Reaction time deficits in a 3D virtual reality test in patients with ME/CFS
Anja-Maria Ladek; Marianna Lucio; Christian Y Mardin; Bettina Hohberger
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Purpose
Chronic Fatigue Syndrome (ME/CFS) is a debilitating post-infectious disorder affecting approximately 140,000–310,000 individuals in Germany, characterized by symptoms such as post-exertional malaise (PEM) and cognitive impairments.
Considering the neurotropic effects of various pathogens, this study hypothesized that reaction time (RT) in three-dimensional (3D) visual tasks would be significantly prolonged in ME/CFS patients compared to controls.
Methods
A total of 112 participants (56 ME/CFS patients and 56 controls) were recruited at the Department of Ophthalmology, Universität of Erlangen-Nürnberg. RT was assessed using a Virtual-Reality-Ocular-Test-System, presenting 3D stimuli at three disparity levels (275, 550, 1100) across 9 viewing directions. Participants completed three gaming repetitions (G1, G2, G3).
Mixed-effects models were used to evaluate group differences, with age and gender included as covariates. Pairwise contrasts were calculated to assess changes across repetitions. The study has been approved by the local ethics committee and performed in accordance with the tenets of the Declaration of Helsinki.
Results
Least square means (LS-Means) for RT in ME/CFS patients were significantly prolonged compared to controls at all disparity levels: 2333 ms vs. 1561 ms (disparity 275), 1625 ms vs. 1208 ms (disparity 550), and 1264 ms vs. 959 ms (disparity 1100), all p < 0.001. Age was a significant covariate (p<0.001), while gender showed no effect.
Both groups demonstrated improvements in RT over repetitions; however, controls exhibited greater improvements. The difference in RT between groups became more pronounced by G3 (p = 0.00021). ME/CFS patients consistently lagged behind controls, particularly in later gaming repetitions, potentially reflecting the impact of PEM.
Conclusions
ME/CFS patients exhibit prolonged RTs in a virtual 3D environment compared to controls, with their performance deteriorating further over time. This highlights the potential utility of virtual 3D vision testing as a diagnostic and functional assessment tool for ME/CFS, particularly in understanding cognitive and physical impairments associated with PEM.
This abstract was presented at the 2025 ARVO Annual Meeting, held in Salt Lake City, Utah, May 4-8, 2025.
Link [Investigative Ophthalmology & Visual Science] (Abstract only)
Anja-Maria Ladek; Marianna Lucio; Christian Y Mardin; Bettina Hohberger
[Line breaks added]
Purpose
Chronic Fatigue Syndrome (ME/CFS) is a debilitating post-infectious disorder affecting approximately 140,000–310,000 individuals in Germany, characterized by symptoms such as post-exertional malaise (PEM) and cognitive impairments.
Considering the neurotropic effects of various pathogens, this study hypothesized that reaction time (RT) in three-dimensional (3D) visual tasks would be significantly prolonged in ME/CFS patients compared to controls.
Methods
A total of 112 participants (56 ME/CFS patients and 56 controls) were recruited at the Department of Ophthalmology, Universität of Erlangen-Nürnberg. RT was assessed using a Virtual-Reality-Ocular-Test-System, presenting 3D stimuli at three disparity levels (275, 550, 1100) across 9 viewing directions. Participants completed three gaming repetitions (G1, G2, G3).
Mixed-effects models were used to evaluate group differences, with age and gender included as covariates. Pairwise contrasts were calculated to assess changes across repetitions. The study has been approved by the local ethics committee and performed in accordance with the tenets of the Declaration of Helsinki.
Results
Least square means (LS-Means) for RT in ME/CFS patients were significantly prolonged compared to controls at all disparity levels: 2333 ms vs. 1561 ms (disparity 275), 1625 ms vs. 1208 ms (disparity 550), and 1264 ms vs. 959 ms (disparity 1100), all p < 0.001. Age was a significant covariate (p<0.001), while gender showed no effect.
Both groups demonstrated improvements in RT over repetitions; however, controls exhibited greater improvements. The difference in RT between groups became more pronounced by G3 (p = 0.00021). ME/CFS patients consistently lagged behind controls, particularly in later gaming repetitions, potentially reflecting the impact of PEM.
Conclusions
ME/CFS patients exhibit prolonged RTs in a virtual 3D environment compared to controls, with their performance deteriorating further over time. This highlights the potential utility of virtual 3D vision testing as a diagnostic and functional assessment tool for ME/CFS, particularly in understanding cognitive and physical impairments associated with PEM.
This abstract was presented at the 2025 ARVO Annual Meeting, held in Salt Lake City, Utah, May 4-8, 2025.
Link [Investigative Ophthalmology & Visual Science] (Abstract only)
