Guidelines for the Development of Immersive Virtual Reality Software for Cognitive Neuroscience and Neuropsychology: The Development of Virtual Reality Everyday Assessment Lab (VR-EAL), a Neuropsychological Test Battery in Immersive Virtual Reality

Abstract

Virtual reality (VR) head-mounted displays (HMD) appear to be effective research tools, which may address the problem of ecological validity in neuropsychological testing. However, their widespread implementation is hindered by VR induced symptoms and effects (VRISE) and the lack of skills in VR software development. This study offers guidelines for the development of VR software in cognitive neuroscience and neuropsychology, by describing and discussing the stages of the development of Virtual Reality Everyday Assessment Lab (VR-EAL), the first neuropsychological battery in immersive VR. Techniques for evaluating cognitive functions within a realistic storyline are discussed. The utility of various assets in Unity, software development kits, and other software are described so that cognitive scientists can overcome challenges pertinent to VRISE and the quality of the VR software. In addition, this pilot study attempts to evaluate VR-EAL in accordance with the necessary criteria for VR software for research purposes. The VR neuroscience questionnaire (VRNQ; Kourtesis et al., 2019b) was implemented to appraise the quality of the three versions of VR-EAL in terms of user experience, game mechanics, in-game assistance, and VRISE. Twenty-five participants aged between 20 and 45 years with 12-16 years of full-time education evaluated various versions of VR-EAL. The final version of VR-EAL achieved high scores in every sub-score of the VRNQ and exceeded its parsimonious cut-offs. It also appeared to have better in-game assistance and game mechanics, while its improved graphics substantially Kourtesis et al. VR Research Software Development increased the quality of the user experience and almost eradicated VRISE. The results substantially support the feasibility of the development of effective VR research and clinical software without the presence of VRISE during a 60-min VR session.

Validation of the Virtual Reality Everyday Assessment Lab (VR-EAL): An Immersive Virtual Reality Neuropsychological Battery with Enhanced Ecological Validity

“…VR-EAL endeavors to be the first immersive VR neuropsychological battery of everyday cognitive functions. Our previous work has shown that the VR-EAL does not induce VRISE (Kourtesis et al, 2020). However, we have yet to 2 P. Kourtesis et al demonstrate the validity of the VR-EAL as a neuropsychological tool.…”

“…VR-EAL attempts to assess everyday cognitive functioning by assessing prospective memory, episodic memory (i.e., immediate and delayed recognition), executive functioning (i.e., planning, multitasking), and selective visual, visuospatial, and auditory (bi-aural) attention within a realistic immersive VR scenario lasting around 60 min (Kourtesis et al, 2020). See Table 1 and Figures 1 and 2 for a summary of the VR-EAL tasks assessing each cognitive ability.…”

“…See Table 2 for the description of the VR-EAL tasks and Table 3 for the administration procedures and scoring of the VR-EAL tasks. For a full description of the VR-EAL's scenarios, tasks, and scoring, see Kourtesis et al (2020). Also, a brief video recording of the VR-EAL may be accessed at this hyperlink: https://www.youtube.com/ watch?v = IHEIvS37Xy8&t=.…”

“…We recently developed the Virtual Reality Everyday Assessment Lab (VR-EAL) to create an immersive virtual environment that simulates everyday tasks proximal to real life to assess prospective memory, episodic memory (immediate and delayed recognition), executive functions (i.e., multitasking and planning), and selective visual, visuospatial, and auditory attention (Kourtesis, Korre, Collina, Doumas, & MacPherson, 2020). In the VR-EAL, individuals are exposed to alternating tutorials (practice trials) and storyline tasks (assessments) to allow them to become familiarized with both the immersive VR technology and the specific controls and procedures of each VR-EAL task.…”

Feasibility and user-experience of virtual reality in neuropsychological assessment following stroke

“…Negative effects are expected to decrease with further VR HMD development (Kourtesis et al, 2019), which was also shown in this study where healthy controls experienced more negative effects when tested with the older Oculus Rift DK2 compared to the more sophisticated HTC Vive. Current best practice guides for VR development focus on alleviating negative effects by using several approaches to reduce sensory mismatch, such as display factors (e.g., higher refresh rates) and intuitiveness of interaction and navigation (Kourtesis et al, 2019;Kourtesis et al, 2020;Oculus, 2017;Weech et al, 2019). Furthermore, negative effects decrease over repeated exposures, which emphasizes the importance of practice trials to help a user become more familiar with a particular device (Germine et al, 2019;Kennedy et al, 2000).…”