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

Area of Science:

• Neuroscience
• Psychology
• Human-Computer Interaction

Background:

• Traditional neuropsychological tests of executive function lack real-world predictive relevance.
• Virtual reality (VR) offers a potential solution by adapting tests for immersive environments.
• The Color-Trails Test (CTT), a pencil-and-paper executive function assessment, was adapted into two VR versions.

Purpose of the Study:

• To develop and evaluate VR-based versions of the CTT for assessing sustained and divided attention.
• To assess the construct validity, test-retest reliability, and age-related discriminant validity of the VR CTT versions.
• To explore the effects of VR implementation on motor function during cognitive tasks.

Main Methods:

• Developed two VR versions of the CTT: DOME-CTT (large-scale) and HMD-CTT (head-mounted display).
• Administered original CTT and VR versions to 147 healthy adults across three age groups (young, middle-aged, older).
• Collected data on completion times (Trails A and B) and reconstructed upper-limb movement spatiotemporal characteristics using motion capture.

Main Results:

• Moderate correlations confirmed construct validity between original CTT and VR versions (r=0.58-0.71).
• VR versions demonstrated good test-retest reliability (ICC=0.59-0.89) and discriminant validity (AUC=0.70-0.92).
• VR completion times were longer; older adults showed slower movement onset, consistent with higher executive load in Trails B.

Conclusions:

• VR-based CTT versions are feasible and valid, preserving core neuropsychological task features.
• Spatiotemporal analysis of motor movements during VR tasks may enhance ecological validity.
• This approach represents a novel paradigm for studying cognitive-motor interactions.