with a thorough neuropsychological assessment, which mostly consists of paper-and-pencil tests to assess cognitive function. One drawback is that paper-and-pencil tests do not relate to the dynamics and complexity of daily life. As a result, paper-and-pencil tests sometimes fail to capture mild cognitive impairment, and test results do not translate easily to daily life. We investigated the feasibility, user-experience and the added value of three novel instruments: an inventory to systematically assess cognitive complaints in daily life, a digital neuropsychological assessment (in collaboration with Philips Research) and virtual reality (in collaboration with Atoms2Bits). The Cognitive Complaints – Participation (CoCo-P) inventory was developed with clinicians, researchers and patients to assess cognitive complaints in daily life. A digital neuropsychological assessment allows neuropsychologists to assess cognitive disorders, that are not observed or captured with paper-and-pencil tests. Finally, virtual reality seemed highly feasible in patients with ABI. We additionally showed the added value of virtual reality to assess mild cognitive impairment in a simulated daily environment. This dissertation only describes the first steps, but we are moving forward in assessing, understanding and treating cognitive difficulties patients encounter in daily life.