Is virtual reality-based cognitive training in parallel with functional near-infrared spectroscopy-derived neurofeedback beneficial to improve cognitive function in older adults with mild cognitive impairment?

PURPOSE: Cognitive training in parallel with functional near-infrared spectroscopy (fNIRS)-derived neurofeedback has been identified to be beneficial in enhancing cognitive function in patients with mild cognitive impairment (MCI). However, effects of virtual reality (VR)-based cognitive training ensuring ecological validity in parallel with fNIRS-derived neurofeedback on neural efficiency has received little attention. This study investigated effects of VR-based cognitive training in parallel with fNIRS-derived neurofeedback on cognitive function and neural efficiency in patients with MCI. METHOD: Ninety participants were randomly assigned into the active group (AG) receiving VR-based cognitive training in parallel with fNIRS-derived neurofeedback, the sham group (SG), or wait-list group (CG). The AG and SG group performed each intervention for fifteen minutes a session, for eight sessions. The Trail Making Test Part B and Backward Digit Span Test were used for outcomes. In addition, activity in the dorsolateral prefrontal cortex (DLPFC) during cognitive testing using fNIRS was measured. RESULTS: After the eight sessions, the AG achieved greater improvements in all outcomes than the other groups. In addition, the AG showed a lower DLPFC activity during cognitive testing than the other groups. CONCLUSIONS: VR-based cognitive training in parallel with fNIRS-derived neurofeedback is superior to enhancing cognitive function and neural efficiency.