Virtual reality paced serial assessment test for neuropsychological assessment of a military cohort.

The assessment and treatment of traumatic brain injury (TBI) has become a difficult challenge for the DoD medical health system. Clinical neuropsychologists are being asked to make statements regarding a soldier's functional skills, ability to return to active duty, and competence in tasks of community living. Given the increasing prevalence of blast injuries to the head, and the fact that many brain injuries may have no external marker of injury, there is need for researching innovative assessment methods in detecting blast-related brain injury. To address these issues, two virtual reality-based Paced Auditory/Visual Serial Addition Tests (PA/VSAT) were developed that involve the participant being immersed in a Virtual Middle Eastern City as serial addition stimuli are presented. This study is an initial validation of the VRPASAT and VRPVSAT as assessments of neurocognitive functioning. When compared to the paper-and-pencil version of the test, as well as the Automated Neuropsychological Assessment Metrics, the VRPASAT and VRPVSAT appear to have enhanced capacity for providing an indication of a participant's performance while immersed in a military relevant simulation.