Comparison of Vestibulo-Ocular Reflex and Cognitive Functions in E-Athletes and Non-Athletes

Esports requires rapid visuomotor coordination, attentional control, and working memory. While traditional sports have been extensively studied in relation to cognitive and vestibular performance, limited evidence exists regarding esports. Some studies suggest that video gaming may improve executive function, visuospatial memory, and processing speed, whereas others have reported impairments in response inhibition. In addition, the potential effects of esports on vestibulo-ocular reflex (VOR) function, which is essential for gaze stability during head movements, remain largely unexplored.

This cross-sectional study is designed to compare cognitive and vestibular performance between esports athletes and non-athlete controls. Participants include young adults with and without at least four years of competitive gaming experience. Cognitive abilities are assessed with the Stroop Test, which measures selective attention, inhibition, and processing speed, and the Corsi Block-Tapping Test, which evaluates visuospatial short-term and working memory. Vestibular performance is assessed with the Functional Head Impulse Test (F-HIT), which measures dynamic visual accuracy during passive head impulses in horizontal and vertical planes.

The primary outcome is Stroop Test Part V completion time under interference conditions. Secondary outcomes include Stroop errors and corrections, forward and backward Corsi spans, and F-HIT percent correct answers. By integrating cognitive and vestibular assessments, this study aims to provide preliminary evidence on whether intensive esports participation is associated with cognitive advantages, vestibular adaptations, or both. The findings may contribute to a better understanding of the health and performance characteristics of esports athletes and guide the development of evidence-based training strategies.

Inclusion criteria

• Age between 17 and 27 years
• Normal or corrected-to-normal vision
• Montreal Cognitive Assessment (MoCA) score within normal limits
• No neurological or psychiatric disorder
• No neck movement restriction
• Ability to adapt to cognitive and vestibular tests
• For e-athlete group: ≥4 years of esports experience and ≥20 hours per week of training
• For control group: No prior competitive esports or organized sports training

Exclusion criteria

• Hearing loss or tinnitus affecting functional performance
• History of dizziness within the last 3 months
• Active or diagnosed migraine with vestibular involvement
• Benign paroxysmal positional vertigo (BPPV)
• History of head trauma
• Systemic or neurological diseases affecting cognitive or vestibular function
• Visual impairments not corrected with glasses or lenses