ARTORG Center for Biomedical Engineering Research

Development of an adaptive virtual environment for closed loop control of cognitive processes in critically ill patients

Project Members: Stephan Gerber, Marie-Madlen Jeitziner, Patric Wyss, Alvin Chesham, Prabitha Urwyler, René M. Müri, Stephan M. Jakob, Tobias Nef
Project Start: 01.09.2016

Around 70% of patients in the intensive care unit (ICU) suffer from long-term functional deficits and reduction of quality of life after prolonged stay in the ICU. It is assumed that the noisy and stressful ICU environment exposes patients to both stimulus overload and deprivation and puts them at risk of alterations in sensory perception that can result in cognitive dysfunction.

The main goal of this PhD is to develop an adaptive 3D virtual environment for closed loop control of cognitive processes to prevent or reduce cognitive impairment. In contrast to non-adaptive VR environments that do not change the content, adaptive VR environments are characterized by the dynamic adaptation to the patient’s needs.

By measuring physiological parameters (e.g. heartrate, eye movements), the content can be adapted in real-time to influence a desired cognitive parameter (e.g. visual attention) of the patient. Furthermore, the system should be safe to use with critically ill patients and full fill all standard hygiene and security requirements in the ICU. In a first study, the developed system will be tested in healthy participants followed by a second observational study testing the system in critically ill patients. Finally, the gained knowledge from these studies will be combined to develop an adaptive VR environment where it is possible to change the level of cognitive demand in a closed loop based on physiological and oculomotor data of patients directly measured in the ICU. 


Keywords: Virtual reality, Audio-visual stimulation, Critical illness, Intensive care unit, Cognition

Videos publication:

Stimulation VR Nature

Stimulation VR Urban

Stimulation including the region of interest

Virtual reality nature stimulation


Gerber, Stephan Moreno; Jeitziner, Marie-Madlen; Wyss, Patric; Chesham, Alvin; Urwyler, Prabitha; Müri, René Martin; Jakob, Stephan; Nef, Tobias (2017). Visuo-acoustic stimulation that helps you to relax: A virtual reality setup for patients in the intensive care unit.Scientific Reports, 7(1), pp. 1-10. Nature Publishing Group 10.1038/s41598-017-13153-1