Short Report The use of immersive virtual reality for cancer-related cognitive impairment assessment and rehabilitation: A clinical feasibility study Yingchun Zeng a , Linghui Zeng a , Andy S.K. Cheng b, * , Xijun Wei c , Boran Wang d , Jingchi Jiang e , Jin Zhou f, * a School of Medicine, Zhejiang University City College, Hangzhou, China b Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China c Department of Rehabilitation Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen, China d Department of Computer Sciences, Harbin Institute of Technology, Shenzhen, China e Department of Computer Sciences, Harbin Institute of Technology, Harbin, China f Department of Nursing, Integrated Hospital of Traditional Chinse Medicine, Southern Medical University, Guangzhou, China ARTICLE INFO Keywords: Immersive VR Cognitive assessment Rehabilitation intervention Chinese cancer patients ABSTRACT Objective: This brief study aimed to examine the potential effects of virtual reality (VR)-assisted cognitive reha- bilitation intervention on the health outcomes of patients with cancer. Methods: A single group of pre-test and post-test study designs were used. An innovative VR system was developed to assess cancer-related cognitive impairment and provide cognitive rehabilitation. The potential effects of the system were determined by measuring changes in cognitive function (learning and memory, information pro- cessing speed, executive function, and verbal fluency) and the severity of depression, anxiety, and insomnia. Results: Nine subjects completed the entire VR intervention and were included in the analysis. The participants’ mean age was 43.3 years (standard deviation, 8.9 years). The VR-based cognitive intervention significantly improved the subjective cognitive measures of perceived cognitive impairment and perceived cognitive ability (P ¼ 0.01 and P < 0.01, respectively). The intervention also improved the objective cognitive measures of verbal learning memory as measured using the Auditory Verbal Learning Test (eg., P < 0.01 for 5-min delay recall), information processing speed as measured using the trail-making test-A (P ¼ 0.02) and executive function as measured using the trail-making test-B (P ¼ 0.03). Only the subtest of delayed recall showed no statistically significant difference after the intervention (P ¼ 0.69). The VR-based psychological intervention significantly reduced the severity of sleep disorders (P < 0.01). Conclusions: The use of immersive VR was shown to have potential effects on improving cognitive function for patients with cancer. Future studies will require a larger sample size to examine the effects of immersive VR- assisted cognitive rehabilitation on the health outcomes of patients with cancer. Introduction In recent decades, cancer-related cognitive impairment (CRCI) has been frequently reported in patients with brain tumors and non-central nervous system cancers. 1–3 The prevalence of CRCI ranges from 21% to 75%. 1 Moreover, CRCI negatively affects cancer survivors’ working ability, social and occupational functioning, and daily life, and eventually decreases their quality of life. 1,3–5 Commonly impaired domains of cognition in patients with cancer include attention/concentration, verbal memory, and executive function, resulting in difficulties in engaging in multitasking, low information processing speed, and language problems. 1,6,7 With recent and ongoing advances in technology, the early detection of cognitive decline and the provision of effective interventions are likely to be feasible with the assistance of artificial intelligence (AI). 8 Of the available AI technologies, virtual reality (VR) is an optimal option for use in cognitive assessment and rehabilitation as it enables the assessment of human behaviors under more ‘natural’ conditions. VR ensures an accu- rate recording of real-time data and the number of errors made, without having to rely on a researcher's subjective assessments and note-taking. * Corresponding author. E-mail addresses: andy.cheng@polyu.edu.hk (A.S.K. Cheng), 596830447@qq.com (J. Zhou). Contents lists available at ScienceDirect Asia-Pacific Journal of Oncology Nursing journal homepage: www.apjon.org https://doi.org/10.1016/j.apjon.2022.100079 Received 12 February 2022; Accepted 1 May 2022 2347-5625/© 2022 The Authors. Published by Elsevier Inc. on behalf of Asian Oncology Nursing Society. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/). Asia-Pacific Journal of Oncology Nursing 9 (2022) 100079