TY - JOUR A1 - Ziebell, Philipp A1 - Rodrigues, Johannes A1 - Forster, André A1 - Sanguinetti, Joseph L. A1 - Allen, John JB. A1 - Hewig, Johannes T1 - Inhibition of midfrontal theta with transcranial ultrasound explains greater approach versus withdrawal behavior in humans JF - Brain Stimulation N2 - Highlights • Transcranial ultrasound neuromodulation/stimulation (TUS) is a growing field. • We conducted a double-blind sham-controlled within-subjects large sample TUS study. • Right prefrontal cortex TUS inhibits midfrontal theta electroencephalography (MFT). • TUS MFT inhibition explains greater approach versus withdrawal in a virtual T-maze. • This distinct TUS-MFT-behavior link merits future basic and applied research. Abstract Recent reviews highlighted low-intensity transcranial focused ultrasound (TUS) as a promising new tool for non-invasive neuromodulation in basic and applied sciences. Our preregistered double-blind within-subjects study (N = 152) utilized TUS targeting the right prefrontal cortex, which, in earlier work, was found to positively enhance self-reported global mood, decrease negative states of self-reported emotional conflict (anxiety/worrying), and modulate related midfrontal functional magnetic resonance imaging activity in affect regulation brain networks. To further explore TUS effects on objective physiological and behavioral variables, we used a virtual T-maze task that has been established in prior studies to measure motivational conflicts regarding whether participants execute approach versus withdrawal behavior (with free-choice responses via continuous joystick movements) while allowing to record related electroencephalographic data such as midfrontal theta activity (MFT). MFT, a reliable marker of conflict representation on a neuronal level, was of particular interest to us since it has repeatedly been shown to explain related behavior, with relatively low MFT typically preceding approach-like risky behavior and relatively high MFT typically preceding withdrawal-like risk aversion. Our central hypothesis is that TUS decreases MFT in T-maze conflict situations and thereby increases approach and reduces withdrawal. Results indicate that TUS led to significant MFT decreases, which significantly explained increases in approach behavior and decreases in withdrawal behavior. This study expands TUS evidence on a physiological and behavioral level with a large sample size of human subjects, suggesting the promise of further research based on this distinct TUS-MFT-behavior link to influence conflict monitoring and its behavioral consequences. Ultimately, this can serve as a foundation for future clinical work to establish TUS interventions for emotional and motivational mental health. KW - approach versus withdrawal KW - electroencephalography (EEG) KW - midfrontal theta (MFT) KW - right prefrontal cortex (PFC) KW - transcranial ultrasound neuromodulation/stimulation (TUS) KW - virtual reality Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-349890 VL - 16 IS - 5 ER - TY - JOUR A1 - Winkler, Markus H. A1 - Li, Yonghui A1 - Pauli, Paul A1 - Mühlberger, Andreas T1 - Modulation of smoking cue reactivity by social context—Implications for exposure therapy in virtual reality JF - Frontiers in Virtual Reality N2 - Rationale: Social factors are considered important for the initiation and maintenance of drug abuse. Virtual reality (VR) research on cue reactivity and exposure frequently incorporates social stimuli as part of complex drug-intake scenarios. Attempts are rarely made to dissect the impact of the different components and their interactive effects. The present study critically extends this line of research by investigating the modulatory effects of social context on the reactivity evoked by proximal smoking cues. Methods: Thirty-two smokers and 33 never-smokers were presented in VR with proximal cues and neutral stimuli, embedded in a social context or a neutral context. A virtual hand model was used to translate real hand movements into VR. Each trial started with the presentation of the different stimulus–context combinations. Discrete stimuli were presented on the table in front of the participants, and contextual stimuli were presented at the end of the table. Afterward, participants were instructed to grasp the target stimulus (a cigarette vs. a pencil) in front of them. After successful contact, the stimulus appeared in the virtual hand. Modulation of cue reactivity by social context was assessed by self-report, physiological measures, and overt approach behavior. Results: The results revealed modulatory effects of social context on the responses to proximal smoking cues in smokers. In contrast to never-smokers, smoking cues evoked craving in smokers, which was attenuated in a social context. Furthermore, social context increased the latency to approach and contact the cigarette in the group of smokers but did not affect behavioral approach responses in never-smokers. Other data provided indications for interactive, but also main effects of cues and contexts. Interestingly, cue-evoked craving was increased after contact with the virtual cigarette. Conclusion: The present study critically extends previous research by providing evidence for the modulation of cue reactivity by social context. The results are particularly important given the well-established role of drug-associated environmental contexts in the stimulus control of addictive behaviors. Our results emphasize the need to address social context effects on cue reactivity in basic research and treatment and further suggest that changes in the perceived availability of smoking might enhance or inhibit cue-evoked reactivity. KW - cue reactivity KW - social context KW - cue exposure therapy KW - cue availability KW - smoking KW - substance use disorders KW - addiction KW - virtual reality Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-306199 VL - 4 ER - TY - JOUR A1 - Bergauer, Lisa A1 - Akbas, Samira A1 - Braun, Julia A1 - Ganter, Michael T. A1 - Meybohm, Patrick A1 - Hottenrott, Sebastian A1 - Zacharowski, Kai A1 - Raimann, Florian J. A1 - Rivas, Eva A1 - López-Baamonde, Manuel A1 - Spahn, Donat R. A1 - Noethiger, Christoph B. A1 - Tscholl, David W. A1 - Roche, Tadzio R. T1 - Visual Blood, visualisation of blood gas analysis in virtual reality, leads to more correct diagnoses: a computer-based, multicentre, simulation study JF - Bioengineering N2 - Interpreting blood gas analysis results can be challenging for the clinician, especially in stressful situations under time pressure. To foster fast and correct interpretation of blood gas results, we developed Visual Blood. This computer-based, multicentre, noninferiority study compared Visual Blood and conventional arterial blood gas (ABG) printouts. We presented six scenarios to anaesthesiologists, once with Visual Blood and once with the conventional ABG printout. The primary outcome was ABG parameter perception. The secondary outcomes included correct clinical diagnoses, perceived diagnostic confidence, and perceived workload. To analyse the results, we used mixed models and matched odds ratios. Analysing 300 within-subject cases, we showed noninferiority of Visual Blood compared to ABG printouts concerning the rate of correctly perceived ABG parameters (rate ratio, 0.96; 95% CI, 0.92–1.00; p = 0.06). Additionally, the study revealed two times higher odds of making the correct clinical diagnosis using Visual Blood (OR, 2.16; 95% CI, 1.42–3.29; p < 0.001) than using ABG printouts. There was no or, respectively, weak evidence for a difference in diagnostic confidence (OR, 0.84; 95% CI, 0.58–1.21; p = 0.34) and perceived workload (Coefficient, 2.44; 95% CI, −0.09–4.98; p = 0.06). This study showed that participants did not perceive the ABG parameters better, but using Visual Blood resulted in more correct clinical diagnoses than using conventional ABG printouts. This suggests that Visual Blood allows for a higher level of situation awareness beyond individual parameters’ perception. However, the study also highlighted the limitations of today’s virtual reality headsets and Visual Blood. KW - virtual reality KW - blood gas analysis KW - data display KW - point-of-care KW - situation awareness KW - user-centred design KW - diagnostic correctness Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-310979 SN - 2306-5354 VL - 10 IS - 3 ER - TY - JOUR A1 - Perra, Alessandra A1 - Riccardo, Chiara Laura A1 - De Lorenzo, Valerio A1 - De Marco, Erika A1 - Di Natale, Lorenzo A1 - Kurotschka, Peter Konstantin A1 - Preti, Antonio A1 - Carta, Mauro Giovanni T1 - Fully immersive virtual reality-based cognitive remediation for adults with psychosocial disabilities: a systematic scoping review of methods intervention gaps and meta-analysis of published effectiveness studies JF - International Journal of Environmental Research and Public Health N2 - Background: Cognitive Remediation (CR) programs are effective for the treatment of mental diseases; in recent years, Virtual Reality (VR) rehabilitation tools are increasingly used. This study aimed to systematically review and meta-analyze the published randomized controlled trials that used fully immersive VR tools for CR programs in psychiatric rehabilitation. We also wanted to map currently published CR/VR interventions, their methods components, and their evidence base, including the framework of the development intervention of CR in fully immersive VR. Methods: Level 1 of evidence. This study followed the PRISMA extension for Scoping Reviews and Systematic Review. Three electronic databases (Pubmed, Cochrane Library, Embase) were systematically searched, and studies were included if they met the eligibility criteria: only randomized clinical trials, only studies with fully immersive VR, and only CR for the adult population with mental disorders. Results: We found 4905 (database) plus 7 (manual/citation searching articles) eligible studies. According to inclusion criteria, 11 studies were finally reviewed. Of these, nine included patients with mild cognitive impairment, one with schizophrenia, and one with mild dementia. Most studies used an ecological scenario, with improvement across all cognitive domains. Although eight studies showed significant efficacy of CR/VR, the interventions’ development was poorly described, and few details were given on the interventions’ components. Conclusions: Although CR/VR seems to be effective in clinical and feasibility outcomes, the interventions and their components are not clearly described. This limits the understanding of the effectiveness and undermines their real-world implementation and the establishment of a gold standard for fully immersive VR/CR. KW - virtual reality KW - cognitive remediation KW - mental health KW - recovery KW - psychiatric rehabilitation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-304948 SN - 1660-4601 VL - 20 IS - 2 ER - TY - JOUR A1 - Perra, Alessandra A1 - Galetti, Alessia A1 - Zaccheddu, Rosanna A1 - Locci, Aurora A1 - Piludu, Federica A1 - Preti, Antonio A1 - Primavera, Diego A1 - Di Natale, Lorenzo A1 - Nardi, Antonio Egidio A1 - Kurotshka, Peter Konstantin A1 - Cossu, Giulia A1 - Sancassiani, Federica A1 - Stella, Giusy A1 - De Lorenzo, Valerio A1 - Zreik, Thurayya A1 - Carta, Mauro Giovanni T1 - A recovery-oriented program for people with bipolar disorder through virtual reality-based Cognitive Remediation: results of a feasibility randomized clinical trial JF - Journal of Clinical Medicine N2 - Background: Cognitive impairment is a frequent consequence of bipolar disorder (BD) that is difficult to prevent and treat. In addition, the quality of the preliminary evidence on the treatment of BD through Cognitive Remediation (CR) with traditional methods is poor. This study aims to evaluate the feasibility of a CR intervention with fully immersive Virtual Reality (VR) as an additional treatment for BD and offers preliminary data on its efficacy. Methods: Feasibility randomized controlled cross-over clinical study, with experimental condition lasting three months, crossed between two groups. Experimental condition: CR fully immersive VR recovery-oriented program plus conventional care; Control condition: conventional care. The control group began the experimental condition after a three months period of conventional care (waiting list). After the randomization of 50 people with BD diagnosis, the final sample consists of 39 participants in the experimental condition and 25 in the control condition because of dropouts. Results: Acceptability and tolerability of the intervention were good. Compared to the waitlist group, the experimental group reported a significant improvement regarding cognitive functions (memory: p = 0.003; attention: p = 0.002, verbal fluency: p = 0.010, executive function: p = 0.003), depressive symptoms (p = 0.030), emotional awareness (p = 0.007) and biological rhythms (p = 0.029). Conclusions: The results are preliminary and cannot be considered exhaustive due to the small sample size. However, the evidence of efficacy, together with the good acceptability of the intervention, is of interest. These results suggest the need to conduct studies with larger samples that can confirm this data. Trial registration: ClinicalTrialsgov NCT05070065, registered in September 2021 KW - virtual reality KW - Cognitive Remediation KW - mental health KW - recovery Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-311201 SN - 2077-0383 VL - 12 IS - 6 ER - TY - JOUR A1 - Hein, Rebecca M. A1 - Latoschik, Marc Erich A1 - Wienrich, Carolin T1 - Inter- and transcultural learning in cocial virtual reality: a proposal for an inter- and transcultural virtual object database to be used in the implementation, reflection, and evaluation of virtual encounters JF - Multimodal Technologies and Interaction N2 - Visual stimuli are frequently used to improve memory, language learning or perception, and understanding of metacognitive processes. However, in virtual reality (VR), there are few systematically and empirically derived databases. This paper proposes the first collection of virtual objects based on empirical evaluation for inter-and transcultural encounters between English- and German-speaking learners. We used explicit and implicit measurement methods to identify cultural associations and the degree of stereotypical perception for each virtual stimuli (n = 293) through two online studies, including native German and English-speaking participants. The analysis resulted in a final well-describable database of 128 objects (called InteractionSuitcase). In future applications, the objects can be used as a great interaction or conversation asset and behavioral measurement tool in social VR applications, especially in the field of foreign language education. For example, encounters can use the objects to describe their culture, or teachers can intuitively assess stereotyped attitudes of the encounters. KW - virtual stimuli KW - implicit association test KW - virtual reality KW - social VR KW - InteractionSuitcase Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-278974 SN - 2414-4088 VL - 6 IS - 7 ER - TY - JOUR A1 - Landeck, Maximilian A1 - Alvarez Igarzábal, Federico A1 - Unruh, Fabian A1 - Habenicht, Hannah A1 - Khoshnoud, Shiva A1 - Wittmann, Marc A1 - Lugrin, Jean-Luc A1 - Latoschik, Marc Erich T1 - Journey through a virtual tunnel: Simulated motion and its effects on the experience of time JF - Frontiers in Virtual Reality N2 - This paper examines the relationship between time and motion perception in virtual environments. Previous work has shown that the perception of motion can affect the perception of time. We developed a virtual environment that simulates motion in a tunnel and measured its effects on the estimation of the duration of time, the speed at which perceived time passes, and the illusion of self-motion, also known as vection. When large areas of the visual field move in the same direction, vection can occur; observers often perceive this as self-motion rather than motion of the environment. To generate different levels of vection and investigate its effects on time perception, we developed an abstract procedural tunnel generator. The generator can simulate different speeds and densities of tunnel sections (visibly distinguishable sections that form the virtual tunnel), as well as the degree of embodiment of the user avatar (with or without virtual hands). We exposed participants to various tunnel simulations with different durations, speeds, and densities in a remote desktop and a virtual reality (VR) laboratory study. Time passed subjectively faster under high-speed and high-density conditions in both studies. The experience of self-motion was also stronger under high-speed and high-density conditions. Both studies revealed a significant correlation between the perceived passage of time and perceived self-motion. Subjects in the virtual reality study reported a stronger self-motion experience, a faster perceived passage of time, and shorter time estimates than subjects in the desktop study. Our results suggest that a virtual tunnel simulation can manipulate time perception in virtual reality. We will explore these results for the development of virtual reality applications for therapeutic approaches in our future work. This could be particularly useful in treating disorders like depression, autism, and schizophrenia, which are known to be associated with distortions in time perception. For example, the tunnel could be therapeutically applied by resetting patients’ time perceptions by exposing them to the tunnel under different conditions, such as increasing or decreasing perceived time. KW - passage of time KW - illusion of self-motion KW - vection KW - virtual tunnel KW - therapeutic application KW - virtual reality KW - extended reality (XR) Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-301519 SN - 2673-4192 VL - 3 ER - TY - JOUR A1 - Glémarec, Yann A1 - Lugrin, Jean-Luc A1 - Bosser, Anne-Gwenn A1 - Buche, Cédric A1 - Latoschik, Marc Erich T1 - Controlling the stage: a high-level control system for virtual audiences in Virtual Reality JF - Frontiers in Virtual Reality N2 - This article presents a novel method for controlling a virtual audience system (VAS) in Virtual Reality (VR) application, called STAGE, which has been originally designed for supervised public speaking training in university seminars dedicated to the preparation and delivery of scientific talks. We are interested in creating pedagogical narratives: narratives encompass affective phenomenon and rather than organizing events changing the course of a training scenario, pedagogical plans using our system focus on organizing the affects it arouses for the trainees. Efficiently controlling a virtual audience towards a specific training objective while evaluating the speaker’s performance presents a challenge for a seminar instructor: the high level of cognitive and physical demands required to be able to control the virtual audience, whilst evaluating speaker’s performance, adjusting and allowing it to quickly react to the user’s behaviors and interactions. It is indeed a critical limitation of a number of existing systems that they rely on a Wizard of Oz approach, where the tutor drives the audience in reaction to the user’s performance. We address this problem by integrating with a VAS a high-level control component for tutors, which allows using predefined audience behavior rules, defining custom ones, as well as intervening during run-time for finer control of the unfolding of the pedagogical plan. At its core, this component offers a tool to program, select, modify and monitor interactive training narratives using a high-level representation. The STAGE offers the following features: i) a high-level API to program pedagogical narratives focusing on a specific public speaking situation and training objectives, ii) an interactive visualization interface iii) computation and visualization of user metrics, iv) a semi-autonomous virtual audience composed of virtual spectators with automatic reactions to the speaker and surrounding spectators while following the pedagogical plan V) and the possibility for the instructor to embody a virtual spectator to ask questions or guide the speaker from within the Virtual Environment. We present here the design, and implementation of the tutoring system and its integration in STAGE, and discuss its reception by end-users. KW - virtual reality KW - virtual agent KW - behavior perception KW - public speaking KW - education Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284601 SN - 2673-4192 VL - 3 ER - TY - JOUR A1 - Steinhaeusser, Sophia C. A1 - Oberdörfer, Sebastian A1 - von Mammen, Sebastian A1 - Latoschik, Marc Erich A1 - Lugrin, Birgit T1 - Joyful adventures and frightening places – designing emotion-inducing virtual environments JF - Frontiers in Virtual Reality N2 - Virtual environments (VEs) can evoke and support emotions, as experienced when playing emotionally arousing games. We theoretically approach the design of fear and joy evoking VEs based on a literature review of empirical studies on virtual and real environments as well as video games’ reviews and content analyses. We define the design space and identify central design elements that evoke specific positive and negative emotions. Based on that, we derive and present guidelines for emotion-inducing VE design with respect to design themes, colors and textures, and lighting configurations. To validate our guidelines in two user studies, we 1) expose participants to 360° videos of VEs designed following the individual guidelines and 2) immerse them in a neutral, positive and negative emotion-inducing VEs combining all respective guidelines in Virtual Reality. The results support our theoretically derived guidelines by revealing significant differences in terms of fear and joy induction. KW - virtual reality KW - virtual environments KW - immersion KW - emotions KW - design Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-284831 SN - 2673-4192 VL - 3 ER - TY - JOUR A1 - Kiser, Dominik P. A1 - Gromer, Daniel A1 - Pauli, Paul A1 - Hilger, Kirsten T1 - A virtual reality social conditioned place preference paradigm for humans: Does trait social anxiety affect approach and avoidance of virtual agents? JF - Frontiers in Virtual Reality N2 - Approach and avoidance of positive and negative social cues are fundamental to prevent isolation and ensure survival. High trait social anxiety is characterized by an avoidance of social situations and extensive avoidance is a risk factor for the development of social anxiety disorder (SAD). Therefore, experimental methods to assess social avoidance behavior in humans are essential. The social conditioned place preference (SCPP) paradigm is a well-established experimental paradigm in animal research that is used to objectively investigate social approach–avoidance mechanisms. We retranslated this paradigm for human research using virtual reality. To this end, 58 healthy adults were exposed to either a happy- or angry-looking virtual agent in a specific room, and the effects of this encounter on dwell time as well as evaluation of this room in a later test without an agent were examined. We did not observe a general SCPP effect on dwell time or ratings but discovered a moderation by trait social anxiety, in which participants with higher trait social anxiety spent less time in the room in which the angry agent was present before, suggesting that higher levels of trait social anxiety foster conditioned social avoidance. However, further studies are needed to verify this observation and substantiate an association with social anxiety disorder. We discussed the strengths, limitations, and technical implications of our paradigm for future investigations to more comprehensively understand the mechanisms involved in social anxiety and facilitate the development of new personalized treatment approaches by using virtual reality. KW - retranslational research KW - conditioned place preference KW - approach–avoidance KW - social anxiety KW - virtual reality KW - personality traits KW - individual differences Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-293564 SN - 2673-4192 VL - 3 ER -