Virtual environments in brain damage rehabilitation: a rationale from basic neuroscience.

The potential of virtual environments in assessment and training of cognitive function is a more than adequate reason for their application to neurorehabilitation. However, there is a more fundamental justification, and one which is firmly rooted in the neuroscience literature. Over the last half century there has been a wealth of published evidence that enriching the environments of laboratory rats stimulates neuroplastic change in the cerebral cortex, enhances learning and problem solving in normal rats and reduces cognitive impairment in brain damaged rats. Central to all three effects of enrichment are the increased levels of interaction with the physical environment engendered by enrichment. Placing humans who have damaged brains in virtual environments is one way of enhancing their levels of environmental interaction which, because of cognitive impairments and sensory and motor disabilities, is otherwise difficult to achieve. In this chapter we explore the potential of virtual environments as enriched environments within the rehabilitation regime. The underlying assumption, that interaction with a virtual environment is functionally equivalent to interaction with a real environment, is examined. Three lines of relevant evidence are reviewed, neuroimaging studies and psychophysiological studies of people in virtual environments and studies of transfer of training from virtual to real tasks. An agenda for future research in this are is proposed.