The use of head-mounted displays (HMD) for virtual reality (VR) application-based purposes including therapy, rehabilitation, and training is increasing. Despite advancements in VR technologies, many users still experience sickness symptoms. VR sickness may be influenced by technological differences within HMDs such as resolution and refresh rate, however, VR content also plays a significant role. The primary objective of this systematic review and meta-analysis was to examine the literature on HMDs that report Simulator Sickness Questionnaire (SSQ) scores to determine the impact of content. User factors associated with VR sickness were also examined. A systematic search was conducted according to PRISMA guidelines. Fifty-five articles met inclusion criteria, representing 3,016 participants (mean age range 19.5-80; 41% female). Findings show gaming content recorded the highest total SSQ mean 34.26 (95%CI 29.57-38.95). VR sickness profiles were also influenced by visual stimulation, locomotion and exposure times. Older samples (mean age ≥35 years) scored significantly lower total SSQ means than younger samples, however, these findings are based on a small evidence base as a limited number of studies included older users. No sex differences were found. Across all types of content, the pooled total SSQ mean was relatively high 28.00 (95%CI 24.66-31.35) compared with recommended SSQ cut-off scores. These findings are of relevance for informing future research and the application of VR in different contexts.

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Factors Associated With Virtual Reality Sickness in Head-Mounted Displays: A Systematic Review and Meta-Analysis

Background: Substance Use Disorder (SUD) and behavioral addictions are common and require a multidisciplinary approach. New technologies like Virtual Reality could have the potential to improve assessment and treatment of these disorders. Objective: In the present paper, we therefore present an overview of Virtual Reality (Head Mounted Devices) in the field of addiction medicine for craving assessment and treatment. Method: We conducted a systematic review by querying PubMed database for the titles of articles published up to March 2019 with the terms [virtual] AND [addictive] OR [addiction] OR [substance] OR [alcohol] OR [cocaine] OR [cannabis] OR [opioid] OR [tobacco] OR [nicotine] OR [methamphetamine] OR [gaming] OR [gambling]. Results: We screened 319 abstracts and analyzed 37 articles, dividing them into two categories, the first for assessment of cue reactivity (craving, psychophysiological response and attention to cue) and the second for intervention, each drug (nicotine, cocaine, alcohol, cannabis, gambling) being detailed within each category. Conclusions: This overview suggest that VR provide benefits in the assessment and treatment of substance use disorders and behavior addictions and achieve high levels of ecological validity. While, craving provocation in VR is effective across addiction disorders, treatments based exclusively on virtual exposure to drug related cues as shown heterogenous results.

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Virtual Reality (VR) in Assessment and Treatment of Addictive Disorders: A Systematic Review.

Estimating VR Sickness and user experience using different HMD technologies: An evaluation study

Immersive technologies, such as virtual and augmented reality, initially failed to live up to expectations, but have improved greatly, with many new head-worn displays and associated applications b...

https://www.tandfonline.com/doi/pdf/10.1080/10447318.2020.1828535

Identifying Causes of and Solutions for Cybersickness in Immersive Technology: Reformulation of a Research and Development Agenda

The advent of consumer virtual reality provides a pressing need for interventions that combat sickness in simulated environments (cybersickness). This research builds on multiple theories of cybers...

Estimating the sensorimotor components of cybersickness

In the past decade, there has been a rapid advance in Virtual Reality (VR) technology. Key to the user's VR experience are multimodal interactions involving all senses. The human brain must integrate real-time vision, hearing, vestibular and proprioceptive inputs to produce the compelling and captivating feeling of immersion in a VR environment. A serious problem with VR is that users may develop symptoms similar to motion sickness, a malady called cybersickness. At present the underlying cause of cybersickness is not yet fully understood. Cybersickness may be due to a discrepancy between the sensory signals which provide information about the body's orientation and motion: in many VR applications, optic flow elicits an illusory sensation of motion which tells users that they are moving in a certain direction with certain acceleration. However, since users are not actually moving, their proprioceptive and vestibular organs provide no cues of self-motion. These conflicting signals may lead to sensory discrepancies and eventually cybersickness. Here we review the current literature to develop a conceptual scheme for understanding the neural mechanisms of cybersickness. We discuss an approach to cybersickness based on sensory cue integration, focusing on the dynamic re-weighting of visual and vestibular signals for self-motion.

/pdf/cybersickness-a-multisensory-integration-perspective-1rvbf5610v.pdf

Cybersickness: a Multisensory Integration Perspective.

The popularity of virtual reality (VR) has increased rapidly in recent years. While significant technological advancements are apparent, a troublesome problem with VR is that between 20% and 80% of users will experience unpleasant side effects such as nausea, disorientation, blurred vision and headaches-a malady known as Cybersickness. Cybersickness may be caused by a conflict between sensory signals for self-motion: while vision signals that the user is moving in a certain direction with certain acceleration, the vestibular organs provide no corroborating information. To resolve the sensory conflict, vestibular cues may be down-weighted leading to an alteration of how the brain interprets actual vestibular information. This may account for the frequently reported after-effects of VR exposure. Here, we investigated whether exposure to vection in VR modulates vestibular processing. We measured vestibular-evoked myogenic potentials (VEMPs) during brief immersion in a vection-inducing VR environment presented via head-mounted display. We found changes in VEMP asymmetry ratio, with a substantial increase in VEMP amplitude recorded on the left sternocleidomastoid muscle following just one minute of exposure to vection in VR. Our results suggest that exposure to vection in VR modulates vestibular processing, which may explain common after-effects of VR.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/ejn.14499

Vection in virtual reality modulates vestibular-evoked myogenic potentials.

During exposure to Virtual Reality (VR) a sensory conflict may be present, whereby the visual system signals that the user is moving in a certain direction with a certain acceleration, while the vestibular system signals that the user is stationary. In order to reduce this conflict, the brain may down-weight vestibular signals, which may in turn affect vestibular contributions to self-motion perception. Here we investigated whether vestibular perceptual sensitivity is affected by VR exposure. Participants' ability to detect artificial vestibular inputs was measured during optic flow or random motion stimuli on a VR head-mounted display. Sensitivity to vestibular signals was significantly reduced when optic flow stimuli were presented, but importantly this was only the case when both visual and vestibular cues conveyed information on the same plane of self-motion. Our results suggest that the brain dynamically adjusts the weight given to incoming sensory cues for self-motion in VR; however this is dependent on the congruency of visual and vestibular cues.

/pdf/multisensory-interactions-in-virtual-reality-optic-flow-3ahtnxeho1.pdf

Maria Gallagher

Papers

Cybersickness: a Multisensory Integration Perspective.

Vection in virtual reality modulates vestibular-evoked myogenic potentials.

Multisensory Interactions in Virtual Reality: Optic Flow Reduces Vestibular Sensitivity, but Only for Congruent Planes of Motion.

Older adults fail to form stable task representations during model-based reversal inference.

Dissociation of proprioceptive drift and feelings of ownership in the somatic rubber hand illusion.