Virtual Reality Test Research Articles

Cognition Assessment in Virtual Reality: Validity and feasibility of a novel virtual reality test for real-life cognitive functions in mood disorders and psychosis spectrum disorders

There is a pressing need for measures of real-life cognitive functioning in patients with mood or psychotic disorders in clinical settings and treatment trials targeting cognition. We developed the first immersive virtual reality cognition assessment tool, the Cognition Assessment in Virtual Reality (CAVIR), which assesses verbal memory, processing speed, attention, working memory and planning skills in an interactive virtual reality kitchen scenario. This study investigates the sensitivity and validity of the CAVIR for cognitive impairments in mood and psychotic disorders and its association with functioning and neuropsychological performance. Symptomatically stable patients with mood disorders (MD; n = 40) or psychosis spectrum disorders (PSD; n = 41) and healthy control participants (HC; n = 40) completed the CAVIR and standard neuropsychological tests and were rated for clinical symptoms and daily functioning. We found that the CAVIR was sensitive to cognitive impairments across MD and PSD with large effect sizes (MD: F(73) = 11.61, p < .01, ηp2 = 0.14; PSD: F(72) = 18.24, p < .001, ηp2 = 0.19). There was a moderate to strong positive correlation between performance on the CAVIR and on neuropsychological tests (r(121) = 0.58, p < .001), which prevailed after adjustment for age, years of education and verbal IQ (B = 0.67, p < .001). Lower CAVIR scores correlated moderately with more observer-rated and performance-based functional disability (r(121) = -0.30, p < .01 and r(68) = 0.44, p < .001, respectively), also after adjustment for age, years of education and verbal IQ (B = 0.03, p < .001). In conclusion, the CAVIR is a sensitive and valid instrument for measuring real-life cognitive impairments in mood and psychotic disorders. After further psychometric assessments, the CAVIR can be implemented in clinical settings and trials targeting cognition.

Virtual Reality for Modern Society

Treatment and recovery of the intellectual, mental, and engine sequela of focal sensory system brokenness regularly depends on appraisal instruments to illuminate conclusion and to follow changes in clinical status. Regularly, these evaluations utilize paper-and-pencil psychometrics, involved simple/PC tests, and rating of conduct inside the setting of true useful conditions. The current survey talks about the utilization of virtual reality (VR) innovation in clinical medication, particularly in careful preparing, torment the board and restorative treatment of psychological maladjustment. We present the regular kinds of VR test systems and their operational standards in previously mentioned fields. The clinical impacts are additionally talked about. In pretty much every examination that managed VR test systems, scientists have come to a similar end result that the two specialists and patients could profit by this novel innovation. In addition, favourable circumstances and burdens of the use of VR innovation in each field were talked about, and the future exploration headings were proposed

Reaction Time-Based Cognitive Assessments in Virtual Reality - A Feasibility Study with an Age Diverse Sample.

While virtual reality (VR) is an emerging paradigm in a variety of research contexts, VR-based embodiment effects on behavior and performance still lack in sufficient evidence regarding to bias in cognitive performance assessment. In this methodological observational study, we compare the VR measurement of cognitive performance with a conventional computer-based testing approach in real life (RL) in younger and older adults. The differences between VR and RL scenarios are investigated using the background of two theoretical models from cognitive psychology. Furthermore, data assessment reliability and validity are analyzed, concerning the feasibility of technological and ergonomic aspects. A within-group comparison showed no change in information processing speed in either one of the two age groups, i.e., both groups perform equally well in RL and in a VR testing environment. The use of lifelike VR environments for cognitive performance tests seems not to lead to any performance changes compared to RL computer-based assessments, making VR suitable for similar applications. On technical concerns, we recommend the careful use of reaction time paradigms regarding to input hardware and stimuli presentation.

The Effect of Training in Virtual Reality on the Precision of Hand Movements

The main point of the work was to use virtual reality to discover its benefits on training, specifically on the precision of hand movements in specific settings, and then evaluate its effects both for virtual reality and the transfer of the results to the real world. A virtual reality simulation was created using the Unity3D game engine and real-world experimental material was also prepared. A total of 16 participants took part in the training, which lasted for approximately one month. Once the data was gathered from both the virtual reality and real-world tests, we carried out in-depth statistical analysis. The results suggest positive outcomes in most aspects in virtual reality training productivity, but only partial transfer of the training benefits to the real world scenario. The possible reasons for this are described in the work and suggestions are given to duplicate the study with different variables to try to achieve different results.

The Feasibility of Using Virtual Reality and Eye Tracking in Research With Older Adults With and Without Alzheimer's Disease.

Aim: To examine the feasibility of using large scale spatial, self-mobile, virtual reality, and eye tracking in older adults with and without Alzheimer's disease (AD).Methods: Older adults with early stage AD (n = 38) and a control group without AD (n = 50) were asked to find their way in a large, projected VR simulation of a retirement community repeatedly over 10 trials for each of 2 days, while wearing eye tracking glasses. Feasibility measures, including tolerance, side effects, and ability to complete the VR and eye tracking were collected. This study reports the analysis of the feasibility data for the VR and eye tracking and comparison of findings between the groups.Results: Over 80% of the subjects were able to complete the VR portion of the study. Only four subjects, all in the AD group, could not use the joystick and were excluded. Withdrawal rate (18%) was similar between the groups [X2(2) = 2.82, N = 88, p = 0.245] with most withdrawals occurring after the fourth trial. Simulation sickness was not significantly different between the groups. Only 60% of the subjects had completed eye tracking videos; more subjects in the AD group had complete eye tracking videos than the control group; X2(1) = 7.411, N = 88, p = 0.006. Eye tracking incompletion was primarily due to inability to calibration issues.Conclusion: Virtual reality testing and eye tracking can be used in older adults with and without AD in a large-scale way-finding task, but that there are some limitations.

Executive Dysfunctions in Schizophrenia: A Critical Review of Traditional, Ecological, and Virtual Reality Assessments.

In recent years, interest has grown in measuring executive function in schizophrenia with ecological and virtual reality (VR) tools. However, there is a lack of critical analysis comparing those tools with traditional ones. This paper aims to characterize executive dysfunction in schizophrenia by comparing ecological and virtual reality assessments with traditional tools, and to describe the neurobiological and psychopathological correlates. The analysis revealed that ecological and VR tests have higher levels of verisimilitude and similar levels of veridicality compared to traditional tools. Both negative symptoms and disorganization correlate significantly with executive dysfunction as measured by traditional tools, but their relationships with measures based on ecological and VR methods are still unclear. Although there is much research on brain correlates of executive impairments in schizophrenia with traditional tools, it is uncertain if these results will be confirmed with the use of ecological and VR tools. In the diagnosis of executive dysfunction, it is important to use a variety of neuropsychological methods—especially those with confirmed ecological validity—to properly recognize the underlying characteristics of the observed deficits and to implement effective forms of therapy.

Human–Robot Collaborative Assembly Based on Eye-Hand and a Finite State Machine in a Virtual Environment

With the development of the global economy, the demand for manufacturing is increasing. Accordingly, human–robot collaborative assembly has become a research hotspot. This paper aims to solve the efficiency problems inherent in traditional human-machine collaboration. Based on eye–hand and finite state machines, a collaborative assembly method is proposed. The method determines the human’s intention by collecting posture and eye data, which can control a robot to grasp an object, move it, and perform co-assembly. The robot’s automatic path planning is based on a probabilistic roadmap planner. Virtual reality tests show that the proposed method is more efficient than traditional methods.

Multimodal immersive trail making-virtual reality paradigm to study cognitive-motor interactions

BackgroundNeuropsychological tests of executive function have limited real-world predictive and functional relevance. An emerging solution for this limitation is to adapt the tests for implementation in virtual reality (VR). We thus developed two VR-based versions of the classic Color-Trails Test (CTT), a well-validated pencil-and-paper executive function test assessing sustained (Trails A) and divided (Trails B) attention—one for a large-scale VR system (DOME-CTT) and the other for a portable head-mount display VR system (HMD-CTT). We then evaluated construct validity, test–retest reliability, and age-related discriminant validity of the VR-based versions and explored effects on motor function.MethodsHealthy adults (n = 147) in three age groups (young: n = 50; middle-aged: n = 80; older: n = 17) participated. All participants were administered the original CTT, some completing the DOME-CTT (14 young, 29 middle-aged) and the rest completing the HMD-CTT. Primary outcomes were Trails A and B completion times (tA, tB). Spatiotemporal characteristics of upper-limb reaching movements during VR test performance were reconstructed from motion capture data. Statistics included correlations and repeated measures analysis of variance.ResultsConstruct validity was substantiated by moderate correlations between the’gold standard’ pencil-and-paper CTT and the VR adaptations (DOME-CTT: tA 0.58, tB 0.71; HMD-CTT: tA 0.62, tB 0.69). VR versions showed relatively high test–retest reliability (intraclass correlation; VR: tA 0.60–0.75, tB 0.59–0.89; original: tA 0.75–0.85, tB 0.77–0.80) and discriminant validity (area under the curve; VR: tA 0.70–0.92, tB 0.71–0.92; original: tA 0.73–0.95, tB 0.77–0.95). VR completion times were longer than for the original pencil-and-paper test; completion times were longer with advanced age. Compared with Trails A, Trails B target-to-target VR hand trajectories were characterized by delayed, more erratic acceleration and deceleration, consistent with the greater executive function demands of divided vs. sustained attention; acceleration onset later for older participants.ConclusionsThe present study demonstrates the feasibility and validity of converting a neuropsychological test from two-dimensional pencil-and-paper to three-dimensional VR-based format while preserving core neuropsychological task features. Findings on the spatiotemporal morphology of motor planning/execution during the cognitive tasks may lead to multimodal analysis methods that enrich the ecological validity of VR-based neuropsychological testing, representing a novel paradigm for studying cognitive-motor interactions.

The effectiveness of a virtual reality attention task to predict depression and anxiety in comparison with current clinical measures

Previous studies have revealed that attention and inhibition are impaired in individuals with elevated symptoms of depression and anxiety. Virtual reality (VR)-based neuropsychological assessment may be a valid instrument for assessing attention and inhibition given its higher ecological validity when compared to classical tests. However, it is still unclear as to whether a VR assessment can predict depression and anxiety with the same or higher level of effectiveness and adherence as classical neuropsychological measures. The current study examined the effectiveness of a new VR test, Nesplora Aquarium, by testing participants with low (N = 41) and elevated (N = 41) symptoms of depression and anxiety. Participants completed a continuous performance test where they had to respond to stimuli (species of fish) in a virtual aquarium, as well as paper-and-pencil and computerised tests. Participants’ performance in Nesplora Aquarium was positively associated with classic measures of attention and inhibition, and effectively predicted symptoms of depression and anxiety above and beyond traditional cognitive measures such as psychomotor speed and executive functioning, spatial working memory span. Hence, VR is a safe, enjoyable, effective and more ecological alternative for the assessment of attention and inhibition among individuals with elevated anxiety and depression symptoms.

The Virtual Cooking Task: A Preliminary Comparison Between Neuropsychological and Ecological Virtual Reality Tests to Assess Executive Functions Alterations in Patients Affected by Alcohol Use Disorder.

Alcohol use disorder (AUD) is a major global problem. Neuropsychological studies have shown that AUD causes deficits in executive functions (EFs), a set of higher order cognitive skills that govern individual behavior in everyday situations. Many standardized neuropsychological tests are used to evaluate EF. These are reliable and valid but have limitations in predicting real-life performance. To address this, we present a preliminary study to test the virtual cooking task (VCT) as an alternative to standardized neuropsychological tests. The VCT includes four subtasks developed to assess attentional, planning, and cognitive shifting abilities; it was tested in an immersive three-dimensional environment. To evaluate the VCT performance and standardized neuropsychological tests, data were gathered from a sample of healthy subjects (control group [CG]; n = 23) and AUD patients (n = 18). The standardized neuropsychological measures used consisted of questionnaires (Attentional Control Scale, Barratt Impulsiveness Scale, and Cognitive Flexibility Scale) and specific tests (Dot-probe task, Go/No-go test, Stroop test, the trail making test, and Tower of London test). The results showed significant higher correlations for AUD patients than for the CG for the VCT, questionnaires, and specific tests, mainly related to planning and cognitive shifting abilities. Furthermore, comparative analyses of the VCT performance showed that the AUD patients made more errors and had higher latency times than the CG. The present study provides initial evidence that a more ecologically valid assessment can be a useful tool to detect cognitive impairments in many neuropsychological and mental disorders, affecting daily activities.

Evaluating adaptation effect in real versus virtual reality environments with people who stutter

ABSTRACT Introduction The adaptation effect refers to the gradual reduction of dysfluencies with repeated exposure to a substance. The concept of adaptation was originally defined in light of the reading task. Yet, limited studies have also confirmed the adaptation effect in spontaneous-speech. The reduction in the dysfluencies can be attributed to the reduction in the anxiety, or getting habituated to the content of reading material or due to motor learning. Methods This research aimed at measuring the adaptation effect in real and virtual reality (VR) environments for spontaneous-speech and reading. The objectives were divided into two categories. The first objective aimed at comparing the adaption effect for the real and VR environments on the reading task, while the second objective addressed the same objective, but for the spontaneous-speech task. The study involved 24 participants in the age range of 19–33 years. SSI-4 was administered on the participants. Conclusion The reduction in dysfluencies was seen for both real and VR testing environments. The reduction in the dysfluency was more marked for reading-task compared to spontaneous-speech task. The results shed light on the relationship between adaptation effect and the test environment.

Wavelet Decomposition in Analysis of Impact of Virtual Reality Head Mounted Display Systems on Postural Stability

This study investigated how spatial projection systems influences body balance including postural stability. Analyzing precisely defined frequency bands of movements of the center of pressure makes it possible to determine the effectiveness of the balance system’s response to disruptions and disorders and may be used as an indicator in the diagnosis of motor dysfunction. The study involved 28 participants for whom the center of pressure was assessed in a test with open eyes, closed eyes and with virtual reality projection. Percent distributions of energy during wavelet decomposition were calculated. Changes in body stability were determined for the virtual reality tests and these changes were classified as an intermediate value between the open-eyes test and the closed-eyes test. The results indicate the importance of using safety support systems in therapies involving Virtual Reality. The results also show the necessity of measurements times in stabilographic evaluations in order to conduct a more thorough analysis of very low frequencies of the center of pressure signal.

Virtual reality assessment of daily life executive functions in mood disorders: associations with neuropsychological and functional measures

BackgroundMood disorders are often accompanied by cognitive difficulties that impede patients' functional capacity. However, neuropsychological tests provide limited insight into patients' ability to tackle daily life cognitive challenges. To address this challenge, we investigated the sensitivity and validity of the Jansari assessment of Executive Functions (JEF©) virtual reality test in patients with mood disorders and its associations with functional capacity. MethodsIn total, 21 patients with bipolar disorder or unipolar disorder in full or partial remission and 29 healthy control participants were recruited for the study. Participants attended one test session during which they underwent diagnostic assessments, mood ratings and assessments with JEF©, a battery of standard neuropsychological tests (RAVLT, Trial Making A and B, Fluency tests, letter-number sequencing and RBANS digit span and coding tests) and functional capacity measures (UPSA-B and FAST). ResultsPatients showed impaired executive functions on JEF© compared to the control group. Relative to the control group, patients were also impaired on neuropsychological sub-composite scores of executive function, verbal memory and processing speed as well as on a global cognition composite score. In addition, JEF© scores predicted performance on a global cognition composite based on neuropsychological tests, and a performance-based measure of functional capacity. LimitationsThis study had a relatively small sample size and included a mixed group of patients with unipolar or bipolar disorder. ConclusionsJEF© is a sensitive and valid measure of daily life executive impairments in patients with mood disorders that is associated with functional capacity.

EEG characteristics of motion sickness subjects in automatic driving mode based on virtual reality tests

EEG characteristics of motion sickness subjects in automatic driving mode based on virtual reality tests

Increasing cognitive demand in assessments of visuo-spatial neglect: Testing the concepts of static and dynamic tests

ABSTRACT Introduction Numerous tests of visuo-spatial neglect (VSN) have been developed. In this study, we propose a clustering of VSN tests by making a distinction between static tests with low levels of cognitive demand (i.e. tests without movement or time-restrictions, such as paper-and-pencil tests) and dynamic tests with high levels of cognitive demand (i.e. tests incorporating movement and time-restrictions, such as virtual reality tests). The concepts of static and dynamic tests have not been systematically investigated so far. Here, we investigated (1) whether we would find dissociations between patients showing VSN on test within the static cluster but not on tests within the dynamic cluster, and vice versa; (2) whether differences in demographic or clinical characteristics could be identified between these groups of patients; and (3) whether the underlying factor structure would correspond to our proposed distinction between static and dynamic clusters of tests. Method Sixty-one patients with VSN completed three static tests (shape cancellation, line bisection, letter cancellation) and three dynamic tests (Catherine Bergego Scale, Mobility Assessment Course, simulated driving test). Results Thirteen percent of patients showed VSN on tests within the static cluster, 33% on tests within the dynamic cluster, and 54% on tests within both clusters. Patients with VSN on the dynamic tests (alone or in addition to static tests) had poorer motor function, poorer walking abilities and were more dependent in daily life than patients showing VSN on the static cluster alone. The underlying factor structure corresponded to our proposed conceptual distinction between static and dynamic clusters of tests. Conclusions Static and dynamic tests compose different clusters and double dissociations are shown between clusters. Future research involving data-driven approaches might result in a better understanding on how different tests of VSN relate to each other, and, more importantly, a better understanding of VSN and its phenotypes.

Transfer of 360° virtual reality and match broadcast video-based tests to on-field decision-making

ABSTRACT This study aimed to assess the level of transfer of two reliable and valid video modes to in-game decision-making performance. Two video-based tests of 25 clips each (360°VR and match broadcast vision) assessed off-field decision-making accuracy in elite Australian football umpires (n=21). Game performance was assessed across four games for each participant, classified into two groups based on this measure; “highly skilled” or ‘skilled’. Decision-making was assessed for correct, missed and unwarranted decisions in video-based tests and in-game assessments. Independent t-tests analysed differences between highly skilled and skilled in-game decision-makers for each test. Correlations also compared experience and in-game with video-based test decision-making performance. For both video-based tests, there were no significant differences between highly skilled and skilled in-game decision-makers, nor any significant correlations. Officials who made less unwarranted decisions in-game (highly skilled) made significantly less unwarranted decisions in the match broadcast test. There was a significant correlation between experience and 360°VR correct decision-making. Neither video-based test had the sensitivity to discriminate between elite officials, potentially due to the third-person perspective (match broadcast task) or sub-elite players presented (360°VR). Optimising the representativeness of off-field tasks through including similar constraints to performance environments is an important consideration for researchers and practitioners.

Automatic Identification of Brain Independent Components in Electroencephalography Data Collected while Standing in a Virtually Immersive Environment - A Deep Learning-Based Approach.

Electroencephalography (EEG) is a commonly used method for monitoring brain activity. Automating an EEG signal processing pipeline is imperative to the exploration of real-time brain computer interface (BCI) applications. EEG analysis demands substantial training and time for removal of distinct unwanted independent components (ICs), generated via independent component analysis, corresponding to artifacts. The considerable subject-wise variations across these components motivates defining a procedural way to identify and eliminate these artifacts. We propose DeepIC-virtual, a convolutional neural network (CNN) deep learning classifier to automatically identify brain components in the ICs extracted from the subject's EEG data gathered while they are being immersed in a virtual reality (VR) environment. This work examined the feasibility of DL techniques to provide automated ICs classification on noisy and visually engaging upright stance EEG data. We collected the EEG data for six subjects while they were standing upright in a VR testing setup simulating pseudo-randomized variations in height and depth conditions and induced perturbations. An extensive 1432 IC representation images data set was generated and manually labelled via an expert as brain components or one of the six distinct removable artifacts. The supervised CNN architecture was utilized to categorize good brain ICs and bad artifactual ICs via generated images of topographical maps. Our model categorizing good versus bad IC topographical maps resulted in a binary classification accuracy and area under curve of 89.20% and 0.93 respectively. Despite significant imbalance, only 1 out of the 57 present brain ICs in the withheld testing set was miss-classified as an artifact. These results will hopefully encourage clinicians to integrate BCI methods and neurofeedback to control anxiety and provide a treatment of acrophobia, given the viability of automatic classification of artifactual ICs.

Development of a new virtual reality test of cognition: assessing the test-retest reliability, convergent and ecological validity of CONVIRT

BackgroundTechnological advances provide an opportunity to refine tools that assess central nervous system performance. This study aimed to assess the test-retest reliability and convergent and ecological validity of a newly developed, virtual-reality, concussion assessment tool, ‘CONVIRT’, which uses eye-tracking technology to assess visual processing speed, and manual reaction time (pushing a button on a riding crop) to assess attention and decision-making. CONVIRT was developed for horse jockeys, as of all sportspersons, they are most at risk of concussion.MethodsParticipants (N = 165), were assessed with CONVIRT, which uses virtual reality to give the user the experience of riding a horse during a horserace. Participants were also assessed with standard Cogstate computer-based concussion measures in-between two completions of the CONVIRT battery. The physiological arousal induced by the test batteries were assessed via measures of heart rate and heart rate variability (LF/HF ratio).ResultsSatisfactory test-retest reliability and convergent validity with Cogstate attention and decision-making subtests and divergent validity in visual processing speed measures were observed. CONVIRT also increased heart rate and LF/HF ratio, which may better approximate participant arousal levels in their workplace.ConclusionsCONVIRT may be a reliable and valid tool to assess elements of cognition and CNS disruption. The increased ecological validity may also mean better informed ‘return-to-play’ decisions and stronger industry acceptance due to the real-world meaningfulness of the assessment. However, before this can be achieved, the sensitivity of the CONVIRT battery needs to be demonstrated.

A Framework for the Testing and Validation of Simulated Environments in Experimentation and Training.

New computer technologies, like virtual reality (VR), have created opportunities to study human behavior and train skills in novel ways. VR holds significant promise for maximizing the efficiency and effectiveness of skill learning in a variety of settings (e.g., sport, medicine, safety-critical industries) through immersive learning and augmentation of existing training methods. In many cases the adoption of VR for training has, however, preceded rigorous testing and validation of the simulation tool. In order for VR to be implemented successfully for both training and psychological experimentation it is necessary to first establish whether the simulation captures fundamental features of the real task and environment, and elicits realistic behaviors. Unfortunately evaluation of VR environments too often confuses presentation and function, and relies on superficial visual features that are not the key determinants of successful training outcomes. Therefore evidence-based methods of establishing the fidelity and validity of VR environments are required. To this end, we outline a taxonomy of the subtypes of fidelity and validity, and propose a variety of practical methods for testing and validating VR training simulations. Ultimately, a successful VR environment is one that enables transfer of learning to the real-world. We propose that key elements of psychological, affective and ergonomic fidelity, are the real determinants of successful transfer. By adopting an evidence-based approach to VR simulation design and testing it is possible to develop valid environments that allow the potential of VR training to be maximized.

Humans Predict Action using Grammar-like Structures

Efficient action prediction is of central importance for the fluent workflow between humans and equally so for human-robot interaction. To achieve prediction, actions can be algorithmically encoded by a series of events, where every event corresponds to a change in a (static or dynamic) relation between some of the objects in the scene. These structures are similar to a context-free grammar and, importantly, within this framework the actual objects are irrelevant for prediction, only their relational changes matter. Manipulation actions and others can be uniquely encoded this way. Using a virtual reality setup and testing several different manipulation actions, here we show that humans predict actions in an event-based manner following the sequence of relational changes. Testing this with chained actions, we measure the percentage predictive temporal gain for humans and compare it to action-chains performed by robots showing that the gain is approximately equal. Event-based and, thus, object independent action recognition and prediction may be important for cognitively deducing properties of unknown objects seen in action, helping to address bootstrapping of object knowledge especially in infants.