The quantified athlete in virtual spaces: a theoretical model for integrating VR and biometric data to redefine peak performance training

Abstract

Artikel ini mengusulkan model teoretis inovatif untuk mengintegrasikan data biometrik atlet (seperti HRV, EEG, EMG) dengan data kinerja dari lingkungan Virtual Reality (VR) dalam sebuah sistem umpan balik tertutup (closed-loop). Evolusi pelatihan atlet telah beralih dari metode tradisional yang subjektif ke pendekatan berbasis data. Namun, sering kali terjadi kesenjangan antara analisis data fisiologis dan data teknis dari VR, yang menghambat pemahaman holistik tentang performa. Model ini dirancang untuk menutup celah tersebut dengan menghubungkan tiga komponen utama: Atlet (sumber data biometrik), Lingkungan Virtual (arena performa), dan Pusat Integrasi Data (The 'Brain'). Pusat ini menggunakan algoritma machine learning untuk menganalisis data secara real-time, mengidentifikasi korelasi misalnya, antara peningkatan detak jantung dan penurunan akurasi, serta memberikan umpan balik instan kepada atlet dan pelatih melalui dashboard atau isyarat dalam VR. Penerapannya dalam berbagai skenario, seperti sepak bola dan tenis, menunjukkan potensi peningkatan performa hingga 30%, percepatan pembelajaran keterampilan, dan pengelolaan kecemasan yang lebih baik. Meski menghadapi tantangan teknis dan etika, model ini membuka peluang bagi pelatihan yang sangat personalisasi, rehabilitasi yang dipercepat, dan pencegahan cedera, sehingga mendefinisikan ulang paradigma pelatihan atlet modern menuju optimasi yang benar-benar holistik.

References
  1. Abraham, D. M. & P., P. (2024). A methodological framework for descriptive phenomenological research. Western Journal of Nursing Research, 47(2), 125-134. https://doi.org/10.1177/01939459241308071
  2. Babu, M., Lautman, Z., Lin, X., Sobota, M. H. & Snyder, M. P. (2023). Wearable devices: Implications for precision medicine and the future of health care. Annual Review of Medicine, 75(1), 401-415. https://doi.org/10.1146/annurev-med-052422-020437
  3. Bello, Y. & Figetakis, E. (2023). Iot-based wearables: A comprehensive survey. arXiv. https://doi.org/10.48550/arxiv.2304.09861
  4. Bensch, L., Casini, A., Cowley, A., Dufresne, F., Guerra, E., Medeiros, P. d., Nilsson, T., Rometsch, F., Treuer, A. & Vock, A. (2024). Applied user research in virtual reality: Tools, methods, and challenges. arXiv. https://doi.org/10.48550/arxiv.2402.15695
  5. Borsboom, D., Maas, H. L. J. v. d., Dalege, J., Kievit, R. A. & Haig, B. D. (2021). Theory construction methodology: A practical framework for building theories in psychology. Perspectives on Psychological Science, 16(4), 756-766. https://doi.org/10.1177/1745691620969647
  6. Carvalho, C. R., Fernández, J. M., del-Ama, A. J., Barroso, F. O. & Moreno, J. C. (2023). Review of electromyography onset detection methods for real-time control of robotic exoskeletons. Journal of NeuroEngineering and Rehabilitation, 20(1). https://doi.org/10.1186/s12984-023-01268-8
  7. Carvalho, C. R., Fernández, J. M., del-Ama, A. J., Barroso, F. O. & Moreno, J. C. (2023). Review of electromyography onset detection methods for real-time control of robotic exoskeletons. Journal of NeuroEngineering and Rehabilitation, 20(1). https://doi.org/10.1186/s12984-023-01268-8
  8. Cooper, N., Millela, F., Cant, I., White, M. D. & Meyer, G. (2021). Transfer of training—virtual reality training with augmented multisensory cues improves user experience during training and task performance in the real world. Public Library of Science (PLoS), 16(3), e0248225. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0248225&type=printable
  9. Delves, R. I. M., Aughey, R. J., Ball, K. & Duthie, G. M. (2021). The quantification of acceleration events in elite team sport: A systematic review. Sports Medicine - Open, 7(1). https://doi.org/10.1186/s40798-021-00332-8
  10. Demir, G. T., Namlı, S., Çakır, E., Batu, B., Ateş, F., Yılmaz, E., Güvendi, B., Adaş, S. K. & Çağın, M. (2025). The role of mental toughness, sport imagery and anxiety in athletic performance: Structural equation modelling analysis. BMC Psychology, 13(1). https://doi.org/10.1186/s40359-025-03250-6
  11. Demir, G. T., Namlı, S., Çakır, E., Batu, B., Ateş, F., Yılmaz, E., Güvendi, B., Adaş, S. K. & Çağın, M. (2025). The role of mental toughness, sport imagery and anxiety in athletic performance: Structural equation modelling analysis. BMC Psychology, 13(1). https://doi.org/10.1186/s40359-025-03250-6
  12. Dongping, F., Yiyu, L. & Linhao, C. (2022). yuan‐shengdialectical holism and systems thinking: A systemism research tradition that integrated chinese and western holism. Systems Research and Behavioral Science, 39(6), 1047-1058. https://doi.org/10.1002/sres.2914
  13. Eather, N., Wade, L., Pankowiak, A. & Eime, R. (2023). The impact of sports participation on mental health and social outcomes in adults: A systematic review and the ‘mental health through sport’ conceptual model. Systematic Reviews, 12(1). https://doi.org/10.1186/s13643-023-02264-8
  14. El-Malahi, O., Mohajeri, D., Mincu, R., Bäuerle, A., Rothenaicher, K., Knuschke, R., Rammos, C., Rassaf, T. & Lortz, J. (2024). Beneficial impacts of physical activity on heart rate variability: A systematic review and meta-analysis. Public Library of Science (PLoS), 19(4), e0299793. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0299793&type=printable
  15. Elleri, D., Dunger, D. B. & Hovorka, R. (2011). Closed-loop insulin delivery for treatment of type 1 diabetes. BMC Medicine, 9(1). https://doi.org/10.1186/1741-7015-9-120
  16. Elsharkawy, A. I. A. M., Ataya, A. A. S., Yeo, D., An, E., Hwang, S. & Kim, S. (2024). Sync-vr: Synchronizing your senses to conquer motion sickness for enriching in-vehicle virtual reality. Proceedings of the CHI Conference on Human Factors in Computing Systems, 1-17. https://doi.org/10.1145/3613904.3642941
  17. Gadepally, V. & Kepner, J. (2020). Technical report: Developing a working data hub. arXiv. https://doi.org/10.48550/arxiv.2004.00190
  18. Gagneré, G. (2024). Directing avatars in live performances -- an autonomy simulacrum of virtual entities. arXiv. https://doi.org/10.48550/arxiv.2411.10452
  19. Gao, Y. & Zhu, X. (2023). Research on the learning experience of virtual simulation class experimental teaching and learning based on the perspective of nursing students. BMC Nursing, 22(1). https://doi.org/10.1186/s12912-023-01534-z
  20. Gazzarrini, E., Garcia, E., Gosein, D., Moya, A. V., Kounelis, A. & Espinal, X. (2023). The virtual research environment: Towards a comprehensive analysis platform. arXiv. https://doi.org/10.48550/arxiv.2305.10166
  21. Hemert, R. v., Kamp, J. v. d. & Hartman, E. (2024). The influence of situational constraints on in-game penalty kicks in soccer. International Journal of Performance Analysis in Sport, 1-13. https://doi.org/10.1080/24748668.2024.2430840
  22. Hernandez, D., Brown, T., Conerly, T., DasSarma, N., Drain, D., El-Showk, S., Elhage, N., Hatfield-Dodds, Z., Henighan, T., Hume, T., Johnston, S., Mann, B., Olah, C., Olsson, C., Amodei, D., Joseph, N., Kaplan, J. & McCandlish, S. (2022). Scaling laws and interpretability of learning from repeated data. arXiv. https://doi.org/10.48550/arxiv.2205.10487
  23. Hilpisch, C., Krüger, K., Raab, M., Wiese, L., Zentgraf, K. & Mutz, M. (2024). Burnout symptoms in elite athletes: Assessing the role of effort–reward imbalance, support and emotions. International Review for the Sociology of Sport, 59(7), 1054-1074. https://doi.org/10.1177/10126902241248767
  24. Jaber, M. J., Bindahmsh, A. A., Baker, O. G., Alaqlan, A., Almotairi, S. M., Elmohandis, Z. E., Qasem, M. N., AlTmaizy, H. M., Preez, S. E. d., Alrafidi, R. A., Alshodukhi, A. M., Nami, F. N. A. & Abuzir, B. M. (2025). Burnout combating strategies, triggers, implications, and self-coping mechanisms among nurses working in saudi arabia: A multicenter, mixed methods study. BMC Nursing, 24(1). https://doi.org/10.1186/s12912-025-03191-w
  25. Jain, M. & Markan, C. M. (2022). Calibration of off-the-shelf low-cost wearable eeg headset for application in field studies. arXiv. https://doi.org/10.48550/arxiv.2209.12633
  26. Jansen, P., Côté, M., Khot, T., Bransom, E., Mishra, B. D., Majumder, B. P., Tafjord, O. & Clark, P. (2024). Discoveryworld: A virtual environment for developing and evaluating automated scientific discovery agents. arXiv. https://doi.org/10.48550/arxiv.2406.06769
  27. Jonkman, A. H., Warnaar, R. S. P., Baccinelli, W., Carbon, N. M., D’Cruz, R. F., Doorduin, J., Doorn, J. L. M. v., Elshof, J., Estrada-Petrocelli, L., Graßhoff, J., Heunks, L. M. A., Koopman, A. A., Langer, D., Moore, C. M., Silveira, J. M. N., Petersen, E., Poddighe, D., Ramsay, M., Rodrigues, A., ... Oppersma, E. (2024). Analysis and applications of respiratory surface emg: Report of a round table meeting. Critical Care, 28(1). https://doi.org/10.1186/s13054-023-04779-x
  28. Kiani, S., Rezaei, I., Abasi, S., Zakerabasali, S. & Yazdani, A. (2023). Technical aspects of virtual augmented reality-based rehabilitation systems for musculoskeletal disorders of the lower limbs: A systematic review. BMC Musculoskeletal Disorders, 24(1). https://doi.org/10.1186/s12891-022-06062-6
  29. Kim, H., Song, S., Cho, B. H. & Jang, D. P. (2024). Deep learning-based stress detection for daily life use using single-channel eeg and gsr in a virtual reality interview paradigm. PLOS ONE, 19(7), e0305864. https://doi.org/10.1371/journal.pone.0305864
  30. Kittel, A., Lindsay, R., Noury, P. L. & Wilkins, L. (2024). The use of extended reality technologies in sport perceptual-cognitive skill research: A systematic scoping review. Sports Medicine - Open, 10(1). https://doi.org/10.1186/s40798-024-00794-6
  31. Krasmik, Y., Aimaganbetova, O., Iancheva, T., Zhantikeyev, S., Lashkova, E., Makhmutov, A. & Rakhmalin, B. (2024). Motivational determinants of athletes’ self-realisation depending on their professional qualification. BMC Psychology, 12(1). https://doi.org/10.1186/s40359-024-01895-3
  32. Lanes, O., Beji, M., Corcoles, A. D., Dalyac, C., Gambetta, J. M., Henriet, L., Javadi-Abhari, A., Kandala, A., Mezzacapo, A., Porter, C., Sheldon, S., Watrous, J., Zoufal, C., Dauphin, A. & Peropadre, B. (2025). A framework for quantum advantage. arXiv. https://doi.org/10.48550/arxiv.2506.20658
  33. LaValle, S. M., Center, E. G., Ojala, T., Pouke, M., Prencipe, N., Sakcak, B., Suomalainen, M., Timperi, K. G. & Weinstein, V. (2023). From virtual reality to the emerging discipline of perception engineering. Annual Review of Control, Robotics, and Autonomous Systems, 7(1), 409-436. https://doi.org/10.1146/annurev-control-062323-102456
  34. Li, Y., Zeng, W., Dong, W., Han, D., Chen, L., Chen, H., Kang, Z., Gong, S., Yan, H., Siok, W. T. & Wang, N. (2024). A tale of single-channel electroencephalogram: Devices, datasets, signal processing, applications, and future directions. arXiv. https://doi.org/10.48550/arxiv.2407.14850
  35. Lin, B., Guo, B., Zhuang, L., Zhang, D. & Wang, F. (2024). Neural oscillations predict flow experience. Cognitive Neurodynamics, 19(1). https://doi.org/10.1007/s11571-024-10205-x
  36. Lv, M., Liu, J., Wang, Y. & Zhang, D. (2019). From burnout to growth: How job burnout links to posttraumatic growth in healthcare workers.. https://doi.org/10.1186/s40798-019-0221-0.pdf
  37. Ma’mun, A., Anggorowati, R., Risma, R., Slamet, S. & Anira, A. (2022). An historical overview of the culture of sports in indonesia: Global issues and challenges for future indonesian sports development policies. Asian Journal of Sport History & Culture, 1(2), 161-182. https://doi.org/10.1080/27690148.2022.2119091
  38. Makridakis, S., Spiliotis, E., Hollyman, R., Petropoulos, F., Swanson, N. & Gaba, A. (2023). The m6 forecasting competition: Bridging the gap between forecasting and investment decisions. arXiv. https://doi.org/10.48550/arxiv.2310.13357
  39. Marmo, A. C. & Grunlan, M. A. (2023). Biomedical silicones: Leveraging additive strategies to propel modern utility. ACS Macro Letters, 12(2), 172-182. https://doi.org/10.1021/acsmacrolett.2c00701
  40. Martínez, G., Hernández, J. A., Reviriego, P. & Reinheimer, P. (2023). Round trip time (rtt) delay in the internet: Analysis and trends. arXiv. https://doi.org/10.48550/arxiv.2301.07788
  41. Minaee, S., Abdolrashidi, A., Su, H., Bennamoun, M. & Zhang, D. (2023). Biometrics recognition using deep learning: A survey. Artificial Intelligence Review, 56(8), 8647-8695. https://doi.org/10.1007/s10462-022-10237-x
  42. Nador, J. D., Uittenhove, K., Gordillo, D. & Ramon, M. (2021). Super-recognizers, or su-perceivers? insights from fast periodic visual stimulation (fpvs) eeg.. https://doi.org/10.3758/s13414-021-02382-2.pdf
  43. Nair, V., Garrido, G. M., Song, D. & O'Brien, J. F. (2022). Exploring the privacy risks of adversarial vr game design. arXiv. https://doi.org/10.48550/arxiv.2207.13176
  44. Napitupulu, L. Y., Suciati, N., Navastara, D. A., Napitupulu, L. Y., Suciati, N. & Navastara, D. A. (2017). Implementasi deteksi serangan epilepsi dari data rekaman eeg menggunakan weighted permutation entropy dan support vector machine.. http://ejurnal.its.ac.id/index.php/teknik/article/download/23796/4414
  45. Neto, P. C., Gonçalves, T., Pinto, J. R., Silva, W., Sequeira, A. F., Ross, A. & Cardoso, J. S. (2022). Causality-inspired taxonomy for explainable artificial intelligence. arXiv. https://doi.org/10.48550/arxiv.2208.09500
  46. Oja, P., Memon, A. R., Titze, S., Jurakic, D., Chen, S., Shrestha, N., Em, S., Matolic, T., Vasankari, T., Heinonen, A., Grgic, J., Koski, P., Kokko, S., Kelly, P., Foster, C., Podnar, H. & Pedisic, Z. (2024). Health benefits of different sports: A systematic review and meta-analysis of longitudinal and intervention studies including 2.6 million adult participants. Sports Medicine - Open, 10(1). https://doi.org/10.1186/s40798-024-00692-x
  47. Omam, S., Babini, M. H., Sim, S., Tee, R., Nathan, V., Gohery, S., Burvill, C., Kuca, K., Krejcar, O. & Namazi, H. (2021). Decoding of the coupling between brain and skin activities in olfactory stimulation by analysis of eeg and gsr signals. Waves in Random and Complex Media, 34(3), 1521-1535. https://doi.org/10.1080/17455030.2021.1942305
  48. Pallavicini, F., Orena, E., Santo, S. d., Greci, L., Caragnano, C., Ranieri, P., Vuolato, C., Pepe, A., Veronese, G., Stefanini, S., Achille, F., Dakanalis, A., Bernardelli, L., Sforza, F., Rossini, A., Caltagirone, C., Fascendini, S., Clerici, M., Riva, G. & Mantovani, F. (2022). A virtual reality home-based training for the management of stress and anxiety among healthcare workers during the covid-19 pandemic: Study protocol for a randomized controlled trial. Trials, 23(1). https://doi.org/10.1186/s13063-022-06337-2
  49. Park, J. J. H., Siden, E., Zoratti, M. J., Dron, L., Harari, O., Singer, J., Lester, R. T., Thorlund, K. & Mills, E. J. (2019). Systematic review of basket trials, umbrella trials, and platform trials: A landscape analysis of master protocols. Trials, 20(1). https://doi.org/10.1186/s13063-019-3664-1
  50. Poggi, I. & Ansani, A. (2018). The lexicon of the conductor's gaze. http://hdl.handle.net/11573/1201643
  51. Purvanova, R. K. & Kenda, R. (2021). The impact of virtuality on team effectiveness in organizational and non‐organizational teams: A meta‐analysis. Applied Psychology, 71(3), 1082-1131. https://doi.org/10.1111/apps.12348
  52. Rao, A. K., Bhavsar, A., Chowdhury, S. R., Chandra, S., Negi, R., Duraisamy, P. & Dutt, V. (2024). Evaluating the efficacy of haptic feedback, 360° treadmill-integrated virtual reality framework and longitudinal training on decision-making performance in a complex search-and-shoot simulation. arXiv. https://doi.org/10.48550/arxiv.2404.09147
  53. Riches, S., Iannelli, H., Reynolds, L., Fisher, H. L., Cross, S. & Attoe, C. (2022). Virtual reality-based training for mental health staff: A novel approach to increase empathy, compassion, and subjective understanding of service user experience. Advances in Simulation, 7(1). https://doi.org/10.1186/s41077-022-00217-0
  54. Roberts, M. D., McCarthy, J. J., Hornberger, T. A., Phillips, S. M., Mackey, A. L., Nader, G. A., Boppart, M. D., Kavazis, A. N., Reidy, P. T., Ogasawara, R., Libardi, C. A., Ugrinowitsch, C., Booth, F. W. & Esser, K. A. (2023). Mechanisms of mechanical overload-induced skeletal muscle hypertrophy: Current understanding and future directions. Physiological Reviews, 103(4), 2679-2757. https://doi.org/10.1152/physrev.00039.2022
  55. Ronkainen, H., Lundgren, T., Kenttä, G., Ihalainen, J. K., Valtonen, M. & Lappalainen, R. (2024). Psychological flexibility skills and mental wellbeing in athletes: An exploration of associations and gender differences. https://article.sciencepg.com/pdf/j.pbs.20241302.14
  56. Schoeffer, J., Jakubik, J., Voessing, M., Kuehl, N. & Satzger, G. (2023). Ai reliance and decision quality: Fundamentals, interdependence, and the effects of interventions. arXiv. https://doi.org/10.48550/arxiv.2304.08804
  57. Shaik, T., Tao, X., Higgins, N., Li, L., Gururajan, R., Zhou, X. & Acharya, U. R. (2023). Remote patient monitoring using artificial intelligence: Current state, applications, and challenges. WIREs Data Mining and Knowledge Discovery, 13(2). https://doi.org/10.1002/widm.1485
  58. Storey, V. C., Yue, W. T., Zhao, J. L. & Lukyanenko, R. (2025). Generative artificial intelligence: Evolving technology, growing societal impact, and opportunities for information systems research. Information Systems Frontiers. https://doi.org/10.1007/s10796-025-10581-7
  59. Swann, C., Crust, L., Jackman, P., Vella, S. A., Allen, M. S. & Keegan, R. (2017). Psychological states underlying excellent performance in sport: Toward an integrated model of flow and clutch states. Journal of Applied Sport Psychology, 29(4), 375-401. https://doi.org/10.1080/10413200.2016.1272650
  60. Symons, I. K., Bruce, L. & Main, L. C. (2023). Impact of overtraining on cognitive function in endurance athletes: A systematic review. Sports Medicine - Open, 9(1). https://doi.org/10.1186/s40798-023-00614-3
  61. Tjandra, B., Negara, M. S. N. & Handoko, N. S. C. (2023). Deteksi sampah di permukaan dan dalam perairan pada objek video dengan metode robust and efficient post-processing dan tubelet-level bounding box linking. arXiv. https://doi.org/10.48550/arxiv.2307.10039
  62. Tønnessen, E., Sandbakk, Ø., Sandbakk, S. B., Seiler, S. & Haugen, T. (2024). Training session models in endurance sports: A norwegian perspective on best practice recommendations. Sports Medicine, 54(11), 2935-2953. https://doi.org/10.1007/s40279-024-02067-4
  63. Topete, A., He, C., Protzko, J., Schooler, J. & Hegarty, M. (2024). How is gps used? understanding navigation system use and its relation to spatial ability. Cognitive Research: Principles and Implications, 9(1). https://doi.org/10.1186/s41235-024-00545-x
  64. Torre, S., Severino, A. U. & Ligorio, M. B. (2024). Learning outcomes and training satisfaction: A case study of blended customization in professional training. Technology, Knowledge and Learning, 30(3), 1663-1702. https://doi.org/10.1007/s10758-024-09778-7
  65. Tosi, D., Kokaj, R. & Roccetti, M. (2024). 15 years of big data: A systematic literature review. Journal of Big Data, 11(1). https://doi.org/10.1186/s40537-024-00914-9
  66. Veerasatian, T., Rattanapitoon, S. K., Thimahatthanakusol, P. & Rattanapitoon, N. K. (2024). Letter to the editor concerning "multi-class cervical spine fracture classification using deep ensemble model based on ct images" by k. goutham raju, et al. (eur spine j [2025]; doi: 10.1007/s00586-025-09415-6).. https://doi.org/10.1007/s10484-024-09644-3.pdf
  67. Virtanen, S., Aaltonen, M., Latvala, A., Forsman, M., Lichtenstein, P. & Chang, Z. (2024). Effectiveness of substance use disorder treatment as an alternative to imprisonment. BMC Psychiatry, 24(1). https://doi.org/10.1186/s12888-024-05734-y
  68. Walha, A., Ghozzi, F. & Gargouri, F. (2024). Data integration from traditional to big data: Main features and comparisons of etl approaches. The Journal of Supercomputing, 80(19), 26687-26725. https://doi.org/10.1007/s11227-024-06413-1
  69. Wang, Q., Chang, Y., Cai, R., Li, Z., Hariharan, B., Holynski, A. & Snavely, N. (2023). Tracking everything everywhere all at once. arXiv. https://doi.org/10.48550/arxiv.2306.05422
  70. Wang, M., Pinilla, G., Leung, C., Peddada, A., Yu, E., Akmal, S., Cha, Y., Dyson, L., Kumar, A. & Kaplin, A. (2021). Relapse risk factors for patients with comorbid affective disorders and substance abuse disorders from an intensive treatment unit. The American Journal on Addictions, 30(5), 461-467. https://doi.org/10.1111/ajad.13192
  71. Wei, W. & Ren, L. (2023). From unimodal to multimodal: Improving semg-based pattern recognition via deep generative models. arXiv. https://doi.org/10.48550/arxiv.2308.04091
  72. Yang, J., Ding, R., Brown, E., Qi, X. & Xie, S. (2024). V-irl: Grounding virtual intelligence in real life. Lecture Notes in Computer Science, 36-55. https://doi.org/10.1007/978-3-031-72995-9_3
  73. Yfantidou, S., Sermpezis, P. & Vakali, A. (2022). 14 years of self-tracking technology for mhealth -- literature review: Lessons learnt and the past self framework. arXiv. https://doi.org/10.48550/arxiv.2104.11483
  74. Yi, X., Zhou, Y., Habermann, M., Golyanik, V., Pan, S., Theobalt, C. & Xu, F. (2023). Egolocate: Real-time motion capture, localization, and mapping with sparse body-mounted sensors. arXiv. https://doi.org/10.48550/arxiv.2305.01599
  75. You, J., Choi, J., Shin, H. & Suh, B. (2023). The eyes have it!: Using human-selected features for predicting athletes' performance. arXiv. https://doi.org/10.48550/arxiv.2304.03148
  76. Zhang, H., Zhou, Q., Chen, H., Hu, X., Li, W., Bai, Y., Han, J., Wang, Y., Liang, Z., Chen, D., Cong, F., Yan, J. & Li, X. (2023). The applied principles of eeg analysis methods in neuroscience and clinical neurology. Military Medical Research, 10(1). https://doi.org/10.1186/s40779-023-00502-7.