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Background: Individuals with mild cognitive impairment (MCI) syndrome often report navigation difficulties, accompanied by impairments in egocentric and allocentric spatial memory. However, studies have shown that both bodily (e.g., motor commands, proprioception, vestibular information) and visual-cognitive (e.g., maps, directional arrows, attentional markers) cues can support spatial memory in MCI. Objective: We aimed to assess navigation cues for innovative spatial training in aging. Methods: Fifteen MCI patients were recruited for this study. Their egocentric and allocentric memory recall performances were tested through a navigation task with five different virtual reality (VR) assistive encoding navigation procedures (bodily, vision only, interactive allocentric map, reduced executive load, free navigation without cues). Bodily condition consisted of an immersive VR setup to engage self-motion cues, vision only condition consisted of passive navigation without interaction, in the interactive allocentric map condition patients could use a bird-view map, in the reduced executive load condition directional cues and attentional markers were employed, and during free navigation no aid was implemented. Results: Bodily condition improved spatial memory compared to vision only and free navigation without cues. In addition, the interactive allocentric map was superior to the free navigation without cues. Surprisingly, the reduced executive load was comparable to vison only condition. Moreover, a detrimental impact of free navigation was observed on allocentric memory across testing trials. Conclusions: These findings challenge the notion of an amodal representation of space in aging, suggesting that spatial maps can be influenced by the modality in which the environment was originally encoded.

Extensive literature elucidated the mechanisms underlying the ability to memorize the positions of objects in space. However, less is known about the impact that objects' features have on spatial memory. The present study aims to investigate differences in egocentric and allocentric object-location memory between hand stimuli depicted in a first-person perspective (1PP) or in a third-person one (3PP). Fifty-two adults encoded spatial positions within a virtual museum environment featuring four square buildings. Each of these buildings featured eight paintings positioned along the walls, with two pictures displayed on each of the four walls. Thirty-two stimuli were employed, which represented pictures of the right hand performing various types of gestures. Half of the stimuli depicted the hand in the 1PP, while the other half depicted the hand in the 3PP. Both free and guided explorations served as encoding conditions. Immediately after that, participants underwent a two-step object-location memory task. Participants were provided with a map of the museum and asked to identify the correct building where the image was located (allocentric memory). Then, they were presented with a schematic representation of the exhibition room divided into four sections and instructed to select the section where they thought the picture was located (egocentric memory). Our findings indicate a memory performance boost associated with egocentric recall, regardless of the perspective of the bodily stimuli. The results are discussed considering the emerging literature on the mnemonic properties of body-related stimuli for spatial memory.

Background: Egocentric and allocentric spatial memory impairments affect the navigation abilities of older adults with mild cognitive impairment (MCI). Embodied cognition research hints that specific aids can be implemented into virtual reality (VR) training to enhance spatial memory.Objective: In this study, we preliminarily tested 'ANTaging', an embodied-based immersive VR training for egocentric and allocentric memory, compared to treatment as usual (TAU) spatial training in MCI.Methods: MCI patients were recruited for this controlled trial. A cognitive battery was administered at pre-test, after ten sessions of ANTaging or TAU intervention, and at 3-month follow-up (FU). The primary outcomes were spatial cognition tests (Corsi supra-span, CSS; Manikin test, MT). VR egocentric and allocentric performance was also collected.Results: We found that ANTaging significantly improved MT scores at FU compared to TAU. CSS slightly improved in both groups. Concerning secondary outcomes, auditory-verbal forgetting significantly improved at post-test in the ANTaging but not TAU group and significantly declined at FU in the TAU but not in the ANTaging group. Global cognition significantly improved at FU for TAU and remained stable for ANTaging. Other tests showed no improvement or deterioration. Clinical significance showed that ANTaging is effective for CSS. Virtual egocentric and allocentric memory performance improved across ANTaging sessions.Conclusions: ANTaging holds the potential to be superior for improving spatial cognition in MCI compared to TAU. Embodied cognition research provides insights for designing effective spatial navigation rehabilitation in aging.

In this chapter, we will analyze several philosophical issues related to the concept of the Metaverse. After having argued that the technological and conceptual propellant of the Metaverse is virtual reality, the fundamental properties characterizing virtual reality are illustrated, and the degree of reality possessed by virtual reality is questioned. In this regard, two different views exist: virtual realist and virtual irrealist. The former argues that virtual entities are real, while the latter argues that virtual entities are not real but are akin to characters in fiction. Virtual realists do not affirm, of course, that virtual entities are composed of atoms and molecules in the same manner as physical entities, but rather that they are made of bits, that is, ultimately, of information. However, this does not diminish their reality compared to the entities encountered in everyday life. No direct argument will be given here in favor of one position over the other, but an ethical dilemma regarding virtual reality will be proposed: are actions that are evil within the real world also evil within virtual reality? Since our responses to this question vary from case to case, depending on the level of realism of virtual reality, our conclusion will be that the reality of the virtual is a matter of degree.

Immersive virtual reality (IVR) technology provides several educational affordances that make it a valuable tool for learning, especially from a constructivist learning perspective. Combined with the increasing availability of Metaverse social platforms, such as ENGAGE and AltSpace VR, where students and teachers can meet and work together, IVR may transform how students learn and interact with educational content. However, little is known about students’ attitudes toward IVR in education. To address this gap, we surveyed 329 undergraduate students from different universities in Italy. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict students’ intention to adopt IVR for learning. We further explored the role that different individual factors, including students’ learning styles, affordances perceptions, and personal innovativeness, have on their attitudes toward IVR. A hierarchical multiple regression analysis revealed that the four constructs of the UTAUT, namely performance expectancy, effort expectancy, social influence, and facilitating conditions were the strongest predictors of students’ intention to use IVR in education and that individual factors only had little impact on it. Based on these results, this study provides helpful indications for researchers and educators who wish to introduce IVR effectively in educational contexts. Given the new possibilities provided by Metaverse applications based on IVR technology for learning, it is indeed crucial to fully understand the attitudes different stakeholders in education have toward adopting this technology in educational contexts.

What distinguishes real-world communities from their online counterparts? Social and cognitive neuroscience research on social networks and collective intentionality will be used in the article to answer this question. Physical communities are born in places. And places engage ‘‘we-mode’’ neurobiological and cognitive processes as behavioral synchrony, shared attention, deliberate attunement, interbrain synchronization, and so on, which create coherent social networks of very different individuals who are supported by a ‘‘wisdom of crowd.’’ Digital technologies remove physical boundaries, giving people more freedom to choose their activities and groups. At the same time, however, the lack of physical co-presence of community members significantly reduces their possibility of activating ‘‘we-mode’’ cognitive processes and social motivation. Because of this, unlike physical communities that allow interaction between people from varied origins and stories, digital communities are always made up of people who have the same interests and knowledge (communities of practice). This new situation disrupts the ‘‘wisdom of crowd,’’ making the community more radical and less accurate (polarization effect), allowing influential users to wield disproportionate influence over the group’s beliefs, and producing inequalities in the distribution of social capital. However, a new emergent technology—the Metaverse—has the potential to reverse this trend. Several studies have revealed that virtual and augmented reality—the major technologies underlying the Metaverse—can engage the same neurobiological and cognitive ‘‘we-mode’’ processes as real-world environments. If the many flaws in this technology are fixed, it might encourage people to engage in more meaningful and constructive interactions in online communities.

Our physical and psychological well-being is significantly influenced by how we perceive our body, in addition to our thoughts and emotions associated with it. Dysfunctional body perceptions and attitudes play a key role in the development and maintenance of severe conditions such as eating disorders in both males and females. Given its relevance, some attempts have been made to improve body image assessment methods in terms of perceptual accuracy and body satisfaction taking advantage of technological advances such as virtual reality. However, existing applications have mainly focused on women and clinical conditions. In this study, we presented the Body Image Virtual Reality Assessment (BIVRA), a virtual reality figure rating scale to assess body image in both male and female subjects. We tested BIVRA's ability to measure perceptual accuracy and compared its results with a standardized body satisfaction questionnaire. Additionally, we investigated gender differences. BIVRA was found to be effective in assessing body image. We observed that a perceptually based task successfully captured both low and high levels of body representations, shedding light on the significant gender differences. The association between BIVRA and the body satisfaction questionnaires was moderated by gender, with a stronger association for women. While further validation of BIVRA is needed to fully exploit its potential, our results suggest that the integration of virtual reality into the assessment of body image and related disorders may significantly enhance our understanding of individuals struggling with body image issues and has the potential to advance current methods and techniques.

The metaverse, an emerging digital universe blurring the lines between reality and virtuality, offers a view into a future where human interaction transcends physical boundaries. In this article, we analyze the multidimensional facets of the metaverse, scrutinizing the landscape of challenges and opportunities it offers. The article delves into the challenges faced by human society in adapting to the metaverse, including the digital divide, ethical dilemmas, the level of trust, and the potential erosion of social and physical reality. Amid the allure of boundless creativity, questions arise about the very essence of human experience—identity, empathy, social relationships, life satisfaction, and the nature of reality itself. The metaverse, with all its complexities, challenges us to redefine the boundaries of human interaction, urging us to tread cautiously while embracing the limitless possibilities it presents. As we venture ‘‘toward a humane metaverse,’’ we must navigate the intricate interplay of technology and humanity, shaping a future where the virtual realm enhances, rather than diminishes, the richness of the human experience.

Purpose of Review: We review the first pilot studies applying metaverse-related technologies in psychiatric patients and discuss the rationale for using this complex federation of technologies to treat mental diseases. Concerning previous virtual-reality applications in medical care, metaverse technologies provide the unique opportunity to define, control, and shape virtual scenarios shared by multi-users to exploit the “synchronized brains” potential exacerbated by social interactions. Recent Findings: The application of an avatar-based sexual therapy program conducted on a metaverse platform has been demonstrated to be more effective concerning traditional sexual coaching for treating female orgasm disorders. Again, a metaverse-based social skills training program has been tested on children with autism spectrum disorders, demonstrating a significant impact on social interaction abilities. Summary: Metaverse-related technologies could enable us to develop new reliable approaches for treating diseases where behavioral symptoms can be addressed using socio-attentive tasks and social-interaction strategies.

Immersive virtual reality (IVR) technology provides several educational affordances that make it a valuable tool for learning, especially from a constructivist learning perspective. Combined with the increasing availability of Metaverse social platforms, such as ENGAGE and AltSpace VR, where students and teachers can meet and work together, IVR may transform how students learn and interact with educational content. However, little is known about students' attitudes toward IVR in education. To address this gap, we surveyed 329 undergraduate students from different universities in Italy. We used the Unified Theory of Acceptance and Use of Technology (UTAUT) to predict students' intention to adopt IVR for learning. We further explored the role that different individual factors, including students' learning styles, affordances perceptions, and personal innovativeness, have on their attitudes toward IVR. A hierarchical multiple regression analysis revealed that the four constructs of the UTAUT, namely performance expectancy, effort expectancy, social influence, and facilitating conditions were the strongest predictors of students' intention to use IVR in education and that individual factors only had little impact on it. Based on these results, this study provides helpful indications for researchers and educators who wish to introduce IVR effectively in educational contexts. Given the new possibilities provided by Metaverse applications based on IVR technology for learning, it is indeed crucial to fully understand the attitudes different stakeholders in education have toward adopting this technology in educational contexts.

Nowadays, the web presents real estate sites providing the possibility to use low-cost virtual reality (VR) solutions without sacrificing the high quality of graphic visualization of their contents to attract customers through enhanced digital experiences and increase the probability of selling their products. However, whether immersive VR technologies improve the chances of selling real estate is unclear. This study examines the effects induced by a real estate website that offers the opportunity to evaluate the potential purchase of a property in two ways: by viewing photos of the house (non-immersive conditions) and by taking a virtual tour of the same house using a VR head-mounted display (immersive conditions). Forty participants interested in evaluating the purchase of a new house, randomly assigned to one of the experimental conditions, participated in the experiment. During the real estate experience, electroencephalography (EEG) and skin conductance (SC) were recorded to collect biological data about the emotional effects raised by each condition. After the study, psychological self-reported questionnaires were collected measuring: emotions, presence, user experience (UX), and a three-item ad hoc scale exploring behavioral intentions (e.g., the perceived pleasantness of the house, the willingness to visit the house, and the purchase intention). Results show that immersive navigation is associated with more positive emotions (EEG), more intense physiological arousal (SC), higher scores on the presence questionnaire, and higher scores on the UX questionnaire compared to the non-immersive one. The psychological scales measuring emotions did not yield significant results. No significant difference in the three-item ad-hoc self-questionnaire was found, except for the item examining willingness to visit the real house building. Implications are also discussed.

Reading other minds is a pervasive feature of human social life. A decade of research indicates that people can automatically track an agent's beliefs regardless of whether this is required. But little is known about the principles t guide automatic belief tracking. In six experiments adapting a false belief task introduced by Kov ' acs et al. (2010), we tested whether belief tracking is interrupted by either an agent's lack of perceptual access or else by an agent's constrained action possibilities. We also tested whether such manipulations create interruptions when participants were instructed to track beliefs. Our main finding: the agent's lack of perceptual access did not interrupt belief tracking when participants were not instructed to track beliefs. Overall, our findings raise a challenge: some of the phenomena that have been labelled mindreading are perhaps not mindreading at all, or-more likely-they are mindreading but not as we know it.

Illusions that create a sense of ownership over a virtual body have been widely used to investigate the characteristics of our bodily experience. Despite the great potential of 360-degree videos to implement full-body ownership illusion, research is in its early stages, and no validated tools—neither commercial nor free—are available for the scientific and clinical community. In the current study, we present and discuss the development and feasibility results of a free 360-degree video-based body ownership illusion that researchers and scholars can experience using a cardboard headset with their smartphones. Forty-six participants underwent the 360-degree video-based full-body ownership illusion, visualizing in a first-person perspective (1PP) or in a mirror view the pre-recorded body of a young female performer. All participants were exposed to a congruent visuo-tactile condition (embodiment condition) and to an incongruent visuo-tactile condition (control condition). Participants completed the Embodiment Questionnaire and the Objectified Body Consciousness (OBC) scale. Results revealed that in the congruent visuo-tactile condition (compared to the control one), participants experienced a strong illusion in terms of body ownership, self-location, and agency. In terms of visual perspective, there was no difference in embodiment feelings between participants who experienced the illusion in 1PP and those who underwent a mirror perspective. Lastly, the control beliefs subscale (i.e., OBC scale) displayed a positive correlation with the self-location illusion susceptibility. Overall, these results point to the feasibility of this novel tool as immersive 360-degree video-based scenarios to deliver bodily illusions, and they open new avenues for future clinical interventions.

Background: Increasing research suggests that gait abnormalities can be a risk factor for Alzheimer’s Disease (AD). Notably, there is growing evidence highlighting this risk factor in individuals with amnestic Mild Cognitive Impairment (aMCI), however further studies are needed. The aim of this study is to analyze cognitive tests results and brain-related measures over time in aMCI and examine how the presence of gait abnormalities (neurological or orthopedic) or normal gait affects these trends. Additionally, we sought to assess the significance of gait and gait-related measures as prognostic indicators for the progression from aMCI to AD dementia, comparing those who converted to AD with those who remained with a stable aMCI diagnosis during the follow-up. Methods: Four hundred two individuals with aMCI from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database were included. Robust linear mixed-effects models were used to study the impact of gait abnormalities on a comprehensive neuropsychological battery over 36 months while controlling for relevant medical variables at baseline. The impact of gait on brain measures was also investigated. Lastly, the Cox proportional-hazards model was used to explore the prognostic relevance of abnormal gait and neuropsychological associated tests. Results: While controlling for relevant covariates, we found that gait abnormalities led to a greater decline over time in attention (DSST) and global cognition (MMSE). Intriguingly, psychomotor speed (TMT-A) and divided attention (TMT-B) declined uniquely in the abnormal gait group. Conversely, specific AD global cognition tests (ADAS-13) and auditory-verbal memory (RAVLT immediate recall) declined over time independently of gait profile. All the other cognitive tests were not significantly affected by time or by gait profile. In addition, we found that ventricles size increased faster in the abnormal gait group compared to the normal gait group. In terms of prognosis, abno

Objective The general objective of the current study was to investigate the efficacy of a novel self-help virtual therapeutic experience (specifically, the COVID Feel Good intervention) in lowering the psychological burden experienced during the COVID-19 lockdowns in four European countries. Methods We focused on participants recruited from June 2020 to May 2021 in the context of a European multicenter project including four university/academic sites. The total number of participants in the longitudinal studies was 107 (study 1, N = 40; study 2, N = 29; study 3, N = 38). The randomized controlled trial (study 4) included 31 participants in total, 16 in the intervention group and 15 in the control group. Primary outcome measures were depression, anxiety, stress symptoms, perceived stress level, and perceived hopelessness. The secondary outcome was experienced social connectedness. Results Using separate linear mixed-effects models, the most consistent result across countries was a reduction in perceived stress after the participation in the COVID Feel Good intervention. By pooling the results of the models using a random-effects meta-analysis, we found that after the COVID Feel Good intervention, participants reported a decrease in perceived general distress (mean standardized effect size for general distress in the treatment groups compared with the control conditions was -0.52 [p =.008, 95% confidence interval = -0.89 to -0.14]) and an increase in the perceived social connection (mean standardized effect size for social connection using COVID Feel Good compared with the control conditions was 0.50 [p ≤.001, 95% confidence interval = 0.25 to 0.76]). Conclusions Findings of this study indicate that a virtual self-help intervention is effective in reducing psychological distress. These results contribute to the growing literature supporting the use of digital psychological therapies to relieve psychological distress among the general population during the COVID-19 pan

Space can be used as a metaphor to describe semantic and perceptual similarity. Research has shown that similarity and spatial information can influence each other. On the one hand, similarity entails spatial closeness; on the other hand, proximity leads to similarity judgment. This spatial information can be stored in declarative memory and measured later on. However, it is unknown if phonological similarity/dissimilarity between words is represented as spatial closeness/distance in declarative memory. In this study, 61 young adults were tested on a remember-know (RK) spatial distance task. Participants learned noun pairs on the PC screen that were manipulated concerning their phonological similarity (similar vs. dissimilar) and reciprocal spatial distance (near vs. far). In the recognition phase, old-new, RK, and spatial distance judgments were asked. We found that for hit responses in both R and K judgments, phonologically similar word pairs were remembered closer compared to phonologically dissimilar pairs. This was also true for false alarms after K judgments. Lastly, the actual spatial distance at encoding was only retained for hit R responses. Results suggest that phonological similarity/dissimilarity is represented respectively with spatial closeness/distance and that this information is stored in the neurocognitive system of declarative memory.

Our lives have drastically changed during the COVID-19 pandemic. Information and communications technologies (ICTs) have replaced other media as the primary means of work, communication, expression, and entertainment throughout this time. As society's reliance on technology increases throughout and possibly after the pandemic, it is critical to fully understand the multifaceted nature of engagement with technology and develop reliable instruments capable of accurately evaluating its processual nature. Therefore, this study aimed at describing and psychometrically validating a novel instrument to measure the dynamics of engagement with technology, namely the Technology Engagement Scale (TES). Data were collected from a representative sample of 2021 participants in Italy. Results from both the confirmatory analysis and the Rasch model suggested the mono-dimensionality of the 5-item TES. Moreover, empirical ordinal alpha indicated a very good internal consistency. Findings provide also solid evidence for the convergent validity of the proposed instrument. Finally, it emerged that TES levels were able to predict the frequency of online activities during the COVID-19 pandemic. Globally, these findings suggest that the TES could be considered a reliable and valid tool, able to evaluate the complex process of engagement with technology in a simple, quick, and easy-to-administer manner.

Background: The COVID-19 pandemic. In this framework, digital self-help interventions have the potential to provide flexible and scalable solutions for delivering evidence-based treatments that do not necessitate face-to-face meetings. Objective: as part of a multicentric project, the purpose of the current randomized controlled trial was to evaluate the efficacy of a Virtual-Reality-based self-help intervention (namely, COVID Feel Good) in lowering the psychological distress experienced during the COVID-19 pandemic in Iran. Methods: 60 participants were randomly assigned to the experimental (COVID Feel Good intervention group) or the control (no-treatment control group) condition. At the beginning of the intervention (Day 0), at the end of the intervention (Day 7), and after a 2-week follow-up (Day 21), measurements of depressive and anxiety levels, general distress, perceived levels of stress, hopelessness (primary outcome measures), perceived interpersonal closeness with the social world, and fear of COVID-19 (secondary outcome measure) were collected. The protocol consists of two integrated parts: the first part includes a relaxing 10-min three-hundred-sixty-degree (360°) video, while the second one includes social tasks with specified objectives. Results: In terms of the primary outcomes, participants in the COVID Feel Good intervention group improved in depression, stress, anxiety, and perceived stress but not hopelessness. Secondary outcome results showed an improvement in perceived social connectedness and a substantial decrease in fear of COVID-19. Conclusions: these findings on the efficacy of COVID Feel Good training add to the growing body of evidence demonstrating the feasibility of digital self-help interventions in promoting well-being during this unique period.

Individuals with mild cognitive impairment (MCI) usually report navigation and spatial memory impairments. Spatial navigation is an embodied process that requires the active involvement of both physical (e.g., motor commands and proprioception) and cognitive (e.g., decision-making and mental rotation) information. Immersive virtual reality (IVR) is a valuable tool that employs this information as real-world navigation does. Given the crucial impact of spatial navigation on daily life, research should focus on ways to enhance it. Though they are still in their development, contemporary IVR methods for spatial navigation training in MCI seem promising. In this usability study, eight patients with MCI syndrome tested an IVR spatial navigation training demo and interacted with the CAVE using active stereo glasses, a foot-motion pad, and a joypad. During the demo, users were asked to report their impressions on the IVR training using the thinking-aloud procedure. Moreover, questionnaires regarding usability, presence and cybersickness were administered at the end of the experience. Our results show that the first version of this system is usable by the patients even if most of them did not have experience with PC/IVR. The system provided a moderate sense of spatial presence and limited negative effects. Issues found during the thinking-aloud procedure concerned the visual aspects, which affected the interaction user-system. Participants reported that they needed more practice with the foot-motion pad even though the overall experience was positively evaluated. Identifying these critical features was essential to develop an improved version of the current system.

Mental health disorders pose a significant challenge to society. The Bayesian perspective on the mind offers unique insights and tools that may help address a variety of mental health conditions. Psychopathological dysfunctions are often connected to altered predictive and active inference processes, in which cognitive and physiological pathogenic beliefs shape the clinical condition and its symptoms. However, there is a lack of general empirical models that integrate cognitive beliefs, physiological experience, and symptoms in healthy and clinical populations. In this study, we examined the relationship between altered predictive mechanisms, interoception, and pathological bodily distortions in healty individuals and in individuals suffering from anorexia nervosa (AN). AN patients (N=15) completed a Virtual Reality Full-Body Illusion along with interoceptive tasks twice: at hospital admission during an acute symptomatological phase (Time 1) and after a 12-week outpatient clinical weight-restoring rehabilitative program (Time 2). Results were compared to a healthy control group. Our findings indicated that higher levels of interoceptive metacognitive awareness were associated with a greater embodiment. However, unlike in healthy participants, AN patients' interoceptive metacognition was linked to embodiment even in multisensory mismatching (asynchronous) conditions. In addition, unlike in healthy participants, higher interoceptive metacognition in AN patients was related to prior abnormal bodily distortions during the acute symptomatology phase. Prediction errors in bodily estimates predicted posterior bodily estimate distortions after the illusion, but while this relationship was only significant in the synchronous condition in healthy participants, there was no significant difference between synchronous and asynchronous conditions in AN patients. Despite the success of the rehabilitation program in restoring some dysfunctional patterns in the AN group, prediction

The large-scale diffusion of tablets and smartphones in the last decades offered new opportunities to broaden educational strategies. In particular, the Mobile-Assisted Language Learning (MALL) emerged as a promising approach leveraging the widespread availability of portable devices. In this study we investigated the feasibility and efficacy of a self-administered MALL homework training based on immersive 360° videos, compared to a training based on not-immersive standard videos showing the same visual content and enriched by an auditory description of the environment. The knowledge of target words was assessed before and after the training. In addition, students’ attitudes toward the technology were assessed before the training. Results indicated that students with a more positive attitude toward technology watched the videos more than those with a less positive attitude. Furthermore, students who underwent the training with 360°videos learned more words than students belonging to the control group, even after controlling for the number of videos views.

Navigation is a multimodal process that requires the active computation of cognitive and bodily cues along with external environmental information. Indeed, according to the embodied cognition framework, the body and the environment build our cognitive representation of the space. This view is supported by findings in the aging population where the decline of bodily information accounts for the deficits in spatial navigation. Consequently, it is crucial to develop innovative rehabilitation solutions in aging that require the active use of bodily and cognitive processing of the space and its elements. Mild cognitive impairment is a geriatric syndrome considered to be a transitional stage between normal aging and dementia. Consequently, it is a preferred time window to administer cognitive rehabilitation programs that could slow down cognitive deterioration. In the current paper, the ANTaging protocol will be presented in its three-step studies: pilot testing, usability study, and proof-of-concept trial.

Despite advances in our understanding of the behavioral and molecular factors that underlie the onset and maintenance of Eating Disorders (EDs), it is still necessary to optimize treatment strategies and establish their efficacy. In this context, over the past 25 years, Virtual Reality (VR) has provided creative treatments for a variety of ED symptoms, including body dissatisfaction, craving, and negative emotions. Recently, different researchers suggested that EDs may reflect a broader impairment in multisensory body integration, and a particular VR technique—VR body swapping—has been used to repair it, but with limited clinical results. In this paper, we use the results of a systematic review employing PRISMA guidelines that explore inner body perception in EDs (21 studies included), with the ultimate goal to analyze the features of multisensory impairment associated with this clinical condition and provide possible solutions. Deficits in interoception, proprioception, and vestibular signals were observed across Anorexia and Bulimia Nervosa, suggesting that: (a) alteration of inner body perception might be a crucial feature of EDs, even if further research is needed and; (b) VR, to be effective with these patients, has to simulate/modify both the external and the internal body. Following this outcome, we introduce a new therapeutic approach—Regenerative Virtual Therapy—that integrates VR with different technologies and clinical strategies to regenerate a faulty bodily experience by stimulating the multisensory brain mechanisms and promoting self-regenerative processes within the brain itself.

Purpose: This post hoc study aimed to assess the hypothesis that subjects with obesity could underestimate their body size. Methods: Data from a previous study with different aims were used to compare 22 female inpatients with obesity with 21 healthy-weight women in the size estimation accuracy of their shoulders, waist, and hips circumferences and widths. The body estimation task with an individualized metric methodology was used to collect data. Frequentist and Bayesian analyses were performed. Results: Samples differed significantly in the accuracy measures of shoulders width and hips as well as waist circumferences: inpatients with obesity underestimated them, while healthy-weight subjects estimated shoulders width accurately but overestimated their hips and waist circumferences. Multiple regression showed that the between-group difference in the accuracy measure of shoulders width was explained by the individuals’ education level, while the difference in the accuracy measure of waist circumference resulted to be independent of both age and education level. Conclusion: This post hoc study supports the hypothesis that female patients with obesity might underestimate their body size. If these results will be confirmed in future studies, interventions specifically designed to equalize estimations to match the real measures of body size may play a key role in weight-reduction programs for people with obesity. Level of evidence: Level III, evidence obtained from cohort or case–control analytic studies.

Navigation and spatial memory impairments are reported by individuals with mild cognitive impairment (MCI), which is considered a transitional stage between normal aging and dementia. Spatial navigation is an embodied process that requires both bodily (e.g., motor commands, proprioception) and cognitive (e.g., decision-making, mental rotation) information. Immersive virtual reality (IVR) is a powerful tool that recruits this information as in real-world navigation. Given the crucial impact of spatial navigation impairments on daily life, its rehabilitation should be a primary objective of research. Nevertheless, current IVR solutions for spatial navigation rehabilitation in MCI are still in their infancy. In this usability study, eight MCI patients tested an IVR spatial navigation training demo and interacted with the CAVE using active stereo glasses, a foot-motion pad, and a joypad. During the demo, thoughts and issues were reported with the thinking-aloud procedure. Questionnaires about usability, presence, and cybersickness were administered at the end of the experience. Our results show that the first version of this system is usable by the patients even if the majority had no experience with PC/IVR. The system provided a moderate sense of spatial presence and very low negative effects. Issues found during the thinking-aloud procedure concerned visual aspects which affected the interaction user-system. Participants needed to practice more with the foot-motion pad even though the overall experience was positively evaluated. By identifying critical aspects, an improved version of the current system has been released.

Oncological treatments are responsible for many of the physical changes (aesthetic and functional) associated with cancer. Because of this, cancer patients are at high risk of developing mental health problems. The aim of this study is to propose an innovative Virtual Reality (VR) training that uses a somatic technique (i.e., embodiment) to create a bridge with the bodily dimension of cancer. After undergoing a psycho-educational procedure, a combination of exposure, out-of-body experience, and body swapping will gradually train the patient to cope with cancer-related difficulties, increasing stress tolerance, and patient empowerment. The most engaging step of this advanced form of Stress Inoculation Training is the body swapping experience, which will guide the patient in embodying a resilient cancer patient who is facing similar difficulties. Through the VR ability to simulate the human brain functioning, and the potential of embodiment to hook to the somatic dimension of illness, we expect that once the concepts endured through the patient’s experience of resilience are triggered, the patient will be more prone to implement functional coping strategies in real life, reaching empowerment and adjusting to the post-treatment difficulties. When the scenarios are built and the training tested, our intervention could be used to support patients with different oncological diseases and who are treated in different cancer hospitals, as well as patients with other non-oncological problems (e.g., social anxiety). Future research should focus on using our paradigm for other clinical populations, and supporting cancer patients in coping with different distressing situations.