Assessment of Topographical Orientation Cognitive Functions Using a Virtual Reality Game

Objective: Topographical disorientation refers to the partial or complete loss of the ability to navigate environments. Traditionally, it has been assessed with "paper and pencil" tests, but recent technological advances have introduced more ecological assessment methods. One such technology is virtual reality (VR), which enables assessment orientation within a three-dimensional environment without the need for actual open spaces. Our aim was to design a test to assess cognitive skills related to topographic orientation in VR environments.Materials and Methods: A battery of neuropsychological tests was administered together with a gamified VR task where participants learned to navigate in a large-scale virtual environment. The sample comprised 40 young adults (11 male; ages 18-35) with no history of neurological impairment.Results: After item reliability analysis, a test with solid internal consistency (Cronbach's alpha = 0.737) was developed. Additionally, a positive correlation was found between the skills of perception, retention, and visuospatial information processing and the VR test (ps ≤ 0.05).Conclusion: This study successfully developed a reliable gamified VR test, aligned with cognitive processes involved in anterograde topographic orientation. Although this tool still requires further studies to establish normative data and measures of specificity and sensitivity in clinical populations, it represents a crucial first step toward implementing this technology in the ecological evaluation of cognitive processes that are difficult to explore in clinical settings.