More information
Description
The aim of the proposed project is to develop an intervention based on theater and drama therapy for diminishing memory loss and psychiatric symptoms, like anxiety, that manifest in Alzheimer’s disease. Thus, we aim to contribute to the social and economic inclusion of this disadvantaged population. For this, we will partner with an outstanding research institution from one of the donor states (Norway), we will collaborate with another research group in Romania, we will recruit young and gender diverse personnel that we will train in an environment of high scientific quality, and we will implement the research results on a cohort of early stage Alzheimer’s patients.
The scope of the current proposal is to build a long-term strategic partnership between the National University of Theatrical Art and Cinema “I.L.Caragiale” in Bucharest (Romania) and it s research department CINETic and the Kavli Institute for Systems Neuroscience in Trondheim (Norway). This collaboration will be established to enhance research-based knowledge development in Romania, in the ‘Health’ and “Social Sciences and Humanities’ thematic areas and under the following key topics: ‘Translational medicine in regenerative medicine, neurodegenerative and rare diseases’, and ‘Social and Economic Inclusion of disadvantaged groups’.
Summary of project results
More than 55 million people worldwide live with dementia, a number that is predicted to increase further due to demographic aging. Alzheimer’s Disease is the most prevalent form of dementia bearing a great emotional and financial impact on the individuals living with dementia, their family and friends, and the wider society. The financial burden of dementia care, as well as the stigma that persists especially in developing countries, often leads to a poor quality of life for dementia patients, many of whom end up being secluded at home, in isolation from social life. There is no cure for AD, and the currently approved medication to treat AD is only temporarily effective and often associated with serious side effects. Current palliative interventions for AD in Romania are suboptimal. As in many other developing countries, most AD patients are cared for by poorly prepared family members, adding a heavy burden on the entire family.
The objectives of the STAD project were to investigate the neurophysiological and endocrine substrate by which social interactions and autobiographical recollections might improve memory and psychiatric symptoms in AD and to design and validate a home-based and a virtual reality-based intervention that can be easily adapted to specific individual needs, increasing the quality of life and the level of social inclusion for AD patients.
In the STAD project we have tested if social interactions and autobiographical recollections driven by a virtual reality task could improve memory and affective states for subjects with dementia in a series of 6 research activities. To answer the question, we have adapted three tasks inspired by social interactions used in theatre training and drama therapy and applied them in research. Two of the tasks were adapted, produced and developed for use in virtual reality, the third task was film-based. The tasks provided the opportunity to study how social interaction, cooperation, physical or virtual presence, synchrony, and olfactive stimulation contribute to spatial, autobiographical end episodic memory for the young, the elderly, and persons affected by early cognitive decline. In our research activities, we have collected behavioural, hormonal and functional data (EEG, icEEG and fMRI) from more than 300 subjects of which more than 120 of them elderly. The tasks were also tested by persons with cognitive decline for further deployment in care facilities and at home.
While stimulation of autobiographical memory in VR proves more efficient in terms of duration and memorability than other forms of stimulation, our data also indicates that VR stimulation failed to maintain peripheral levels of oxytocin, suggesting less efficient social activation. In our combined memory tasks, functional fMRI and EEG data indicate that spatial navigation and social interaction in virtual tasks emerge as dependent on the type of collaboration with a real partner or virtual one. Intracranial EEG data also shows specific theta activation in the left hippocampus when subjects are collaborating with a real partner in a virtual task when compared to a virtual partner, activation correlated with a better performance. Altogether our results indicate the need for extra care when designing social interactions in virtual reality and the need for further inquiry to compensate for the effects of direct social interaction which might not be reproducible in virtual reality. Effects of social interaction on memory also seem moderated by personality and age indicating a need for specially designed tasks for the elderly based on personality type. Additionally, we have observed moderating effects of oxytocin on affect and especially of basal oxytocin levels on positive affect gains following a theatrical procedure-based social interaction.
Our results were published in international research journals. More importantly, the designed task was tested with subjects affected by cognitive decline and elicited very vivid memories for subjects who also found the VR experience as stimulating and easy to use. Through our partnership with National Theatre Bucharest elderly subjects participating in our activities participated also at theatre performances.
Summary of bilateral results
During STAD project the team had three in-person meetings, two of them with representatives of research teams besides PI’s and team coordinators. Regular monthly research meetings were kept monthly planning activities and discussing results. The research team gained a strong understanding of the research capabilities of the partners. Extended teams in partner organizations were introduced by extended lectures offered by the principal investigators of the project both in Norway and Romania, creating perspectives for larger collaborations.