Multidimensional Assessment of Social Cognition in Severe Traumatic Brain Injury: A Pilot Study Using a Non-Immersive Virtual Reality Serious Game

Introduction Social cognition is frequently impaired in traumatic brain injury (TBI). The lack of naturalistic and integrated assessments of social cognition has been highlighted. We investigated REALSoCog’s feasibility, a new non-immersive virtual reality serious game, in severe TBI. Additionally, we explored the impact of post-traumatic stress disorder (PTSD). Methods Ten severe TBI patients completed the REALSoCog task and the PTSD Checklist for DSM-5. They were compared with 27 matched healthy controls. Results Reduced emotional empathy and difficulties in affective theory of mind were found in patients. PTSD was suspected in 60% of our sample. Individual analyses suggested that deficits in social-cognitive scores were more frequent in patients with PTSD. Conclusions This study underscored the relevance of REALSoCog for social cognition assessment. It also suggests the possibility to objectively identify social-behavioral disturbances in patients with severe TBI. Finally, the impact of individual factors (PTSD) on such difficulties should be further explored.