The sensitivity of a virtual reality task to planning and prospective memory impairments: group differences and the efficacy of periodic alerts on performance.

Executive functions have been argued to be the most vulnerable to brain injury. In providing an analogue of everyday situations amenable to control and management virtual reality (VR) may offer better insights into planning deficits consequent upon brain injury. Here 17 participants with a non-progressive brain injury and reported executive difficulties in everyday life were asked to perform a VR task (working in a furniture storage unit) that emphasised planning, rule following and prospective memory tasks. When compared with an age and IQ-matched control group, the patients were significantly poorer in terms of their strategy, their time-based prospective memory, the overall time required and their propensity to break rules. An examination of sensitivity and specificity of the VR task to group membership (brain-injured or control) showed that, with specificity set at maximum, sensitivity was only modest (at just over 50%). A second component to the study investigated whether the patients' performance could be improved by periodic auditory alerts. Previous studies have demonstrated that such cues can improve performance on laboratory tests, executive tests and everyday prospective memory tasks. Here, no significant changes in performance were detected. Potential reasons for this finding are discussed, including symptom severity and differences in the tasks employed in previous studies.