A Simple and Effective Way to Study Executive Functions by Using 360° Videos

Borgnis, Francesca; Baglio, Francesca; Pedroli, Elisa; Rossetto, Federica; Riva, Giuseppe; Cipresso, Pietro · 2021 · Crossref

DOI: 10.3389/fnins.2021.622095

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Summary

This perspective paper addresses the limitations of traditional neuropsychological tests in assessing executive functions (EFs), which often lack ecological validity and fail to predict real-world performance. The authors propose the Executive-functions Innovative Tool 360° (EXIT 360°), a novel assessment method designed to evaluate EFs in ecologically valid, everyday scenarios. The motivation stems from the significant public health impact of executive dysfunctions on personal independence and the need for early, accurate detection strategies that overcome the high costs, logistical difficulties, and low sensitivity of standard paper-and-pencil or complex virtual reality (VR) tests. The proposed method utilizes 360° videos delivered via a mobile-powered VR headset, combined with an eye tracker (ET) and a portable electroencephalogram (EEG) device. Participants engage in a "game for health" involving seven subtasks of increasing complexity within domestic environments (e.g., kitchens, bedrooms). These tasks require planning, problem-solving, decision-making, attention, visual searching, reasoning, and working memory. The system collects multimodal data, including verbal responses, reaction times, eye movement metrics (fixations, saccades), and brain activity (specifically frontal theta oscillations). To process this extensive dataset, the tool employs machine learning algorithms, specifically Random Forest and Support Vector Machine, to classify patients and integrate verbal and physiological data in real time. The paper outlines the theoretical framework and design specifications rather than reporting empirical results from a completed study. It details how the integration of ET and EEG allows for the detection of subtle executive deficits, such as antisaccadic impairments and frontal lobe anomalies, which are sensitive markers of conditions like Parkinson’s disease and schizophrenia. The use of 360° environments is highlighted for its ability to provide immersion without the motion sickness often associated with traditional VR, while remaining cost-effective and accessible. The machine learning component is described as capable of providing immediate diagnostic feedback and differentiating clinical groups based on the fused data streams. The significance of EXIT 360° lies in its potential to transform clinical assessment by offering a quick (15–20 minutes), portable, and ecologically valid evaluation tool. By simulating real-life domestic challenges, the tool aims to identify executive impairments that affect daily living activities, which are often missed by standard tests. The authors conclude that this multimodal approach enables clinicians to tailor rehabilitation strategies more effectively by providing a comprehensive, real-time profile of a patient’s executive functioning. The tool’s design prioritizes clinical usability, requiring no specialized technical skills, and aims to increase patient engagement through a gamified experience, thereby reducing the emotional burden of neuropsychological testing.

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