$1.5M DOD grant will create virtual reality test to assess TBI in the field

One of the most common injuries sustained by military personnel in recent conflicts has been traumatic brain injury, or TBI. In response to this, and the fact that military operations are increasingly being conducted by small teams in far-flung areas, researchers in the University of Arizona College of Medicine – Tucson’s Department of Psychiatry are working on a portable virtual reality system to assess TBI in the field.

Psychiatry professor William “Scott” Killgore, PhD, and his team in the Social, Cognitive and Affective Neuroscience Lab were recently awarded a $1.5 million grant from the Department of Defense’s United States Army Medical Research Acquisition Activity division to develop a VR assessment system for TBI.

“While most TBIs are mild, such as in the case of a concussion, being able to quickly assess the level of injury is imperative to a service member’s recovery,” Killgore said. “Traditionally, comprehensive neuropsychological assessments are conducted by highly trained professionals who typically have a doctoral degree in clinical psychology and certification in neuropsychology. That is not feasible in remote locations under combat conditions.

“We aim to capitalize on recent advances in artificial intelligence, machine learning and computational neuroscience to develop a lightweight, portable, virtual reality assessment system that can rapidly assess multiple dimensions of cognitive performance – in the field – simultaneously.”

The project, Model Development and Translation of a Virtual Reality Military Operational Neuropsychological Assessment, or VRMONA, will utilize use a type of AI known as deep learning neural networks to identify neuropsychological deficits during a relatively brief interactive and ecologically valid VR combat-related “game.” 

During this brief “game,” the participant will utilize a VR headset and hand sensor system to engage in an immersive set of scenarios relevant to the military. The immersive VR system will allow simultaneous assessment of a variety of neurocognitive domains in real time while the subject interacts with the system’s posed problem scenarios.

As part of the realistic exercise, the participant engages in combat-relevant activities involving friend-or-foe discrimination, visual and auditory perception, situational awareness, decision-making and communication. Throughout the immersive experiences, the system collects data regarding examinee responses, such as accuracy, response time, motor coordination and inhibition.

The data will be extracted in real-time and analyzed using machine learning algorithms to assess the major domains of neuropsychological performance.

Through the use of VR technology, it will be possible to assess ecologically valid military scenarios, where test performance predicts behaviors in real-world settings, that cannot be practicably and reliably assessed through simple observation or traditional paper-and-pencil neuropsychological tests. 

“Dr. Killgore and his team are conducting state-of-the-art research utilizing cutting-edge technologies,” said Jordan Karp, MD, psychiatry professor and department chair. “By incorporating the machine learning of deep neural networks, the SCAN Lab will train the VR system to identify multiple cognitive abilities impacted by TBI. The development of this system can eventually assist in both military and civilian uses.”

In the future, such VR assessment systems could be tailored to a variety of occupational specialties to facilitate precision assessments of TBI.

“VRMONA can be applied in a dual-use capacity across civilian and military contexts, including medical, sport, first responder and other settings. It will allow a rapid assessment of neurocognitive abilities in a matter of minutes rather than hours, and at an extremely fine-grained level that is not possible with contemporary assessment batteries,” Killgore said. “This could represent a paradigm shift in standard neuropsychological assessment.

“Overall, the VRMONA has potential to significantly advance cognitive assessment capabilities in remote locations,” Killgore added. “This will significantly increase the survivability and readiness of U.S. soldiers and will enhance the overall health of military personnel and readiness of the armed forces.”