Virtual reality investigation of strategy formation, rule breaking and prospective memory in patients with focal prefrontal neurosurgical lesions

Planning and organisational ability was investigated in 35 patients with prefrontal lesions, using virtual reality (VR) to mimic everyday activity, but in a laboratory setting. A multicomponential VR procedure, the Bungalow Task was developed to test strategy formation, rule breaking and prospective memory. The task involved simulation of decision-making whilst a participant moved around a virtual bungalow, selecting furniture for removal according to specified instructions, and various aspects of prospective memory were tested. Significant strategy formation and rule breaking impairments were observed and additional time and activity, but not event based prospective memory impairment observed. The study demonstrates the successful use of VR as a neuropsychological tool for investigating executive functioning in an ecologically valid fashion.