The Trail-Making-Test in Virtual Reality (TMT-VR): The Effects of Interaction Modes and Gaming Skills on Cognitive Performance of Young Adults

Virtual Reality (VR) is increasingly used in neuropsychological assessments due to its ability to simulate real-world environments. This study aimed to develop and evaluate the Trail Making Test in VR (TMT-VR) and investigate the effects of different interaction modes and gaming skills on cognitive performance. A total of 71 young female and male adults (aged 18-35) with high and low gaming skills participated in this study. Participants completed the TMT-VR using three interaction modes: eye-tracking, head movement, and controller. Performance metrics included task completion time and accuracy. User experience, usability, and acceptability of TMT-VR were also examined. Results showed that both eye-tracking and head movement modes significantly outperformed the controller in terms of task completion time and accuracy. No significant differences were found between eye-tracking and head movement modes. Gaming skills did not significantly influence task performance using any interaction mode. Participants reported high usability, acceptability, and user experience for the TMT-VR. Eye-tracking facilitated higher accuracy, while head movement higher speed. The TMT-VR offers high usability and user experience and is well accepted by the participants. The findings suggest that VR-based assessments can effectively measure cognitive performance without being influenced by prior gaming skills, indicating potential applicability for diverse populations.