Whatever the illness or health issue, diagnosis is never an enjoyable experience for patients. Those suspected of having mental disorders, for instance, will need to endure scans and tests of all kinds to find out where they stand and what treatment options they should consider. Besides the fear of the outcome, this is often an unpleasant and stressful experience.
Enter Nesplora Technology and Behaviour and its VR-based evaluation tools for mental disorders: A set of virtual reality glasses and headphones, with the patient entering a virtual environment. Reaction to stimuli and the ability to perform specific tasks in this environment will seamlessly provide a diagnosis, leaving clinicians enough information to pick the best possible treatment option.
Mrs Gema Climent, CIO of Nesplora Technology and Behaviour, discusses the VRMIND (Virtual Reality based Evaluation of Mental Disorders) project technology and the company’s present and future plans.
On the one hand, new technologies enable the evaluation of cognitive processes with an objectivity that traditional paper and pencil tests can never achieve. We know what we are measuring at each moment, and that is recorded for a later interpretation.
More specifically, the added value of VR is the ecological validity that contributes to the neuropsychological evaluation, that is, the ability of a tool to reflect the true state of a patient in real life. By evaluating cognitive functions in a simulated real-life environment, we can predict more accurately how the patient’s brain functions. We can then transfer the results of an objective evaluation to a real-world environment.
Can you tell us about the various tools you developed?
So far we have developed and commercialised a tool that evaluates attentional processes in children between six and 16 years old, through tasks that are carried out in a virtual classroom. This tool is called Nesplora Aula. We also have a variant of this tool, Nesplora Aula School, which focuses not so much on the clinical scope but on the educational one. It seeks to identify students’ attentional strengths to reinforce their learning process.
Nesplora Aquarium, on the other hand, is aimed at the adult population to evaluate their attentional processes and working memory. In this case, the environment emulates an aquarium in which the person performs different tasks.
Currently, we are developing two more assessment tools, applicable to patients over 16 years old. Nesplora Ice Cream is designed to evaluate executive functions through exercises that are carried out in a virtual ice cream shop. In contrast, Nesplora Suite focuses on evaluating memory processes. For this, the patient goes into a furniture store.
How do these solutions integrate and compare with other approaches to diagnostics such as neuroimaging?
To carry out a diagnosis, the professional usually relies on tests and criteria of different kinds. In the field of mental health, depending on the disorder in question, we can resort to neuropsychological tests, neuroimaging techniques, tests of a more psychological nature, etc. The good thing about this variety of techniques is that they can complement each other. They provide different information and enable a more precise diagnosis.
Neuroimaging, to take your example, is very commonly complemented with neuropsychological tests when it comes to dementia. This helps the professional in establishing the type of dementia of a patient, which is determined both by the area of the brain that appears to be affected as well as by the cognitive functions that show alterations.
How have you tested the technology and what can you tell us of the results of these tests?
All the tools that we develop at Nesplora Technology and Behaviour have a scientific basis. We carried out different studies to validate them scientifically.
On the one hand, we have normative studies that allow us to determine the normality curve for each age group and gender. This allows us to compare the results of a patient with those of his reference group, to know if he is within the mean or if, on the contrary, he deviates from it. We have extensive samples that allow reliable results for these studies. For Nesplora Aula, scales have been obtained for each gender in the following age ranges: 6-7, 7-8, 9-10, 11-12 and 12-14. For Nesplora Aquarium, three different age ranges have been identified for each gender: 16-40, 41-60 and greater than 61. In both cases, the results obtained coincide with the theory.
On the other hand, we also carry out clinical studies that consist in testing the discriminatory capacity between different disorders and their subtypes. Nesplora Aula was focused on patients with ADHD and other neurodevelopmental disorders. In convergent studies, however, we try to compare our tests with others that have been references until now. We are still developing these two types of studies for Nesplora Aquarium, since this tool is very recent.
What has been the feedback from practitioners so far?
It is true that on many occasions we have perceived a certain reluctance on the part of professionals to include new technologies in their ‘toolbox’. This first barrier is due to a lack of knowledge, but once they know our tools the feedback we receive becomes very positive.
The most common comments are those related to the speed with which the tests are applied and the ease of doing so. In addition, a strong point for our clients is the good reception amongst patients, as the use of virtual environments makes our tools more attractive and increases motivation to be evaluated.
What are your plans for commercialisation?
We look for a global democratisation of our tools through the professional channel of neuropsychology, psychiatry and neurology. Our customer segment is addressed to a clinical sector, principally to a professional collective of neuroscientists, but also hospitals, pharmaceuticals, insurance companies etc. There is another sector that will strongly extend the scope of our enterprise, and we intend to target it with new products that we will be launching soon.
For more information, please see: Project website