The impact of virtual reality on cerebral hemodynamics
Date
2025
Authors
Farstad, Spencer
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Abstract
The regulation of cerebral blood flow (CBF) is essential to match the brain’s high metabolic demand, a process governed by neurovascular coupling (NVC). Dual tasking (DT), the combination of exercise with region-specific neural activation, has been shown to augment CBF responses, yet traditional experimental approaches lack ecological validity. Virtual reality (VR) offers a dynamic, immersive medium that may stimulate CBF through visual, cognitive, and motor engagement, but no prior study has directly measured CBF during VR using gold-standard techniques.
This study developed and validated a custom 3D-printed transcranial Doppler (TCD) ultrasound headpiece integrated with a Meta Quest Pro headset to quantify middle (MCAv) and posterior cerebral artery velocities (PCAv) during VR at rest and during submaximal exercise. Twenty-nine healthy adults (26 ± 5.9 y) completed standardized NVC protocols in passthrough (PT) and VR conditions, immersive VR tasks, and gameplay using the rhythm-based VR game Beat Saber. Cerebrovascular responses were assessed with TCD and complemented by extracranial vascular duplex ultrasound.
Results demonstrated: (1) the 3D-printed headset reliably enabled bilateral insonation during dynamic VR tasks; (2) VR elicited NVC responses at rest and during exercise that were comparable to traditional PT protocols; (3) combining VR with exercise produced a DT effect, with additive increases in MCAv and PCAv, most notably in posterior circulation; and (4) immersive VR gameplay provoked robust, task-dependent increases in cerebral blood velocity, with cardiorespiratory demand rising in parallel with game difficulty and engagement.
These findings establish immersive VR as a physiologically valid tool for assessing and provoking cerebrovascular responses, supporting its use in both research and potential clinical applications. VR-based protocols may enhance ecological validity, provide engaging rehabilitation platforms, and stimulate cerebrovascular adaptations relevant to brain health. Future work should explore longitudinal effects, sex differences, and clinical populations to determine whether acute VR-induced hyperemia translates into functional or neuroplastic benefits.
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Keywords
Brain Blood Flow, Virtual Reality, Neurovascular Coupling, Dual Tasking