## 2 Materials and Methods
### Materials
#### 2.4.3 Cybersickness in VR Questionnaire (CSQ-VR)  
The Cybersickness in VR Questionnaire (CSQ-VR) was used to assess the presence and severity of cybersickness symptoms in participants exposed to the VR environment. It evaluates nausea, vestibular issues, and oculomotor problems using a 7-point Likert scale. Participants responded to six questions, with two questions for each symptom category. Scores were summed to produce a total score, with a maximum possible score of 42 [8]. The psychometric properties of the CSQ-VR have shown good internal consistency, with reported [PERSON]'s alpha values ranging between 0.85 and 0.91, indicating high reliability. The CSQ-VR was validated against other cybersickness measurement tools and demonstrated strong construct validity, making it suitable for assessing cybersickness symptoms in Virtual Reality environments. 2.4.4. The Trail Making Test in Virtual Reality (TMT-VR)  
The Trail Making Test in Virtual Reality (TMT-VR) represents a significant advancement over the traditional paper-and-pencil version of the Trail Making Test. This VR adaptation was designed to harness the immersive capabilities of Virtual Reality, providing a more naturalistic and engaging environment for cognitive assessment. Participants were fully immersed in a 360-degree virtual environment, where numbered cubes were scattered within a field of view that extended across three dimensions, including the third axis (Z), offering a depth component that mirrors real-world spatial challenges (see Figure 1). One of the key enhancements of the TMT-VR is its naturalistic approach to target selection. Unlike the traditional TMT, which relies on a two-dimensional paper format, the TMT-VR allows for the selection of targets through intuitive, real-world interactions such as eye-tracking, head movement, and the use of a VR controller. This approach closely mimics how individuals naturally interact with their environment, providing a more accurate assessment of cognitive functions like visual scanning, spatial awareness, and motor control. The test administration in the TMT-VR is fully automated, including comprehensive tutorials that guide participants through the tasks. This automation ensures that all participants receive consistent instructions and guidance, eliminating the variability that can arise from human administrators. The scoring process is also automated and highly precise, removing the potential for human error in measuring performance. For example, the timing of task completion is automatically recorded, removing the need for manual start and stop actions typically required in traditional assessments, thereby providing a more accurate measure of cognitive processing speed. A further enhancement is the fully randomized placement of targets within the virtual environment. Every time a participant undertakes the TMT-VR, the cubes appear in new, randomized positions, requiring a different spatial pattern of selection with each administration. This randomization ensures that the test has perfect test-retest reliability, as participants cannot simply memorize the location of targets from previous attempts. This feature is particularly important for longitudinal studies or repeated assessments, where the integrity of the test results must be maintained over multiple sessions. Participants interacted with the virtual environment using ray-casting, where a virtual ray is projected from a specific point (e.g., the participant's eye, head, or controller) to select objects. The task required participants to alternate between numbered cubes in ascending order. Each cube had to be fixated upon for 1.5 s to confirm the selection, ensuring intentional and precise interactions. This two-phase process of aiming and confirming selection minimized errors due to inadvertent movements, which are common in traditional and virtual environments. Figure 1: The Tasks of the TMT-VR. Task A **(left)**, Task B **(right)**, Starting Position (**bottom**), and Selection of Targets **(top)**.