Table 2 Inclusion and exclusion criteria for VR study

1. Diagnosed with PBT tumor (brain + spine disease permissible)

1. Lack of definitive tissue diagnosis (no past surgery or biopsy)

2. Enrolled on NOB NHS trial

2. Recent cranial surgery ≤ 2 weeks prior to VR intervention

3. Age ≥ 18 years old

3. Scalp wound healing issues that might interfere with VR headset use

4. Able to speak & understand English

4. Pre-existing diagnosis of epilepsy (prior to brain tumor diagnosis)

5. Able to understand & sign informed consent

5. Diagnosis of GAD, PTSD, claustrophobia, or panic disorder

6. Can reliably self-report symptoms (based on clinician assessment)

6. Hypersensitivity to motion or currently experiencing severe nausea

7. Upcoming clinic or telehealth appointment with MRI scan

7. Visual deficits, including hemianopsia, diplopia, and agnosia, that may interfere with VR experience

8. Reported distress ≥ 1 on past symptom questionnaires