Wayfinding and path integration deficits detected using a virtual reality mobile app in patients with traumatic brain injury

Caroline Seton, Antoine Coutrot, Michael Hornberger, Hugo J. Spiers, Rebecca Knight, Caroline Whyatt, Irene Cristofori (Editor)

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The ability to navigate is supported by a wide network of brain areas which are particularly vulnerable to disruption brain injury, including traumatic brain injury (TBI). Wayfinding and the ability to orient back to the direction you have recently come (path integration) may likely be impacted in daily life but have so far not been tested with patients with TBI. Here, we assessed spatial navigation in thirty–eight participants, fifteen of whom had a history of TBI, and twenty–three control participants. Self-estimated spatial navigation ability was assessed using the Santa Barbara Sense of Direction (SBSOD) scale. No significant difference between TBI patients and a control group was identified. Rather, results indicated that both participant groups demonstrated ‘good’ self–inferred spatial navigational ability on the SBSOD scale. Objective navigation ability was tested via the virtual mobile app test Sea Hero Quest (SHQ), which has been shown to predict real–world navigation difficulties and assesses (a) wayfinding across several environments and (b) path integration. Compared to a sub-sample of 13 control participants, a matched subsample of 10 TBI patients demonstrated generally poorer performance on all wayfinding environments tested. Further analysis revealed that TBI participants consistently spent a shorter duration viewing a map prior to navigating to goals. Patients showed mixed performance on the path integration task, with poor performance evident when proximal cues were absent. Our results provide preliminary evidence that TBI impacts both wayfinding and, to some extent, path integration. The findings suggest long–lasting clinical difficulties experienced in TBI patients affect both wayfinding and to some degree path integration ability.
Original languageEnglish
Article number e0282255
Pages (from-to)1-18
Number of pages18
JournalPLoS ONE
Issue number3 March
Early online date9 Mar 2023
Publication statusPublished - 9 Mar 2023


  • Research Article
  • Medicine and health sciences
  • Engineering and technology
  • Computer and information sciences
  • Biology and life sciences
  • Brain
  • Brain Injuries, Traumatic/diagnosis
  • Mobile Applications
  • Humans
  • Spatial Navigation
  • Virtual Reality


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