Innovations Lectures
February - April 2025
Clinical Neuropsychology
Leiden University
,Lecture 1 → Introduction
● Technology and the brain
○ Brain trainings claims
■ Improve performance in school/work
■ Delay age-related cognitive decline
■ Reduce impairment from health conditions
○ Ongoing research and discussion
■ Lumosity had an FTC lawsuit → made false claims
■ The tasks in brain training games have specific puzzles skills that do not
transfer to everyday tasks
■ Near transfer → puzzle in game skills to puzzle in real life skills
● More evidence for this
■ Far transfer → puzzle in game skills to general real life skills
● Little evidence → training does not enhance performance
○ Daily life solutions
■ We now have many devices in one
■ Smart versions of everything
○ The development of technology
■ Passive → active → interactive
○ Applications in real life
■ Navigation then vs now → before read a map, now the route is planned
for you
■ Education → interactive lessons using tech (VR)
■ Sports → augmented reality trainings to improve performance using
sensors to obtain metrics on performance
■ Geography lessons for children
■ Fitness in VR
● Technology and neuropsychology
○ Only about 6% of tools are computerized
○ Obsolete technologies are used (no new ideas)
○ The most recent publications have less and less computer, technology and
neuroimaging keywords
○ Computer can be combined with classic tasks (eg TMT)
,● Why should we innovate?
○ Technical development → its available so let's use it
○ Scientific motivation → more insights into cognitive function
○ Less limitations than existing materials → more data, less susceptible to issues
● Categories
○ Diagnostic tools
○ Treatment tools
○ eHealth (lecture 7)
○ Neurotechnology (lecture 6)
○ Non-technological “innovations”
● Innovations in diagnostics
○ Computer based assessment of cognition mostly used in military & sports
○ Why not so much in clinical practice?
■ Financial costs
■ Lack of normative data (for all age groups)
■ Concerns about utility and validity
○ Digital versions of existing standard material
● NCATs for military personnel with mTBI (Jones et al, 2021)
○ Scoping literature review → finding gaps in research, not systematic
○ 33 studies that used neurocognitive assessment tools (NCATs) → total of 30
thousand participants
○ NCATs used → ImPACT, ANAM, DANA
○ Randolph criteria was used
○ Recommendations for healthcare professionals
■ Use cautiously → not standalone
■ Use what “feels best to fit their needs and targeted
population”
, ■ Consider age & education as context
■ Remain aware of forthcoming recommendations
● Advantages of computerized NCATs
○ More detailed measurements
■ Time → initiation, inspection, per item
■ Drawing and writing → start, clustering, neglect
○ More easily tailored to specific needs
○ Ease of use
○ Reduces human error
○ Mimics everyday situations → measures everyday function
○ Remote and portable testing
● Disadvantages of NCATs
○ Norm data not directly transferable → validity and reliability need to be proven
○ Technical requirements
○ Training for clinicians
○ Cognitive processes possibly differ for digital environment
○ Cybersickness (can occur in VR)
○ Novelty costs → adjustment time needed
○ Privacy issues → data storage
● Ecological validity of VR diagnostics? (van der Ham, 2015)
○ Comparison of VR validity in three settings
■ Real → with locomotion (able to move around in building)
■ Hybrid → with locomotion and tablet because they were on an open field
■ Virtual → no locomotion, fully VR
■ Virtual+ → no locomotion with compass
○ Results → condition affected performance selectively
■ Only in the real and hybrid condition the
performance remained at the same high level
■ Landmark route knowledge was unaffected
■ Locomotion benefits survey knowledge
○ Conclusion → virtual reality is not always ecologically
valid
February - April 2025
Clinical Neuropsychology
Leiden University
,Lecture 1 → Introduction
● Technology and the brain
○ Brain trainings claims
■ Improve performance in school/work
■ Delay age-related cognitive decline
■ Reduce impairment from health conditions
○ Ongoing research and discussion
■ Lumosity had an FTC lawsuit → made false claims
■ The tasks in brain training games have specific puzzles skills that do not
transfer to everyday tasks
■ Near transfer → puzzle in game skills to puzzle in real life skills
● More evidence for this
■ Far transfer → puzzle in game skills to general real life skills
● Little evidence → training does not enhance performance
○ Daily life solutions
■ We now have many devices in one
■ Smart versions of everything
○ The development of technology
■ Passive → active → interactive
○ Applications in real life
■ Navigation then vs now → before read a map, now the route is planned
for you
■ Education → interactive lessons using tech (VR)
■ Sports → augmented reality trainings to improve performance using
sensors to obtain metrics on performance
■ Geography lessons for children
■ Fitness in VR
● Technology and neuropsychology
○ Only about 6% of tools are computerized
○ Obsolete technologies are used (no new ideas)
○ The most recent publications have less and less computer, technology and
neuroimaging keywords
○ Computer can be combined with classic tasks (eg TMT)
,● Why should we innovate?
○ Technical development → its available so let's use it
○ Scientific motivation → more insights into cognitive function
○ Less limitations than existing materials → more data, less susceptible to issues
● Categories
○ Diagnostic tools
○ Treatment tools
○ eHealth (lecture 7)
○ Neurotechnology (lecture 6)
○ Non-technological “innovations”
● Innovations in diagnostics
○ Computer based assessment of cognition mostly used in military & sports
○ Why not so much in clinical practice?
■ Financial costs
■ Lack of normative data (for all age groups)
■ Concerns about utility and validity
○ Digital versions of existing standard material
● NCATs for military personnel with mTBI (Jones et al, 2021)
○ Scoping literature review → finding gaps in research, not systematic
○ 33 studies that used neurocognitive assessment tools (NCATs) → total of 30
thousand participants
○ NCATs used → ImPACT, ANAM, DANA
○ Randolph criteria was used
○ Recommendations for healthcare professionals
■ Use cautiously → not standalone
■ Use what “feels best to fit their needs and targeted
population”
, ■ Consider age & education as context
■ Remain aware of forthcoming recommendations
● Advantages of computerized NCATs
○ More detailed measurements
■ Time → initiation, inspection, per item
■ Drawing and writing → start, clustering, neglect
○ More easily tailored to specific needs
○ Ease of use
○ Reduces human error
○ Mimics everyday situations → measures everyday function
○ Remote and portable testing
● Disadvantages of NCATs
○ Norm data not directly transferable → validity and reliability need to be proven
○ Technical requirements
○ Training for clinicians
○ Cognitive processes possibly differ for digital environment
○ Cybersickness (can occur in VR)
○ Novelty costs → adjustment time needed
○ Privacy issues → data storage
● Ecological validity of VR diagnostics? (van der Ham, 2015)
○ Comparison of VR validity in three settings
■ Real → with locomotion (able to move around in building)
■ Hybrid → with locomotion and tablet because they were on an open field
■ Virtual → no locomotion, fully VR
■ Virtual+ → no locomotion with compass
○ Results → condition affected performance selectively
■ Only in the real and hybrid condition the
performance remained at the same high level
■ Landmark route knowledge was unaffected
■ Locomotion benefits survey knowledge
○ Conclusion → virtual reality is not always ecologically
valid
