The USC Stevens Neuroimaging and Informatics Institute in the Laboratory of Neuro Imaging (http://loni.usc.edu) has the largest collection/repository of neuroanatomical MRI scans in the world and is at the forefront of both brain imaging and data storage/processing technology. One of our workflow processes involves algorithmic segmentation of MRI scans into labeled anatomical regions (using FreeSurfer, currently the best software for this purpose). This algorithm is imprecise, and users must tediously correct errors manually by using a mouse and keyboard to edit individual MRI slices at a time. We demonstrate preliminary work to improve efficiency of this task by translating it into 3 dimensions and utilizing virtual reality user interfaces to edit multiple slices of data simultaneously.

The Stress Resilience In Virtual Environments (STRIVE) project aims to create a set of combat simulations (adapted from existing Virtual Iraq/Afghanistan exposure therapy system) that are part of a multi-episode narrative experience. Users can be immersed within challenging combat contexts and interact with virtual characters within these episodes as part of an experiential learning approach. Such approaches, often referred to as Stress Inoculation Training, have been found to reduce the neuroendocrine response, increase coping competence and reduce cortisol response. STRIVE is currently developing three combat modules with a narrative arc that includes increasingly intense combat situations, relational development, stress and loss, and emotional trauma. The goal is to raise the service member's threshold for the stress of combat.

Posttraumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 5 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been previously used with reports of positive outcomes. The current paper is a follow-up to a paper presented at IEEE VR2006 and will present the rationale and description of a VR PTSD therapy application (Virtual Iraq) and present the findings from its use with active duty service members since the VR2006 presentation. Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Results from an open clinical trial using Virtual Iraq at the Naval Medical Center-San Diego with 20 treatment completers indicate that 16 no longer met PTSD diagnostic criteria at post-treatment, with only one not maintaining treatment gains at 3 month follow-up.