1. Neurocognitive structure

Being able to find our way around, or to navigate, is an essential human ability we rely on daily. Especially when we fail to navigate successfully, its importance for our daily functioning is obvious. In a minor instance of getting lost, the only consequence may be losing some time to adjust our path. In more serious cases, it can be very stressful, frightening, and have a substantial impact on one’s quality of life. Navigation ability typically consists of a wide range of cognitive functions. In order to select the correct exit on the highway, we need to keep track of our goal location, consult our mental map of the environment, and remember the landmarks we pass along the way, for instance. Currently, there is no unitary characterization of navigation ability, based on direct empirical evidence that encompasses all of these functions. This does not only hinder theoretical progress in the field of spatial cognition, but also prohibits the development of proper diagnostic and training tools in clinical practice and an applied cognitive setting. The aim of this line of research is to provide a neurocognitive model of navigation ability and develop clinical tools to diagnose and treat navigation impairment.

2. Navigation impairment

Around 30% of mild stroke patients report to have problems in finding their way around. This proportion is substantiated by recent objective measures of navigation performance. The consequences of these problems in daily life are substantial: patients avoid going places by themselves as they fear they may get lost, and these measures are correlated negatively with quality of life measures. Despite many reports on individual cases of navigation impairments, there is no up-to-date overview of how navigation impairment can be classified. This is not only important from a neurocognitive point of view (what types of brain damage are linked to what types of behavioral impairments) but also from a clinical perspective. Proper classification is necessary to diagnose and treat navigation impairment. Therefor we are studying a large sample of stroke patients with and without navigation impairment to create this classification.

3. Diagnosis and treatment

Currently, there is no standardized diagnostic tool or treatment for navigation impairment. Yet, we have found convincing evidence that navigation impairment can be fully isolated from performance in other cognitive domains. We aim to develop these tools based on our classification of navigation impairment: if we know more about the characteristics of different types of impairments, suitable tools can be developed. We are using the data we have gathered in stroke patients to search for tasks and questionnaire items that are highly predictive of navigation impairment. In a small sample of stroke patients our first pilot training has been performed and we are planning to implement this training at a larger scale in the near future.

4. Virtual reality and serious gaming

Recent technological advances are valuable to this project. We are working with virtual reality displays to be able to test patients in a laboratory setting, while presenting them with lifelike situations. To increase the potential to generalize findings to the real world, we are conducting experiments with hybrid virtual worlds, in which participants are physically engaged in the real world, but experimental input is presented digitally.
Serious gaming is also very relevant to this project, we are currently developing a serious game in which participants can perform exercises tailor-made to their type of impairment. This allows for elaborate training sessions for longer periods of time, with minimal input from clinicians.

Key publications

Claessen, M.H.G., Van der Ham, I.J.M., Jagersma, E., & Visser-Meily, J.M.A. (2015). Navigation strategy training using virtual reality in six chronic stroke patients: A novel and explorative approach to the rehabilitation of navigation impairment. Neuropsychological Rehabilitation. Advance online publication.

Van der Ham, I.J.M., Faber, A.M.E., Venselaar, M., Van Kreveld, M.J., & Löffler, M. (2015). Ecological validity of virtual environments to assess human navigation ability. Frontiers in Psychology, 6, 637.

Van der Ham, I.J.M. & Van den Hoven, J. (2014). Lateralization of route continuation and route order. Spatial Cognition IX, Lecture Notes in Computer Science, 8684, 137-146.

Van der Ham, I.J.M., Kant, N., Postma, A., & Visser-Meily, J.M.A. (2013) Is navigation ability a problem in mild stroke patients? Insights from self-reported navigation measures. Journal of Rehabilitation Medicine, 45(5), 429-433.

Van der Ham, I.J.M., Van Zandvoort, M.J.E., Meilinger, T., Bosch, S.E., Kant, N., & Postma, A. (2010). Spatial and temporal aspects of navigation in two neurological patients. NeuroReport, 21, 685-689.

• navigation
• neuropsychology
• serious gaming
• virtual reality

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