CITmed: Cognitive Interaction Technology for Medical Applications
The CITmed project aims at the development of a novel medical device for the
application of virtual reality (VR) in the diagnosis and rehabilitation in neurology,
neuropsychology, and psychiatry, as well as the implementation of respective clinical studies.
The fields of application will be primarily disturbances of brain functions resulting from
apoplexia, cerebral trauma caused by accidents, and neurological and psychiatric diseases.
Despite the huge social costs resulting from such disease patterns, methods for diagnosis and,
in particular, rehabilitative treatment of patients are still insufficient. This is particularly
evident in cases where higher cognitive functions are affected. Recent experimental studies have
shown that VR techniques can build up dynamic, interactive stimulus-environments that are
applicable for (i) the diagnosis of behavioral reactions resulting from cognitive processing,
and (ii) the installation of interactions between humans and VR environments allowing for the
rehabilitation of disturbed brain functions in a context close to everyday life.
The main objective of the CITmed project is to provide a novel systems-platform for the
application of interactive VR diagnosis and rehabilitation in neurology, neuropsychology, and
psychiatry. We are developing a cost-efficient and low maintenance VR system for the easy-to-use
interaction of patients with virtual everyday scenarios. The diagnosis and rehabilitation will
be based on novel neuropsychological tests that are custom-tailored to our VR environment. The
software to be developed targets clinical use.
As a winner of the
the CITmed project is funded through the NRW Ziel 2 program
(Europäischer Fonds für regionale Entwicklung). CITmed is embedded into
Bielefeld's Center of Excellence CITEC, which
is the ideal environment for this highly interdisciplinary project.
01.09.2009: Official start of the CITmed project!
16.11.2010: The CITmed project is exhibited at the MEDICA 2010 trade fair
(see the official uni.news).
While there exist many established rehabilitation programs for patients with
disturbed brain functions and cognitive deficits, they all suffer from one
major problem: Patients improve their cognitive capacities in the employed
paper-and-pencil tests, but this improvement cannot be transferred to daily
situations and problems. A VR training system has the advantage of being much
more flexible than standard paper-and-pencil tests. We therefore try to
overcome the above limitations by designing as realistic as possible VR
training scenarios that are close to every day routines. One example is
shopping in a virtual supermarket, which requires (and hence trains!) memory,
spatial attention, spatial orientation, and executive functions.
The main technical challenges for designing a successfull VR platform for
clinical use are cost efficiency, a low level of maintenance, ease of use for
the patient, and a sufficiently high level of immersion. In order to meet
these goals, our OctaVis
system, described in , builds a 360° projection by arranging eight
screens in an octagon around the patient (Figure 1).
A major challenge is the design of an easy-to-use interaction metaphor for
navigating through and interacting with the virtual environment. In
the OctaVis system the user
navigates by rotating the chair into the direction of desired movement and
using a "throttle joystick" in the armrest. Items can be selected by simply
touching them on the touch-sensitive screens. This user interaction, depicted
in Figure 2 and shown the video below, has been successfully evaluated, such
that even elderly patients without previous experience in virtual reality
could work with our system [3,5].
In contrast to sophisticated and expensive CAVE solutions, which employ a
network-connected rendering machine per display, our system is driven by a
single PC workstation. Equipped with three graphics cards driving three
displays each, we can control nine displays: the eight octagon displays and
one operator display. Through massive parallelization over the available CPU
cores and graphics cards we are able to achieve real-time visualization even
for highly complex 3D scenes [1,6]. The overall system is described in  and
schematically depicted in Figure 3.
Since our VR system provides a perfectly controllable test environment, it
allows for custom-tailored neuropsychological diagnosis and training
programs. Our system has been evaluated in a multi-centered clinical study
with our four medical partners: the clinics for psychiatry, neurology, and
epilepsy in Bethel and the Marcus-Klinik for neuro-rehabilitation in Bad
Driburg. During a training session the system monitors the patient's path
through the VR environment, logs successful task completions as well as
errors, and measures bio-data such as heart rate and skin conductance. This
massive amount of data provides insight into the patients' cognitive deficits
as well as their respective training improvements, and will thereby allow us
to further improve the training program. Our goal is to prove that the
application of real-life-like VR environments can in particular help to
improve cognitive functions which are indispensable for the patients’ everyday
lives. First results of the clinical studies are very promising [10,12]. In
2013, the CITmed project was awarded with the 3rd place of the Eurographics
OctaVis: A Simple and Efficient Multi-View Rendering System