{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T03:48:02Z","timestamp":1781236082041,"version":"3.54.1"},"reference-count":88,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MTI"],"abstract":"<jats:p>Virtual reality (VR) can enrich neuropsychological testing, yet the ergonomic trade-offs of its input modes remain under-examined. Seventy-seven healthy volunteers\u2014young (19\u201329 y) and middle-aged (35\u201356 y)\u2014completed a VR Trail Making Test with three pointing methods: eye-tracking, head-gaze, and a six-degree-of-freedom hand controller. Completion time, spatial accuracy, and error counts for the simple (Trail A) and alternating (Trail B) sequences were analysed in 3 \u00d7 2 \u00d7 2 mixed-model ANOVAs; post-trial scales captured usability (SUS), user experience (UEQ-S), and acceptability. Age dominated behaviour: younger adults were reliably faster, more precise, and less error-prone. Against this backdrop, input modality mattered. Eye-tracking yielded the best spatial accuracy and shortened Trail A time relative to manual control; head-gaze matched eye-tracking on Trail A speed and became the quickest, least error-prone option on Trail B. Controllers lagged on every metric. Subjective ratings were high across the board, with only a small usability dip in middle-aged low-gamers. Overall, gaze-based ray-casting clearly outperformed manual pointing, but optimal choice depended on task demands: eye-tracking maximised spatial precision, whereas head-gaze offered calibration-free enhanced speed and error-avoidance under heavier cognitive load. TMT-VR appears to be accurate, engaging, and ergonomically adaptable assessment, yet it requires age-specific\u2013stratified norms.<\/jats:p>","DOI":"10.3390\/mti9080076","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T08:13:31Z","timestamp":1753431211000},"page":"76","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Examination of Eye-Tracking, Head-Gaze, and Controller-Based Ray-Casting in TMT-VR: Performance and Usability Across Adulthood"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2914-1064","authenticated-orcid":false,"given":"Panagiotis","family":"Kourtesis","sequence":"first","affiliation":[{"name":"Department of Psychology, The American College of Greece, 15342 Athens, Greece"},{"name":"Department of Informatics & Telecommunications, National and Kapodistrian University of Athens, 16122 Athens, Greece"},{"name":"Department of Psychology, National and Kapodistrian University of Athens, 15784 Athens, Greece"},{"name":"Department of Psychology, The University of Edinburgh, Edinburgh EH8 9Y, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgenia","family":"Giatzoglou","sequence":"additional","affiliation":[{"name":"Department of Psychology, The American College of Greece, 15342 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panagiotis","family":"Vorias","sequence":"additional","affiliation":[{"name":"Department of Psychology, The American College of Greece, 15342 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina Alkisti","family":"Gounari","sequence":"additional","affiliation":[{"name":"Department of Psychology, The American College of Greece, 15342 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Orfanidou","sequence":"additional","affiliation":[{"name":"Department of Psychology, The American College of Greece, 15342 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2628-6014","authenticated-orcid":false,"given":"Chrysanthi","family":"Nega","sequence":"additional","affiliation":[{"name":"Department of Psychology, The American College of Greece, 15342 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0887-6177(03)00039-8","article-title":"Trail Making Test A and B: Normative Data Stratified by Age and Education","volume":"19","author":"Tombaugh","year":"2004","journal-title":"Arch. Clin. Neuropsychol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1017\/S1355617720000764","article-title":"Validation of the Virtual Reality Everyday Assessment Lab (VR-EAL): An Immersive Virtual Reality Neuropsychological Battery with Enhanced Ecological Validity","volume":"27","author":"Kourtesis","year":"2021","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100151","DOI":"10.1016\/j.chbr.2021.100151","article-title":"How Immersive Virtual Reality Methods May Meet the Criteria of the National Academy of Neuropsychology and American Academy of Clinical Neuropsychology: A Software Review of the Virtual Reality Everyday Assessment Lab (VR-EAL)","volume":"4","author":"Kourtesis","year":"2021","journal-title":"Comput. Hum. Behav. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Faria, A.L., Latorre, J., Silva Cameir\u00e3o, M., Berm\u00fadez i Badia, S., and Llorens, R. (2023). Ecologically Valid Virtual Reality-Based Technologies for Assessment and Rehabilitation of Acquired Brain Injury: A Systematic Review. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1233346"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1590\/1980-57642015DN92000009","article-title":"The Most Frequently Used Tests for Assessing Executive Functions in Aging","volume":"9","author":"Faria","year":"2015","journal-title":"Dement. Neuropsychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1038\/nrn3122","article-title":"Virtual Reality in Neuroscience Research and Therapy","volume":"12","author":"Bohil","year":"2011","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1007\/s11065-019-09407-6","article-title":"A Comparison of Virtual Reality Classroom Continuous Performance Tests to Traditional Continuous Performance Tests in Delineating ADHD: A Meta-Analysis","volume":"29","author":"Parsons","year":"2019","journal-title":"Neuropsychol. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1177\/0018720812465006","article-title":"Using Virtual Reality to Assess User Experience","volume":"54","author":"Rebelo","year":"2012","journal-title":"Hum. Factors"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dulau, E., Botha-Ravyse, C.R., Luimula, M., Markopoulos, P., Markopoulos, E., and Tarkkanen, K. (2019, January 23\u201325). A Virtual Reality Game for Cognitive Impairment Screening in the Elderly: A User Perspective. Proceedings of the 2019 10th IEEE International Conference on Cognitive Infocommunications (CogInfoCom), Naples, Italy.","DOI":"10.1109\/CogInfoCom47531.2019.9089973"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Kourtesis, P. (2024). A Comprehensive Review of Multimodal XR Applications, Risks, and Ethical Challenges in the Metaverse. Multimodal Technol. Interact., 8.","DOI":"10.36227\/techrxiv.173156066.61508577\/v1"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Kourtesis, P., Korre, D., Collina, S., Doumas, L.A.A., and MacPherson, S.E. (2020). Guidelines for the Development of Immersive Virtual Reality Software for Cognitive Neuroscience and Neuropsychology: The Development of Virtual Reality Everyday Assessment Lab (VR-EAL), a Neuropsychological Test Battery in Immersive Virtual Reality. Front. Comput. Sci., 1.","DOI":"10.3389\/fcomp.2019.00012"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gounari, K.A., Giatzoglou, E., Kemm, R., Beratis, I.N., Nega, C., and Kourtesis, P. (2025). The Trail Making Test in Virtual Reality (TMT-VR): Examination of the Ecological Validity, Usability, Acceptability, and User Experience in Adults with ADHD. Psychiatr. Int., 6.","DOI":"10.3390\/psychiatryint6010031"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.neuropsychologia.2011.12.013","article-title":"Using Virtual Reality to Characterize Episodic Memory Profiles in Amnestic Mild Cognitive Impairment and Alzheimer\u2019s Disease: Influence of Active and Passive Encoding","volume":"50","author":"Plancher","year":"2012","journal-title":"Neuropsychologia"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Erena, P.V., Fern\u00e1ndez-Guinea, S., and Kourtesis, P. (2025). Cognitive Assessment and Training in Extended Reality: Multimodal Systems, Clinical Utility, and Current Challenges. Encyclopedia, 5.","DOI":"10.31234\/osf.io\/s8xf3"},{"key":"ref_15","unstructured":"Antona, M., and Stephanidis, C. (2019). Taking Neuropsychological Test to the Next Level: Commercial Virtual Reality Video Games for the Assessment of Executive Functions. Universal Access in Human-Computer Interaction. Multimodality and Assistive Environments, Proceedings of the 13th International Conference, UAHCI 2019, Orlando, FL, USA, 26\u201331 July 2019, Springer International Publishing."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1038\/nprot.2006.390","article-title":"Administration and Interpretation of the Trail Making Test","volume":"1","author":"Bowie","year":"2006","journal-title":"Nat. Protoc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.neuropsychologia.2014.01.019","article-title":"Neural Correlates of a Standardized Version of the Trail Making Test in Young and Elderly Adults: A Functional near-Infrared Spectroscopy Study","volume":"56","author":"Guhn","year":"2014","journal-title":"Neuropsychologia"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kourtesis, P., Collina, S., Doumas, L.A.A., and MacPherson, S.E. (2019). Validation of the Virtual Reality Neuroscience Questionnaire: Maximum Duration of Immersive Virtual Reality Sessions Without the Presence of Pertinent Adverse Symptomatology. Front. Hum. Neurosci., 13.","DOI":"10.3389\/fnhum.2019.00417"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Woods, D.L., Wyma, J.M., Herron, T.J., and Yund, E.W. (2015). The Effects of Aging, Malingering, and Traumatic Brain Injury on Computerized Trail-Making Test Performance. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0124345"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Tan, N.C., Lim, J.E., Allen, J.C., Wong, W.T., Quah, J.H.M., Muthulakshmi, P., Teh, T.A., Lim, S.H., and Malhotra, R. (2022). Age-Related Performance in Using a Fully Immersive and Automated Virtual Reality System to Assess Cognitive Function. Front. Psychol., 13.","DOI":"10.3389\/fpsyg.2022.847590"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1080\/13825585.2017.1351916","article-title":"Development of a Cognitive Function Test Using Virtual Reality Technology: Examination in Healthy Participants","volume":"25","author":"Sakai","year":"2018","journal-title":"Aging Neuropsychol. Cogn."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1017\/neu.2017.14","article-title":"A Comparison of Immersive Virtual Reality with Traditional Neuropsychological Measures in the Assessment of Executive Functions","volume":"30","author":"Davison","year":"2018","journal-title":"Acta Neuropsychiatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jneumeth.2018.03.010","article-title":"The Virtual Shop: A New Immersive Virtual Reality Environment and Scenario for the Assessment of Everyday Memory","volume":"303","author":"Ouellet","year":"2018","journal-title":"J. Neurosci. Methods"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Plechat\u00e1, A., Sahula, V., Fayette, D., and Fajnerov\u00e1, I. (2019). Age-Related Differences with Immersive and Non-Immersive Virtual Reality in Memory Assessment. Front. Psychol., 10.","DOI":"10.3389\/fpsyg.2019.01330"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Linari, I., Juantorena, G.E., Ib\u00e1\u00f1ez, A., Petroni, A., and Kamienkowski, J.E. (2022). Unveiling Trail Making Test: Visual and Manual Trajectories Indexing Multiple Executive Processes. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-16431-9"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ziv, G., Lidor, R., and Levin, O. (2022). Reaction Time and Working Memory in Gamers and Non-Gamers. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-10986-3"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Romero-Ayuso, D., del Pino-Gonz\u00e1lez, A., Torres-Jim\u00e9nez, A., Juan-Gonz\u00e1lez, J., Celdr\u00e1n, F.J., Franchella, M.C., Ortega-L\u00f3pez, N., Trivi\u00f1o-Ju\u00e1rez, J.M., Garach-G\u00f3mez, A., and Arrabal-Fern\u00e1ndez, L. (2024). Enhancing Ecological Validity: Virtual Reality Assessment of Executive Functioning in Children and Adolescents with ADHD. Children, 11.","DOI":"10.3390\/children11080986"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1146\/annurev-psych-113011-143750","article-title":"Executive Functions","volume":"64","author":"Diamond","year":"2013","journal-title":"Annu. Rev. Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1006\/cogp.1999.0734","article-title":"The Unity and Diversity of Executive Functions and Their Contributions to Complex \u201cFrontal Lobe\u201d Tasks: A Latent Variable Analysis","volume":"41","author":"Miyake","year":"2000","journal-title":"Cogn. Psychol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"641","DOI":"10.3758\/s13414-012-0284-1","article-title":"Action Video Game Experience Reduces the Cost of Switching Tasks","volume":"74","author":"Cain","year":"2012","journal-title":"Atten. Percept. Psychophys."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e30249","DOI":"10.2196\/30249","article-title":"Examining the Academic Trends in Neuropsychological Tests for Executive Functions Using Virtual Reality: Systematic Literature Review","volume":"9","author":"Kim","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3715","DOI":"10.1109\/TVCG.2022.3203003","article-title":"Action-Specific Perception & Performance on a Fitts\u2019s Law Task in Virtual Reality: The Role of Haptic Feedback","volume":"28","author":"Kourtesis","year":"2022","journal-title":"IEEE Trans. Vis. Comput. Graph."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Giatzoglou, E., Vorias, P., Kemm, R., Karayianni, I., Nega, C., and Kourtesis, P. (2024). The Trail Making Test in Virtual Reality (TMT-VR): The Effects of Interaction Modes and Gaming Skills on Cognitive Performance of Young Adults. Appl. Sci., 14.","DOI":"10.36227\/techrxiv.173156077.71390447\/v1"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Hornsey, R.L., and Hibbard, P.B. (2024). Current Perceptions of Virtual Reality Technology. Appl. Sci., 14.","DOI":"10.3390\/app14104222"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Stadler, S., Cornet, H., and Frenkler, F. (2019, January 23\u201327). A Study in Virtual Reality on (Non-)Gamers\u2019 Attitudes and Behaviors. Proceedings of the 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR), Osaka, Japan.","DOI":"10.1109\/VR.2019.8797750"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"38127","DOI":"10.1007\/s11042-023-17177-w","article-title":"Virtual Reality Evaluation of the Spatial Learning Strategies in Gamers","volume":"83","author":"Vargas","year":"2023","journal-title":"Multimed. Tools Appl."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Xu, W., Wei, Y., Hu, X., Stuerzlinger, W., Wang, Y., and Liang, H.N. (2025, January 8\u201312). Predicting Ray Pointer Landing Poses in VR Using Multimodal LSTM-Based Neural Networks. Proceedings of the 2025 IEEE Conference Virtual Reality and 3D User Interfaces (VR), Saint Malo, France.","DOI":"10.1109\/VR59515.2025.00034"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Wei, Y., Shi, R., Yu, D., Wang, Y., Li, Y., Yu, L., and Liang, H.N. (2025, January 13\u201316). Predicting Gaze-Based Target Selection in Augmented Reality Headsets Based on Eye and Head Endpoint Distributions. Proceedings of the 2023 CHI Conference on Human Factors in Computing Systems, Pittsburgh, PA, USA.","DOI":"10.1145\/3544548.3581042"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Henrikson, R., Grossman, T., Trowbridge, S., Wigdor, D., and Benko, H. (2020, January 25\u201330). Head-Coupled Kinematic Template Matching: A Prediction Model for Ray Pointing in VR. Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems, Honolulu, HI, USA.","DOI":"10.1145\/3313831.3376489"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Yu, D., Lu, X., Shi, R., Liang, H.N., Dingler, T., Velloso, E., and Goncalves, J. (2021, January 8\u201313). Gaze-Supported 3D Object Manipulation in Virtual Reality. Proceedings of the 2021 CHI Conference on Human Factors in Computing Systems, Yokohama, Japan.","DOI":"10.1145\/3411764.3445343"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.ijpsycho.2020.05.010","article-title":"Best Practices in Eye Tracking Research","volume":"155","author":"Carter","year":"2020","journal-title":"Int. J. Psychophysiol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Fairclough, S.H., and Gilleade, K. (2014). Eye Tracking and Eye-Based Human\u2013Computer Interaction. Advances in Physiological Computing, Springer.","DOI":"10.1007\/978-1-4471-6392-3"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Blattgerste, J., Renner, P., and Pfeiffer, T. (2018, January 15). Advantages of Eye-Gaze over Head-Gaze-Based Selection in Virtual and Augmented Reality under Varying Field of Views. In Proceedings of ETRA \u201818: 2018 Symposium on Eye Tracking Research and Applications, Warsaw, Poland.","DOI":"10.1145\/3206343.3206349"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Llanes-Jurado, J., Mar\u00edn-Morales, J., Guixeres, J., and Alca\u00f1iz, M. (2020). Development and Calibration of an Eye-Tracking Fixation Identification Algorithm for Immersive Virtual Reality. Sensors, 20.","DOI":"10.3390\/s20174956"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Fernandes, A.S., Murdison, T.S., Schuetz, I., Komogortsev, O., and Proulx, M.J. (2024, January 4\u20137). The Effect of Degraded Eye Tracking Accuracy on Interactions in VR. Proceedings of the 2024 Symposium on Eye Tracking Research and Applications, Glasgow, UK.","DOI":"10.1145\/3649902.3656369"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"103785","DOI":"10.1016\/j.apergo.2022.103785","article-title":"A Combination of Eye-Gaze and Head-Gaze Interactions Improves Efficiency and User Experience in an Object Positioning Task in Virtual Environments","volume":"103","author":"Deng","year":"2022","journal-title":"Appl. Ergon."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4740","DOI":"10.1109\/TVCG.2023.3320235","article-title":"Comparing Gaze, Head and Controller Selection of Dynamically Revealed Targets in Head-Mounted Displays","volume":"29","author":"Sidenmark","year":"2023","journal-title":"IEEE Trans. Visual. Comput. Graph."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Slater, M., and Sanchez-Vives, M.V. (2016). Enhancing Our Lives with Immersive Virtual Reality. Front. Robot. AI, 3.","DOI":"10.3389\/frobt.2016.00074"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s10055-023-00903-y","article-title":"Eye-Tracking on Virtual Reality: A Survey","volume":"28","author":"Jurado","year":"2024","journal-title":"Virtual Real."},{"key":"ref_50","first-page":"e66314","article-title":"User Experience Testing of the Meta Quest 2 for Integration with the Virtual Reality Simulation for Dementia Coaching, Advocacy, Respite, Education, Relationship, and Simulation (VR-SIM CARERS) Program","volume":"16","author":"Chiu","year":"2024","journal-title":"Cureus"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Gabel, J., Schmidt, S., Ariza, O., and Steinicke, F. (2023, January 9\u201311). Redirecting Rays: Evaluation of Assistive Raycasting Techniques in Virtual Reality. Proceedings of the 29th ACM Symposium on Virtual Reality Software and Technology, Christchurch, New Zealand.","DOI":"10.1145\/3611659.3615716"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1167\/jov.24.7.10","article-title":"Where Was This Thing Again? Evaluating Methods to Indicate Remembered Object Positions in Virtual Reality","volume":"24","author":"Schuetz","year":"2024","journal-title":"J. Vis."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Wu, Z., Wang, D., Zhang, S., Huang, Y., Wang, Z., and Fan, M. (2024, January 11\u201316). Toward Making Virtual Reality (VR) More Inclusive for Older Adults: Investigating Aging Effect on Target Selection and Manipulation Tasks in VR. Proceedings of the Proceedings of the CHI Conference on Human Factors in Computing Systems, Honolulu, HI, USA.","DOI":"10.1145\/3613904.3642558"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"102414","DOI":"10.1016\/j.ijhcs.2020.102414","article-title":"Comparing Selection Mechanisms for Gaze Input Techniques in Head-Mounted Displays","volume":"139","author":"Esteves","year":"2020","journal-title":"Int. J. Hum. Comput. Stud."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Zioga, T., Ferentinos, A., Konsolaki, E., Nega, C., and Kourtesis, P. (2024). Video Game Skills across Diverse Genres and Cognitive Functioning in Early Adulthood: Verbal and Visuospatial Short-Term and Working Memory, Hand\u2013Eye Coordination, and Empathy. Behav. Sci., 14.","DOI":"10.3390\/bs14100874"},{"key":"ref_56","first-page":"722","article-title":"Validation of the Gaming Skills Questionnaire in Adolescence: Effects of Gaming Skills on Cognitive and Affective Functioning","volume":"14","author":"Zioga","year":"2024","journal-title":"Eur. J. Investig. Health Psychol. Educ."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"16","DOI":"10.3390\/virtualworlds2010002","article-title":"Cybersickness in Virtual Reality Questionnaire (CSQ-VR): A Validation and Comparison against SSQ and VRSQ","volume":"2","author":"Kourtesis","year":"2023","journal-title":"Virtual Worlds"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Kourtesis, P., Collina, S., Doumas, L.A.A., and MacPherson, S.E. (2019). Technological Competence Is a Pre-Condition for Effective Implementation of Virtual Reality Head Mounted Displays in Human Neuroscience: A Technological Review and Meta-Analysis. Front. Hum. Neurosci., 13.","DOI":"10.3389\/fnhum.2019.00342"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4633","DOI":"10.1109\/TVCG.2023.3320211","article-title":"Controllers or Bare Hands? A Controlled Evaluation of Input Techniques on Interaction Performance and Exertion in Virtual Reality","volume":"29","author":"Luong","year":"2023","journal-title":"IEEE Trans. Vis. Comput. Graph."},{"key":"ref_60","unstructured":"(2019). Ergonomics of Human-System Interaction\u2014Part 210: Human-Centred Design for Interactive Systems (Standard No. ISO 9241-210:2019(En)). Available online: https:\/\/www.iso.org\/obp\/ui\/en\/#iso:std:iso:9241:-210:ed-2:v1:en."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.cag.2012.12.003","article-title":"A Survey of 3D Object Selection Techniques for Virtual Environments","volume":"37","author":"Argelaguet","year":"2013","journal-title":"Comput. Graph."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Mohan, P., Goh, W.B., Fu, C.W., and Yeung, S.K. (2018, January 16\u201320). DualGaze: Addressing the Midas Touch Problem in Gaze Mediated VR Interaction. Proceedings of the 2018 IEEE International Symposium on Mixed and Augmented Reality Adjunct (ISMAR-Adjunct), Munich, Germany.","DOI":"10.1109\/ISMAR-Adjunct.2018.00039"},{"key":"ref_63","first-page":"206","article-title":"Color Universal Design: The Selection of Four Easily Distinguishable Colors for All Color Vision Types","volume":"Volume 6807","author":"Eschbach","year":"2008","journal-title":"Proceedings of the Color Imaging XIII: Processing"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1080\/10447310802205776","article-title":"An Empirical Evaluation of the System Usability Scale","volume":"24","author":"Bangor","year":"2008","journal-title":"Int. J. Hum. Comput. Interact."},{"key":"ref_65","first-page":"29","article-title":"SUS: A Retrospective","volume":"8","author":"Brooke","year":"2013","journal-title":"J. Usabil. Stud."},{"key":"ref_66","first-page":"103","article-title":"Design and Evaluation of a Short Version of the User Experience Questionnaire (UEQ-S)","volume":"4","author":"Schrepp","year":"2017","journal-title":"Int. J. Interact. Multimed. Artif. Intell."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1177\/1357633X16649531","article-title":"Quantifying Beliefs Regarding Telehealth: Development of the Whole Systems Demonstrator Service User Technology Acceptability Questionnaire","volume":"23","author":"Hirani","year":"2017","journal-title":"J. Telemed. Telecare"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Kourtesis, P., Kouklari, E.-C., Roussos, P., Mantas, V., Papanikolaou, K., Skaloumbakas, C., and Pehlivanidis, A. (2023). Virtual Reality Training of Social Skills in Adults with Autism Spectrum Disorder: An Examination of Acceptability, Usability, User Experience, Social Skills, and Executive Functions. Behav. Sci., 13.","DOI":"10.36227\/techrxiv.22638736.v1"},{"key":"ref_69","unstructured":"R Core Team R (2022). A Language and Environment for Statistical Computing, R Foundation for Statistical Computing."},{"key":"ref_70","unstructured":"RStudio Team (2022). RStudio: Integrated Development Environment for R., RStudio, PBC."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"2312","DOI":"10.1080\/02664763.2019.1630372","article-title":"Ordered Quantile Normalization: A Semiparametric Transformation Built for the Cross-Validation Era","volume":"47","author":"Peterson","year":"2020","journal-title":"J. Appl. Statist."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Wickham, H. (2016). Ggplot2, Use R!; Springer International Publishing.","DOI":"10.1007\/978-3-319-24277-4"},{"key":"ref_73","unstructured":"Wei, T., and Simko, V. (2025, June 23). R Package \u201cCorrplot\u201d: Visualization of a Correlation Matrix, Version 0.84; 2024. Available online: https:\/\/cran.r-project.org\/web\/\/packages\/corrplot\/corrplot.pdf."},{"key":"ref_74","unstructured":"Singmann, H., Bolker, B., Westfall, J., Aust, F., and Ben-Shachar, M.S. (2025, June 23). Afex: Analysis of Factorial Experiments; 2021. Available online: https:\/\/cran.r-project.org\/web\/\/packages\/afex\/afex.pdf."},{"key":"ref_75","unstructured":"Lenth, R. (2025, June 23). Emmeans: Estimated Marginal Means, Aka Least-Squares Means, version 1.8.5.; 2022. Available online: https:\/\/cran.r-project.org\/web\/packages\/emmeans\/index.html."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"10","DOI":"10.16910\/jemr.12.1.3","article-title":"Eye Tracking in Virtual Reality","volume":"12","author":"Clay","year":"2019","journal-title":"J. Eye Mov. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1080\/10447318.2020.1826190","article-title":"Comparison of Eye-Based and Controller-Based Selection in Virtual Reality","volume":"37","author":"Hou","year":"2021","journal-title":"Int. J. Hum. Comput. Interact."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Kim, J., Palmisano, S., Luu, W., and Iwasaki, S. (2021). Effects of Linear Visual-Vestibular Conflict on Presence, Perceived Scene Stability and Cybersickness in the Oculus Go and Oculus Quest. Front. Virtual Real., 2.","DOI":"10.3389\/frvir.2021.582156"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.neurobiolaging.2008.09.023","article-title":"When Does Age-Related Cognitive Decline Begin?","volume":"30","author":"Salthouse","year":"2009","journal-title":"Neurobiol. Aging"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.actpsy.2008.09.005","article-title":"The Effects of Video Game Playing on Attention, Memory, and Executive Control","volume":"129","author":"Boot","year":"2008","journal-title":"Acta Psychol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1080\/10447318.2019.1708612","article-title":"User Acceptance of Virtual Reality: An Extended Technology Acceptance Model","volume":"36","author":"Sagnier","year":"2020","journal-title":"Int. J. Hum. Comput. Interact."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"107153","DOI":"10.1016\/j.chb.2021.107153","article-title":"Game Experience Leads to Improvement in Cognitive Functioning of the Early Middle-Aged Adults in Contrast with the Young-Aged Adults","volume":"129","author":"Kim","year":"2022","journal-title":"Comput. Hum. Behav."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"22388","DOI":"10.1364\/OE.520168","article-title":"High-Fidelity Color Characterization in Virtual Reality across Head Mounted Displays, Game Engines, and Materials","volume":"32","author":"Bayer","year":"2024","journal-title":"Opt. Express"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3390\/virtualworlds3040027","article-title":"Mitigating Cybersickness in Virtual Reality: Impact of Eye\u2013Hand Coordination Tasks, Immersion, and Gaming Skills","volume":"3","author":"Papaefthymiou","year":"2024","journal-title":"Virtual Worlds"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Porcino, T.M., Clua, E., Trevisan, D., Vasconcelos, C.N., and Valente, L. (2017, January 2\u20134). Minimizing Cyber Sickness in Head Mounted Display Systems: Design Guidelines and Applications. Proceedings of the 2017 IEEE 5th International Conference on Serious Games and Applications for Health (SeGAH), Perth, WA, Australia.","DOI":"10.1109\/SeGAH.2017.7939283"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"102771","DOI":"10.1016\/j.arr.2025.102771","article-title":"Immersive Virtual Reality for Older Adults: Challenges and Solutions in Basic Research and Clinical Applications","volume":"109","author":"Schaumburg","year":"2025","journal-title":"Ageing Res. Rev."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"22895","DOI":"10.1007\/s10639-024-12662-7","article-title":"Digital Literacy Scale: Validity and Reliability Study with the Rasch Model","volume":"29","year":"2024","journal-title":"Educ. Inf. Technol."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Marini, M.R., Mocerino, L., Leopardi, L., Malatesta, S.G., and Cinque, L. (2024, January 24\u201326). WSUS: A Novel Usability Metric Based on SUS for VR-Based Tasks in Cultural Heritage Contexts. Proceedings of the 2024 10th International Conference on Virtual Reality (ICVR), Bournemouth, UK.","DOI":"10.1109\/ICVR62393.2024.10868543"}],"container-title":["Multimodal Technologies and Interaction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-4088\/9\/8\/76\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:15:48Z","timestamp":1760033748000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-4088\/9\/8\/76"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,25]]},"references-count":88,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["mti9080076"],"URL":"https:\/\/doi.org\/10.3390\/mti9080076","relation":{},"ISSN":["2414-4088"],"issn-type":[{"value":"2414-4088","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,25]]}}}