Virtual reality, machine learning, and statistical modeling reveal an association between multiple concussion history and impaired perceptual decision-making.

Authors

Gary B Wilkerson, Mohammad Joghataee, Ashish Gupta

Published in

PloS one. Volume 21. Issue 9. Pages e0358042. Epub Sep 21, 2026.

Abstract

Current clinical assessment methods are insufficiently sensitive for detection of subtle post-concussion impairments in perceptual-cognitive function. The purpose of this study was to search for any perceptual response metrics associated with concussion history that might increase understanding of altered brain-behavior relationships. Immersive virtual reality test data were aggregated for 202 healthy adolescents and young adults (116 males, 86 females) who participated in different studies over a 2-year period. Left- versus right-directed neck rotation, arm reach, and step-lunge responses to sequential presentations of 2 types of horizontally moving visual stimuli were measured in terms of time to initiation of body segment movement (perceptual latency [PL]), as well as response completion (response time [RT]). Speed-accuracy tradeoff was represented by rate correct per second for PL (RCS-PL) and RT (RCS-RT) of neck and arm movements, and across-trial inconsistency was represented by PL variability (PLV) and RT variability (RTV). Both supervised machine learning and theory-based statistical regression methods were used to identify metrics that best discriminated between participants who reported a history of no concussion (NC), single concussion (SC), NC + SC, or multiple concussions (MC). Additionally, statistical regression was used to assess a theoretical relationship between metrics believed to align with components of the drift-diffusion computational model of decision-making. The best metric for discrimination between NC + SC and MC was Neck RCS-PL. Neck PLV values demonstrated a strong inverse logarithmic correlation with Neck RCS-PL (r = -0.796, P < 0.001). The Neck RCS-PL and Neck PLV behavioral metrics may have relevance to the two components of the drift-diffusion computational model of perceptual decision-making, and their combination may be associated with a cumulative and persisting deficiency after having sustained more than one lifetime concussion.

PMID:
42766595
Bibliographic data and abstract were imported from PubMed on 22 Sep 2026.

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