Reinforcement learning-driven adaptive game therapy for cognitive impairment patients with improved vision transformer based detection model

BACKGROUND: Cognitive impairment is the growing challenge that requires early diagnosis and personalized management of neurodegenerative conditions like Alzheimer's disease. Neuroimaging modalities like Magnetic Resonance Imaging (MRI) provide valuable structural and functional insights into brain changes associated with cognitive decline. However, existing deep learning (DL) based diagnostic models have the challenges in non-consideration of long-range spatial dependencies and contextual information across brain slices that lead to suboptimal classification accuracy. METHODS: To overcome the limitations, this research introduces the framework that combines an Improved Vision Transformer (Im-ViT) with the Residual Simple Recurrent Unit (ResNet-SRU) based Multilayer Perceptron (MLP) to capture spatial and temporal dependencies in neuroimaging data. Preprocessing using Multiscale Gaussian Filter (MGF) enhances feature clarity by removing multiscale noise. In addition, the system integrates the Visual Working Memory (VWM)-based game therapy, where difficulty levels dynamically adapt using the proposed Iterative Hiking-based Reinforcement Learning (ItHRL) approach. RESULTS: The analysis of the proposed model based on various assessment measures like Accuracy, Recall, Precision, F-Score, Specificity, and Mean Squared Error (MSE) acquired the values of 99.62%, 99.33%, 98.97%, 99.56%, 99.62% and 0.018 respectively. CONCLUSIONS: The proposed model with combined detection and game therapy approach yield higher classification accuracy, faster convergence and patient engagement.