Virtual reality (VR) is increasingly applied in neurological assessment, yet little is known about whether user experience factors, such as cybersickness and sense of presence, relate differently to VR task performance depending on the presence of neurological symptoms. This study tested 58 patients with Post-COVID-19 condition (PCC) symptoms and 54 control individuals (non-PCC group) on a VR-based spatial memory task. The Simulator Sickness Questionnaire (SSQ) and the Igroup Presence Questionnaire (IPQ) were used to assess cybersickness and sense of presence, respectively. Multiple linear regressions, adjusted for age and sex, showed that the PCC group reported significantly higher SSQ scores across all subscales. In contrast, both groups showed similar IPQ responses and task performance (i.e., number of correct responses, number of attempts, and execution time). Moderated regression models, adjusted for the same covariates, showed that cybersickness did not predict task execution time in either group. However, in the PCC group, higher sense of presence ratings predicted faster task completion, an effect not observed in the non-PCC group. Considering covariate effects, age consistently predicted slower performance. In addition, female sex emerged as a significant covariate specifically for sense of presence, with women reporting higher scores than men. Overall, the results indicate that PCC is associated with increased VR-induced cybersickness, while a heightened sense of presence may facilitate motor and cognitive processing during task performance, particularly in individuals with neurological conditions. Further experimental studies are needed to investigate how variations in presence levels influence performance in VR-based cognitive tasks.

Dehydroepiandrosterone (DHEA) and cortisol release appear to have contrasting effects on stress perception during stressful tasks. This study aimed to investigate anticipatory examination stress in college students by considering DHEA, cortisol, psycho-emotional aspects and examination performance. Seventy-six students (66 females, 10 males; age range 18-25 years) provided saliva samples and completed questionnaires in two sessions 48 hours apart. During the second session, the students performed the examination. The questionnaires used were the State-Trait Anxiety Inventory, the Positive and Negative Affect Scale, and the Brief-Coping Orientation to Problems Experienced Inventory. DHEA, cortisol, anxiety and negative affect showed an anticipatory rise before the examination (all ps < 0.001). This rise of DHEA and cortisol was associated with lower positive affect (p = 0.001 and p = 0.043, respectively). However, only the DHEA anticipatory levels were linked to poorer examination marks (p = 0.020). Higher levels of the DHEA/cortisol ratio in anticipation of the examination were related to lower scores on the support-seeking strategy (p = 0.022). There was no association between DHEA and cortisol levels and anxiety, negative affect, active and avoidant coping strategies, or academic record. These results suggest that how DHEA and cortisol respond in anticipation of examination stress significantly impacts students' emotional well-being during examination periods and how they cope with stress. They also suggest that levels of DHEA in anticipation of an academic stressor have detrimental effects on stress management.

Emotionally expressive avatars are often used to increase engagement in virtual environments, but their effects on users’ emotional outcomes and experience during evaluative tasks are not well established. This study examined whether differences in avatar emotional expressiveness are associated with affective responses and user experience during a socially evaluative speech task in virtual reality (VR), and how individual characteristics and emotional variables relate to performance and user experience. Sixty-three university students were randomly assigned to deliver a five-minute self-presentation, simulating a job interview, in front of a virtual mirror while embodied in either a high-expressive or low-expressive avatar. In the present study, the manipulation of avatar expressiveness was implemented using Meta Quest 2 and Meta Quest Pro headsets, differing mainly in facial-tracking capability. Participants completed a structured three-phase protocol: pre-avatar embodiment (baseline questionnaires), avatar embodiment (speech task), and post-avatar embodiment (post-task measures). Emotional state and trait variables, speech fluency and engagement during the task, and user experience variables were assessed. No significant effects of avatar expressiveness were found on emotional or experiential variables. Correlation analyses revealed a positive association between extraversion and avatar embodiment. These findings contribute to our understanding of the factors that are associated with user experience and behaviour in avatar-based VR environments and suggest that individual traits, such as extraversion, should be considered when designing VR applications for training, education, and therapeutic purposes.

Object-location memory (OLM) is the ability to encode and retrieve spatial relationships between objects by using egocentric or allocentric reference frames. Critically, OLM is modulated by emotional memory systems that engage amygdala–hippocampal and arousal-related mechanisms that can bias or disrupt spatial encoding. Despite evidence that emotion shapes memory, its specific impact on OLM remains unclear, particularly in digital contexts. This systematic review examined how emotional valence, particularly stress and anxiety, modulates OLM performance in computer-based and virtual/augmented reality tasks. Following PRISMA guidelines, a systematic search was conducted in Web of Science, Scopus, PsycInfo, and PubMed. Twelve empirical studies published up to 2025 met the inclusion criteria. Results revealed sex-specific effects: anxious women tended to rely on egocentric strategies, whereas stressed men showed greater allocentric flexibility. The timing of stress exposure was critical, often disrupting encoding but occasionally facilitating retrieval. Emotional valence differentially influenced performance: positive stimuli enhanced spatial accuracy, whereas negative stimuli accelerated response times. Spatial working memory (SWM) and mental rotation emerged as key cognitive resources supporting flexible spatial learning, while physiological stress markers showed only weak associations with behavioral outcomes. Future research should standardize paradigms, explore digital and immersive environments, include diverse populations, and clarify theoretical distinctions among arousal, valence, anxiety, and stress to better understand how emotional states shape spatial memory.

Background/Objectives: The ability to preserve cognitive health in aging populations increasingly relies on early detection and intervention in neurodegenerative processes. Spatial memory, a fundamental cognitive ability supporting navigation, environmental awareness, and daily independence, often deteriorates in the preclinical stages of neurodegenerative diseases. However, conventional assessment tools frequently lack ecological validity and fail to capture the multifaceted nature of spatial cognition in real-world contexts. This systematic review aims to examine the application of immersive technologies, specifically Immersive Virtual Reality (VR) and Mixed Reality (MR), in the evaluation and rehabilitation of spatial memory. Methods: Following PRISMA guidelines, a total of 42 peer-reviewed studies were selected from SCOPUS, Web of Science, and PubMed databases. We included original, peer-reviewed studies that assessed spatial memory or cognition using VR/MR in adults aged ≥50 or clinical populations at neurodegenerative risk and reported quantitative data or diagnostic validity. A narrative synthesis was performed to examine the most employed immersive tools, assessing their benefits, limitations, and practical challenges. Results: Findings indicate substantial variability in diagnostic sensitivity, ecological validity, and user engagement across platforms. Nevertheless, the evidence supports the potential of immersive environments as effective tools for the early detection of spatial disorientation and cognitive decline, particularly in at-risk populations such as individuals with Mild Cognitive Impairment and Alzheimer’s Disease. Conclusions: Immersive and semi-immersive VR technologies represent a promising advancement in spatial memory assessment and rehabilitation, offering scalable solutions for both clinical and home-based interventions in aging populations.

Spatial memory is defined as the cognitive ability that enables individuals to encode, store, and retrieve information related to the location of objects in the environment. This function may be compromised by aging or neurodegenerative disorders. Consequently, the development of interventions aimed at its stimulation and rehabilitation is imperative. This study aimed to review empirical work on the neuropsychological rehabilitation of human spatial memory. A systematic search was conducted in PubMed, Scopus, and Web of Science. Studies were included if they involved spatial memory rehabilitation or training programs assessing pre- and post-intervention outcomes. Eight studies met the inclusion criteria and were evaluated in terms of sample characteristics, intervention design, and spatial memory measures. Across studies, post-intervention improvements were observed in tasks assessing visuospatial recall, route learning, and navigation efficiency, measured using instruments such as the Corsi Block-Tapping Test, Rey-Osterrieth Complex Figure, and virtual navigation tasks. Moderate to large effect sizes (Cohen's d = 0.5-0.9) were reported for allocentric and active navigation training, particularly in immersive virtual reality and multimodal interventions. Improvements in visuospatial working memory, route learning, and allocentric navigation were broader in healthy older adults and more specific and compensatory in individuals with mild cognitive impairment. The observed benefits were influenced by variables such as immersion level, type of spatial cues, and baseline cognitive performance. Neuropsychological interventions represent effective strategies for enhancing and maintaining spatial memory. These findings emphasize the need to adapt intervention protocols to individual characteristics and task demands to optimize rehabilitation outcomes.