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Moreno-Fernández RD, Bernabéu-Brotons E, Carbonell-Colomer M, Buades-Sitjar F, Sampedro-Piquero P. Sex-related differences in young binge drinkers on the neurophysiological response to stress in virtual reality. Front Public Health 2024; 12:1348960. [PMID: 38947350 PMCID: PMC11211283 DOI: 10.3389/fpubh.2024.1348960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 06/06/2024] [Indexed: 07/02/2024] Open
Abstract
Background Stress is one of the main environmental factors involved in the onset of different psychopathologies. In youth, stressful life events can trigger inappropriate and health-damaging behaviors, such as binge drinking. This behavior, in turn, can lead to long-lasting changes in the neurophysiological response to stress and the development of psychological disorders late in life, e.g., alcohol use disorder. Our aim was to analyze the pattern of neurophysiological responses triggered with the exposition to a stressful virtual environment in young binge drinkers. Methods AUDIT-3 (third question from the full AUDIT) was used to detect binge drinking (BD) in our young sample (age 18-25 years). According to the score, participants were divided into control (CO) and BD group. Next, a standardized virtual reality (VR) scenario (Richie's Plank) was used for triggering the stress response while measuring the following neurophysiological variables: brain electrical activity by electroencephalogram (EEG) and cortisol levels through saliva samples both measurements registered before and after the stressful situation. Besides, heart rate (HR) with a pulsometer and electrodermal response (EDA) through electrodes placed on fingers were analyzed before, during and after the VR task. Results Regarding the behavior assessed during the VR task, BD group spent significantly less amount of time walking forward the table and a tendency toward more time walking backwards. There was no statistically significant difference between the BD and the CO group regarding time looking down, but when we controlled the variable sex, the BD women group displayed higher amount of time looking down than the rest of the groups. Neurophysiological measurements revealed that there was not any statistically significant difference between groups in any of the EEG registered measures, EDA response and cortisol levels. Sex-related differences were found in HR response to VR scenario, in which BD women displayed the highest peak of response to the stressor. Also, the change in heartbeat was higher in BD women than men. Conclusion Unveiling the neurophysiological alterations associated with BD can help us to prevent and detect early onset of alcohol use disorder. Also, from our data we conclude that participants' sex can modulate some stress responses, especially when unhealthy behaviors such as BD are present. Nevertheless, the moment of registration of the neurophysiological variables respect to the stressor seems to be a crucial variable.
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Affiliation(s)
| | | | | | - Francisco Buades-Sitjar
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Patricia Sampedro-Piquero
- Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
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Kodithuwakku Arachchige SNK, Chander H, Shojaei A, Knight AC, Brown C, Freeman HR, Burch V RF, Chen CC. Effects of virtual heights, dual-tasking, and training on static postural stability. APPLIED ERGONOMICS 2024; 114:104145. [PMID: 37837914 DOI: 10.1016/j.apergo.2023.104145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023]
Abstract
Working at altitudes, dual-tasking (DT), and lack of experience cause falls. This study aimed to investigate the impact of virtual heights, DT, and training on static postural stability. Twenty-eight volunteers' balance at seven virtual environments [VE; ground (G), altitude 1 (A1), edge 1 (E1), altitude 2 (A2), edge 2 (E2), altitude 3 (A3), and edge 3 (E3)] were recorded during single-tasking (ST) and DT over three days. Independent variables were analyzed using a 7 (VE) x 3 (DAY) x 2 (TASK) factorial repeated measures ANOVA. Greater postural sway was observed in A3 and E1, on DAY 1, and during DT. The study demonstrated static postural stability deteriorates at higher virtual altitudes and during DT and improves with training. The findings of the study suggest that virtual reality is a great altitude simulator, which could be used as a potential balance training tool in ergonomic settings.
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Affiliation(s)
- Sachini N K Kodithuwakku Arachchige
- Human Performance Laboratory, Department of Exercise and Nutrition Sciences, Weber State University, Dept 2805, 1435 Village Dr, Ogden, UT, 84408-5150, USA.
| | - Harish Chander
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, PO Box 6186 216, McCarthy Gym, Mississippi State, MS, 39762, USA; Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, 200 Research Blvd, Starkville, MS, 39759, USA.
| | - Alireza Shojaei
- Myers-Lawson School of Construction, Virginia Tech, 1345 Perry St, Blacksburg, VA, 24061, USA.
| | - Adam C Knight
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, PO Box 6186 216, McCarthy Gym, Mississippi State, MS, 39762, USA.
| | - Caitlyn Brown
- Neuromechanics Laboratory, Department of Kinesiology, Mississippi State University, PO Box 6186 216, McCarthy Gym, Mississippi State, MS, 39762, USA.
| | - Hannah R Freeman
- Department of Occupational Therapy, School of Health Professions, University of Alabama at Birmingham, 1716 9th Ave S, Birmingham, AL, 35233, USA.
| | - Reuben F Burch V
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, 200 Research Blvd, Starkville, MS, 39759, USA; Department of Industrial & Systems Engineering, Mississippi State University, 479-2 Hardy Road, 260McCain Hall, Box 9542, Mississippi State, MS, 39762, USA.
| | - Chih-Chia Chen
- Cognitive and Motor Control Laboratory, Department of Kinesiology, Mississippi State University, PO Box 6186, 216 McCarthy Gym, Mississippi State, MS, 39762, USA.
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Kodithuwakku Arachchige SN, Chander H, Turner AJ, Shojaei A, Knight AC, Griffith A, Burch RF, Chen CC. Physiological and Subjective Measures of Anxiety with Repeated Exposure to Virtual Construction Sites at Different Heights. Saf Health Work 2023; 14:303-308. [PMID: 37818213 PMCID: PMC10562126 DOI: 10.1016/j.shaw.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 10/12/2023] Open
Abstract
Background Occupational workers at altitudes are more prone to falls, leading to catastrophic outcomes. Acrophobia, height-related anxiety, and affected executive functions lead to postural instabilities, causing falls. This study investigated the effects of repeated virtual height exposure and training on cognitive processing and height-related anxiety. Methods Twenty-eight healthy volunteers (age 20.48 ± 1.26 years; mass 69.52 ± 13.78 kg) were recruited and tested in seven virtual environments (VE) [ground (G), 2-story altitude (A1), 2-story edge (E1), 4-story altitude (A2), 4-story edge (E2), 6-story altitude (A3), and 6-story edge (E3)] over three days. At each VE, participants identified occupational hazards present in the VE and completed an Attitude Towards Heights Questionnaire (ATHQ) and a modified State-Trait Anxiety Inventory Questionnaire (mSTAIQ). The number of hazards identified and the ATHQ and mSTAIQ scores were analyzed using a 7 (VE; G, A1, A2, A3, E1, E2, E3) x 3 (DAY; DAY 1, DAY 2, DAY 3) factorial repeated measures analysis of variance. Results The participants identified the lowest number of hazards at A3 and E3 VEs and on DAY 1 compared to other VEs and DAYs. ATHQ scores were lowest at G, A1, and E1 VEs. Conclusion Cognitive processing is negatively affected by virtual altitudes, while it improves with short-term training. The features of virtual reality, such as higher involvement, engagement, and reliability, make it a better training tool to be considered in ergonomic settings. The findings of this study will provide insights into cognitive dual-tasking at altitude and its challenges, which will aid in minimizing occupational falls.
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Affiliation(s)
| | - Harish Chander
- Department of Kinesiology, Mississippi State University, MS, USA
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, MS, USA
| | - Alana J. Turner
- Department of Kinesiology, Coastal Carolina University, Conway, SC, USA
| | - Alireza Shojaei
- Myers-Lawson School of Construction, Virginia Tech, Blacksburg, VA, USA
| | - Adam C. Knight
- Department of Kinesiology, Mississippi State University, MS, USA
| | - Aaron Griffith
- Department of Kinesiology, Mississippi State University, MS, USA
| | - Reuben F. Burch
- Human Factors & Athlete Engineering, Center for Advanced Vehicular Systems, Mississippi State University, MS, USA
- Department of Industrial & Systems Engineering, Mississippi State University, MS, USA
| | - Chih-Chia Chen
- Department of Kinesiology, Mississippi State University, MS, USA
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Anghelescu A, Firan FC, Onose G, Munteanu C, Trandafir AI, Ciobanu I, Gheorghița Ș, Ciobanu V. PRISMA Systematic Literature Review, including with Meta-Analysis vs. Chatbot/GPT (AI) regarding Current Scientific Data on the Main Effects of the Calf Blood Deproteinized Hemoderivative Medicine (Actovegin) in Ischemic Stroke. Biomedicines 2023; 11:1623. [PMID: 37371718 PMCID: PMC10295843 DOI: 10.3390/biomedicines11061623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Stroke is a significant public health problem and a leading cause of death and long-term disability worldwide. Several treatments for ischemic stroke have been developed, but these treatments have limited effectiveness. One potential treatment for this condition is Actovegin®/AODEJIN, a calf blood deproteinized hemodialysate/ultrafiltrate that has been shown to have pleiotropic/multifactorial and possibly multimodal effects. The actual actions of this medicine are thought to be mediated by its ability to reduce oxidative stress, inflammation, and apoptosis and to enhance neuronal survival and plasticity. METHODS To obtain the most up-to-date information on the effects of Actovegin®/AODEJIN in ischemic stroke, we systematically reviewed the literature published in the last two years. This review builds upon our previous systematic literature review published in 2020, which used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to search for and select related articles over almost two decades, between 1 January 2001 and 31 December 2019. Additionally, we compared the results of our PRISMA search (human intelligence-based) with those obtained from an interrogation of a GPT-based chatbot (ChatGPT) in order to ensure comprehensive coverage of potentially relevant studies. RESULTS Our updated review found limited new evidence on the use of Actovegin®/AODEJIN in ischemic stroke, although the number of articles on this subject consistently increased compared to that from our initial systematic literature review. Specifically, we found five articles up to 2020 and eight more until December 2022. While these studies suggest that Actovegin®/AODEJIN may have neuroprotective effects in ischemic stroke, further clinical trials are needed to confirm these findings. Consequently, we performed a funnel analysis to evaluate the potential for publication bias. DISCUSSION Our funnel analysis showed no evidence of publication bias, suggesting that the limited number of studies identified was not due to publication bias but rather due to a lack of research in this area. However, there are limitations when using ChatGPT, particularly in distinguishing between truth and falsehood and determining the appropriateness of interpolation. Nevertheless, AI can provide valuable support in conducting PRISMA-type systematic literature reviews, including meta-analyses. CONCLUSIONS The limited number of studies identified in our review highlights the need for additional research in this area, especially as no available therapeutic agents are capable of curing central nervous system lesions. Any contribution, including that of Actovegin (with consideration of a positive balance between benefits and risks), is worthy of further study and periodic reappraisal. The evolving advancements in AI may play a role in the near future.
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Affiliation(s)
- Aurelian Anghelescu
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania;
- The Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (A.-I.T.); (I.C.); (Ș.G.)
| | - Florentina Carmen Firan
- The Physical and Rehabilitation Medicine & Balneology Clinic Division—The NeuroRehabilitation Compartment, Teaching Emergency Hospital of the Ilfov County, 22104 Bucharest, Romania;
| | - Gelu Onose
- The Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (A.-I.T.); (I.C.); (Ș.G.)
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Constantin Munteanu
- The Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (A.-I.T.); (I.C.); (Ș.G.)
- Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa” Iași, 700454 Iași, Romania
| | - Andreea-Iulia Trandafir
- The Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (A.-I.T.); (I.C.); (Ș.G.)
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Ilinca Ciobanu
- The Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (A.-I.T.); (I.C.); (Ș.G.)
| | - Ștefan Gheorghița
- The Neuromuscular Rehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (A.-I.T.); (I.C.); (Ș.G.)
| | - Vlad Ciobanu
- Computer Science Department, Politehnica University of Bucharest, 060042 Bucharest, Romania;
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Ugras GA, Kanat C, Yaman Z, Yilmaz M, Turkmenoglu MO. The Effects of Virtual Reality on Preoperative Anxiety in Patients Undergoing Colorectal and Abdominal Wall Surgery: A Randomized Controlled Trial. J Perianesth Nurs 2023; 38:277-283. [PMID: 36319521 DOI: 10.1016/j.jopan.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 06/24/2022] [Accepted: 07/13/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to investigate the effects of a virtual reality (VR) application on preoperative anxiety (PA) in patients undergoing colorectal and abdominal wall surgery. DESIGN A prospective, parallel two-armed, randomized controlled trial. METHODS Eighty six patients were divided into the control group (n = 43) and in the experimental group (n = 43). The experimental group received a preoperative VR application for 10 minutes. The routine preoperative procedure used at the clinic was used for the patients in the control group. The anxiety level was assessed using the Anxiety Specific to Surgery Questionnaire (ASSQ) and measured with physiological responses to anxiety, such as changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), and peripheral oxygen saturation (SpO2), before and after the VR application. FINDINGS The VR application reduced PA levels in the experimental group (P < .001) and changes in the SBP (P < .001), DBP (P < .001), HR (P < .001), RR (P = .041) and SpO2(P = .019) values) compared to the levels in the control group. CONCLUSIONS VR applications can reduce psychological and physiological responses to PA in patients undergoing colorectal and abdominal wall surgery.
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Affiliation(s)
- Gülay Altun Ugras
- Department of Surgical Nursing, Mersin University, Nursing Faculty, Mersin, Turkey.
| | - Canan Kanat
- Department of Surgical Nursing, Mersin University, Nursing Faculty, Mersin, Turkey
| | - Zeliha Yaman
- Department of Mental Health Nursing, Mersin University, Nursing Faculty, Mersin, Turkey
| | - Mualla Yilmaz
- Department of Mental Health Nursing, Mersin University, Nursing Faculty, Mersin, Turkey
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Kosonogov VV, Efimov KV, Rakhmankulova ZK, Zyabreva IA. Review of Psychophysiological and Psychotherapeutic Studies of Stress Using Virtual Reality Technologies. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2023; 53:81-91. [PMID: 36969359 PMCID: PMC10006560 DOI: 10.1007/s11055-023-01393-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/20/2022] [Indexed: 03/13/2023]
Abstract
This review addresses the use of virtual reality technologies in the psychophysiology and psychotherapy of stress. Studies using virtual reality both to introduce subjects into a state of stress and to help reduce stress reactions are reviewed. Methods developed for treating patients suffering from stress-related disorders (in particular, PTSD and phobias) are described. In many cases, reductions in stress reactions with the help of virtual reality systems are achieved not only at the self-report (experiential) level, but also at the level of central and peripheral nervous system measures. This allows virtual reality to be regarded as a modern, inexpensive, and effective method, firstly, for introducing subjects into a state of stress with the aim of testing various hypotheses in psychophysiology and, secondly, to reduce stress reactions.
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Affiliation(s)
- V. V. Kosonogov
- Institute of Cognitive Neurosciences, HSE University, Moscow, Russia
| | - K. V. Efimov
- Institute of Cognitive Neurosciences, HSE University, Moscow, Russia
| | | | - I. A. Zyabreva
- Institute of Cognitive Neurosciences, HSE University, Moscow, Russia
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Jeanne R, Piton T, Minjoz S, Bassan N, Le Chenechal M, Semblat A, Hot P, Kibleur A, Pellissier S. Gut-Brain Coupling and Multilevel Physiological Response to Biofeedback Relaxation After a Stressful Task Under Virtual Reality Immersion: A Pilot Study. Appl Psychophysiol Biofeedback 2023; 48:109-125. [PMID: 36336770 DOI: 10.1007/s10484-022-09566-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/08/2022]
Abstract
Human physiological reactions to the environment are coordinated by the interactions between brain and viscera. In particular, the brain, heart, and gastrointestinal tract coordinate with each other to provide physiological equilibrium by involving the central, autonomic, and enteric nervous systems. Recent studies have demonstrated an electrophysiological coupling between the gastrointestinal tract and the brain (gut-brain axis) under resting-state conditions. As the gut-brain axis plays a key role in individual stress regulation, we aimed to examine modulation of gut-brain coupling through the use of an overwhelming and a relaxing module as a first step toward modeling of the underlying mechanisms. This study was performed in 12 participants who, under a virtual reality environment, performed a 9-min cognitive stressful task followed by a 9-min period of relaxation. Brain activity was captured by electroencephalography, autonomic activities by photoplethysmography, and electrodermal and gastric activities by electrogastrography. Results showed that compared with the stressful task, relaxation induced a significant decrease in both tonic and phasic sympathetic activity, with an increase in brain alpha power and a decrease in delta power. The intensity of gut-brain coupling, as assessed by the modulation index of the phase-amplitude coupling between the normogastric slow waves and the brain alpha waves, decreased under the relaxation relative to the stress condition. These results highlight the modulatory effect of biofeedback relaxation on gut-brain coupling and suggest noninvasive multilevel electrophysiology as a promising way to investigate the mechanisms underlying gut-brain coupling in physiological and pathological situations.
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Affiliation(s)
- Rudy Jeanne
- LIP/PC2S, Université Savoie Mont Blanc, Université Grenoble Alpes, 73000, Chambéry, France. .,LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, 73000, Chambéry, France.
| | - Timothy Piton
- Ecole Polytechnique Fédérale de Lausanne, 1015, Lausanne, Switzerland.,Open Mind Innovation, 75008, Paris, France
| | - Séphora Minjoz
- LIP/PC2S, Université Savoie Mont Blanc, Université Grenoble Alpes, 73000, Chambéry, France.,LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, 73000, Chambéry, France
| | | | | | | | - Pascal Hot
- LPNC, Université Grenoble Alpes, Université Savoie Mont Blanc, 73000, Chambéry, France.,Institut Universitaire de France, Paris, France
| | | | - Sonia Pellissier
- LIP/PC2S, Université Savoie Mont Blanc, Université Grenoble Alpes, 73000, Chambéry, France
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Grosprêtre S, Eon P, Marcel-Millet P. Virtual reality does not fool the brain only: spinal excitability changes during virtually simulated falling. J Neurophysiol 2023; 129:368-379. [PMID: 36515975 DOI: 10.1152/jn.00383.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Virtual reality (VR) is known to induce substantial activation of brain's motor regions. It remains unclear to what extent virtual reality can trigger the sensorimotor system, and more particularly, whether it can affect lower nervous levels. In this study, we aimed to assess whether VR simulation of challenging and stressful postural situations (Richie's plank experience) could interfere with spinal excitability of postural muscles in 15 healthy young participants. The H-reflex of the triceps surae muscles was elicited with electrical nerve stimulation while participants were standing and wearing a VR headset. Participants went through several conditions, during which stimulations were evoked: standing still (noVR), standing in VR on the ground (groundVR), standing on the edge of a building (plankVR), and falling from the building (fallingVR). Myoelectrical activity of the triceps surae muscles was measured throughout the experiment. Leg and head movements were also measured by means of accelerometers to account for body oscillations. First, no differences in head rotations and myoelectrical activity were to be noted between conditions. Second, triceps H-reflex (HMAX/MMAX) was not affected from noVR to groundVR and plankVR. The most significant finding was a drastic decrease in H-reflex during falling (-47 ± 26.9% between noVR and fallingVR, P = 0.015). It is suggested that experiencing a postural threat in VR efficiently modulates spinal excitability, despite remaining in a quiet standing posture. This study suggests that simulated falling mimics the neural adjustments observed during actual postural challenge tasks.NEW & NOTEWORTHY The present study showed a modulation of spinal excitability induced by virtual reality (VR). In the standing position, soleus H-reflex was downmodulated during a simulated falling, in the absence of apparent changes in body oscillations. Since the same behavior is usually observed during real falling, it was suggested that the visual cues provided by VR were sufficiently strong to lead the neuromuscular system to mimic the actual modulation.
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Affiliation(s)
- Sidney Grosprêtre
- Laboratory Culture Sport Health and Society (C3S-UR 4660), Sport and Performance Department, University of Franche-Comté, Besançon, France
| | - Pauline Eon
- Laboratory Culture Sport Health and Society (C3S-UR 4660), Sport and Performance Department, University of Franche-Comté, Besançon, France
| | - Philémon Marcel-Millet
- Laboratory Culture Sport Health and Society (C3S-UR 4660), Sport and Performance Department, University of Franche-Comté, Besançon, France
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Multimodal Assessment of Changes in Physiological Indicators when Presenting a Video Fragment on Screen (2D) versus a VR (3D) Environment. Behav Neurol 2022; 2022:5346128. [PMID: 36479230 PMCID: PMC9722301 DOI: 10.1155/2022/5346128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/11/2022] [Accepted: 11/12/2022] [Indexed: 11/29/2022] Open
Abstract
The increasing role of virtual environments in society, especially in the context of the pandemic and evolving metaverse technologies, requires a closer study of the physiological state of humans using virtual reality (VR) for entertainment, work, or learning. Despite the fact that many physiological reactions to the content presented in various modalities under VR conditions have already been described, often these studies do not reflect the full range of changes in the physiological reactions that occur to a person during their immersion in the virtual world. This study was designed to find and compare the most sensitive physiological indicators that change when viewing an emotionally intense video fragment in standard format on screen and in virtual reality conditions (in a VR helmet). The research methodology involved randomly presenting a group of subjects with visual content-a short video clip-first on screen (2D) and then in a virtual reality helmet (3D). A special feature of this study is the use of multimodal physiological state assessment throughout the content presentation, in conjunction with psychological testing of the study participants before and after the start of the study. It has been discovered that the most informative physiological indicators reflecting the subjects' condition under virtual reality conditions were changes in theta rhythm amplitude, skin conductance, standard deviation of normal RR-intervals (SDRR), and changes in photoplethysmogram (PPG). The study results suggest that in the process of immersion in a virtual environment, the participants develop a complex functional state, different from the state when watching on screen, which is characterised by the restructuring of autonomic regulation and activation of emotion structures of the brain.
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Aspiotis V, Miltiadous A, Kalafatakis K, Tzimourta KD, Giannakeas N, Tsipouras MG, Peschos D, Glavas E, Tzallas AT. Assessing Electroencephalography as a Stress Indicator: A VR High-Altitude Scenario Monitored through EEG and ECG. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22155792. [PMID: 35957348 PMCID: PMC9371026 DOI: 10.3390/s22155792] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 05/28/2023]
Abstract
Over the last decade, virtual reality (VR) has become an increasingly accessible commodity. Head-mounted display (HMD) immersive technologies allow researchers to simulate experimental scenarios that would be unfeasible or risky in real life. An example is extreme heights exposure simulations, which can be utilized in research on stress system mobilization. Until recently, electroencephalography (EEG)-related research was focused on mental stress prompted by social or mathematical challenges, with only a few studies employing HMD VR techniques to induce stress. In this study, we combine a state-of-the-art EEG wearable device and an electrocardiography (ECG) sensor with a VR headset to provoke stress in a high-altitude scenarios while monitoring EEG and ECG biomarkers in real time. A robust pipeline for signal clearing is implemented to preprocess the noise-infiltrated (due to movement) EEG data. Statistical and correlation analysis is employed to explore the relationship between these biomarkers with stress. The participant pool is divided into two groups based on their heart rate increase, where statistically important EEG biomarker differences emerged between them. Finally, the occipital-region band power changes and occipital asymmetry alterations were found to be associated with height-related stress and brain activation in beta and gamma bands, which correlates with the results of the self-reported Perceived Stress Scale questionnaire.
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Affiliation(s)
- Vasileios Aspiotis
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
- Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece;
| | - Andreas Miltiadous
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
| | - Konstantinos Kalafatakis
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
- Institute of Health Science Education, Barts and the London School of Medicine & Dentistry, Queen Mary University of London (Malta Campus), VCT 2520 Victoria, Malta
| | - Katerina D. Tzimourta
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
- Department of Electrical and Computer Engineering, Faculty of Engineering, University of Western Macedonia, 50100 Kozani, Greece;
| | - Nikolaos Giannakeas
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
| | - Markos G. Tsipouras
- Department of Electrical and Computer Engineering, Faculty of Engineering, University of Western Macedonia, 50100 Kozani, Greece;
| | - Dimitrios Peschos
- Faculty of Medicine, University of Ioannina, 45110 Ioannina, Greece;
| | - Euripidis Glavas
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
| | - Alexandros T. Tzallas
- Human Computer Interaction Laboratory (HCILab), Department of Informatics and Telecommunications, University of Ioannina, Kostakioi, 47100 Arta, Greece; (V.A.); (A.M.); (K.K.); (K.D.T.); (N.G.); (E.G.)
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Lenormand D, Piolino P. In search of a naturalistic neuroimaging approach: Exploration of general feasibility through the case of VR-fMRI and application in the domain of episodic memory. Neurosci Biobehav Rev 2021; 133:104499. [PMID: 34914938 DOI: 10.1016/j.neubiorev.2021.12.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 12/22/2022]
Abstract
Virtual Reality (VR) is an increasingly widespread tool for research as it allows the creation of experiments taking place in multimodal and daily-life-like environments, while keeping a strong experimental control. Adding neuroimaging to VR leads to a better understanding of the underlying brain networks activated during a naturalistic task, whether for research purposes or rehabilitation. The present paper focuses on the specific use of concurrent VR and fMRI and its technical challenges and feasibility, with a brief examination of the general existing solutions. Following the PRISMA guidelines, the review investigates the particular case of how VR-fMRI has explored episodic memory so far, with a comparison of object- and place-based episodic memory. This review confirms the involvement of cerebral regions well-known to be implicated in episodic memory and unravels other regions devoted to bodily and narrative aspects of the self, promoting new avenues of research in the domain of naturalistic episodic memory. Future studies should develop more immersive and interactive virtual neuroimaging features to increase ecological and embodied neurocognition aspects.
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Affiliation(s)
- Diane Lenormand
- Université de Paris, MC(2)Lab, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France.
| | - Pascale Piolino
- Université de Paris, MC(2)Lab, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France; Institut Universitaire de France (IUF), Paris, France
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12
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Chao YP, Chuang HH, Hsin LJ, Kang CJ, Fang TJ, Li HY, Huang CG, Kuo TBJ, Yang CCH, Shyu HY, Wang SL, Shyu LY, Lee LA. Using a 360° Virtual Reality or 2D Video to Learn History Taking and Physical Examination Skills for Undergraduate Medical Students: Pilot Randomized Controlled Trial. JMIR Serious Games 2021; 9:e13124. [PMID: 34813485 PMCID: PMC8663656 DOI: 10.2196/13124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 04/02/2020] [Accepted: 09/10/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Learning through a 360° virtual reality (VR) or 2D video represents an alternative way to learn a complex medical education task. However, there is currently no consensus on how best to assess the effects of different learning materials on cognitive load estimates, heart rate variability (HRV), outcomes, and experience in learning history taking and physical examination (H&P) skills. OBJECTIVE The aim of this study was to investigate how learning materials (ie, VR or 2D video) impact learning outcomes and experience through changes in cognitive load estimates and HRV for learning H&P skills. METHODS This pilot system-design study included 32 undergraduate medical students at an academic teaching hospital. The students were randomly assigned, with a 1:1 allocation, to a 360° VR video group or a 2D video group, matched by age, sex, and cognitive style. The contents of both videos were different with regard to visual angle and self-determination. Learning outcomes were evaluated using the Milestone reporting form. Subjective and objective cognitive loads were estimated using the Paas Cognitive Load Scale, the National Aeronautics and Space Administration Task Load Index, and secondary-task reaction time. Cardiac autonomic function was assessed using HRV measurements. Learning experience was assessed using the AttrakDiff2 questionnaire and qualitative feedback. Statistical significance was accepted at a two-sided P value of <.01. RESULTS All 32 participants received the intended intervention. The sample consisted of 20 (63%) males and 12 (38%) females, with a median age of 24 (IQR 23-25) years. The 360° VR video group seemed to have a higher Milestone level than the 2D video group (P=.04). The reaction time at the 10th minute in the 360° VR video group was significantly higher than that in the 2D video group (P<.001). Multiple logistic regression models of the overall cohort showed that the 360° VR video module was independently and positively associated with a reaction time at the 10th minute of ≥3.6 seconds (exp B=18.8, 95% CI 3.2-110.8; P=.001) and a Milestone level of ≥3 (exp B=15.0, 95% CI 2.3-99.6; P=.005). However, a reaction time at the 10th minute of ≥3.6 seconds was not related to a Milestone level of ≥3. A low-frequency to high-frequency ratio between the 5th and 10th minute of ≥1.43 seemed to be inversely associated with a hedonic stimulation score of ≥2.0 (exp B=0.14, 95% CI 0.03-0.68; P=.015) after adjusting for video module. The main qualitative feedback indicated that the 360° VR video module was fun but caused mild dizziness, whereas the 2D video module was easy to follow but tedious. CONCLUSIONS Our preliminary results showed that 360° VR video learning may be associated with a better Milestone level than 2D video learning, and that this did not seem to be related to cognitive load estimates or HRV indexes in the novice learners. Of note, an increase in sympathovagal balance may have been associated with a lower hedonic stimulation score, which may have met the learners' needs and prompted learning through the different video modules. TRIAL REGISTRATION ClinicalTrials.gov NCT03501641; https://clinicaltrials.gov/ct2/show/NCT03501641.
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Affiliation(s)
- Yi-Ping Chao
- Department of Computer Science and Information Engineering, Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.,Department of Neurology, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Hai-Hua Chuang
- Department of Family Medicine, Chang Gung Memorial Hospital, Taipei Branch & Linkou Main Branch, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Hsin
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Chung-Jan Kang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Hsueh-Yu Li
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Chung-Guei Huang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Terry B J Kuo
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheryl C H Yang
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsin-Yih Shyu
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Educational Technology, Tamkang University, New Taipei, Taiwan
| | - Shu-Ling Wang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Center of Teacher Education, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Liang-Yu Shyu
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, Taiwan
| | - Li-Ang Lee
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Abu Hasan R, Sulaiman S, Ashykin NN, Abdullah MN, Hafeez Y, Ali SSA. Workplace Mental State Monitoring during VR-Based Training for Offshore Environment. SENSORS (BASEL, SWITZERLAND) 2021; 21:4885. [PMID: 34300624 PMCID: PMC8309835 DOI: 10.3390/s21144885] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/22/2021] [Accepted: 06/03/2021] [Indexed: 01/26/2023]
Abstract
Adults are constantly exposed to stressful conditions at their workplace, and this can lead to decreased job performance followed by detrimental clinical health problems. Advancement of sensor technologies has allowed the electroencephalography (EEG) devices to be portable and used in real-time to monitor mental health. However, real-time monitoring is not often practical in workplace environments with complex operations such as kindergarten, firefighting and offshore facilities. Integrating the EEG with virtual reality (VR) that emulates workplace conditions can be a tool to assess and monitor mental health of adults within their working environment. This paper evaluates the mental states induced when performing a stressful task in a VR-based offshore environment. The theta, alpha and beta frequency bands are analysed to assess changes in mental states due to physical discomfort, stress and concentration. During the VR trials, mental states of discomfort and disorientation are observed with the drop of theta activity, whilst the stress induced from the conditional tasks is reflected in the changes of low-alpha and high-beta activities. The deflection of frontal alpha asymmetry from negative to positive direction reflects the learning effects from emotion-focus to problem-solving strategies adopted to accomplish the VR task. This study highlights the need for an integrated VR-EEG system in workplace settings as a tool to monitor and assess mental health of working adults.
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Affiliation(s)
- Rumaisa Abu Hasan
- Centre for Intelligent Signal and Imaging Research (CISIR), Electrical and Electronics Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Malaysia; (R.A.H.); (S.S.); (N.N.A.); (Y.H.)
| | - Shahida Sulaiman
- Centre for Intelligent Signal and Imaging Research (CISIR), Electrical and Electronics Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Malaysia; (R.A.H.); (S.S.); (N.N.A.); (Y.H.)
| | - Nur Nabila Ashykin
- Centre for Intelligent Signal and Imaging Research (CISIR), Electrical and Electronics Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Malaysia; (R.A.H.); (S.S.); (N.N.A.); (Y.H.)
| | | | - Yasir Hafeez
- Centre for Intelligent Signal and Imaging Research (CISIR), Electrical and Electronics Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Malaysia; (R.A.H.); (S.S.); (N.N.A.); (Y.H.)
| | - Syed Saad Azhar Ali
- Centre for Intelligent Signal and Imaging Research (CISIR), Electrical and Electronics Engineering Department, Universiti Teknologi PETRONAS, Bandar Seri Iskandar 32610, Malaysia; (R.A.H.); (S.S.); (N.N.A.); (Y.H.)
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