Assessment of visuospatial neglect in stroke patients using virtual reality: a pilot study

Abstract

One of the neuropsychological deficits that can result from a stroke is the neglect phenomenon. Neglect has traditionally been assessed with paper-and-pencil tasks, which are administered within the reaching space of a person. The purpose of this explorative study is to investigate whether it is possible to assess neglect in the extrapersonal space based on the performance of acute stroke patients, chronic stroke patients and healthy elderly in orientation and exploration tasks when immersed in a three-dimensional (3D)-virtual environment. Six able-bodied healthy elderly and 12 stroke patients (six subacute and six chronic) participated in this explorative cross-sectional study. Neglect was assessed by means of the 3D neglect test. Different parameters were measured at two challenge levels with increasing difficulty. In the easiest level significant differences between the groups were found for total time spent in the test, mean response time left field of vision, and mean response time in the left field of vision of the left virtual reality environment. Differences in search patterns showed that subacute stroke patients had a much more fuzzy search pattern in scanning the environment than healthy elderly and chronic stroke patients. With respect to the more difficult level results showed significant differences between healthy elderly and the total group of stroke patients. The results of this study suggest that a 3D neglect test by means of virtual reality has the potential to detect and measure unilateral neglect.

Validation of a low-cost virtual reality system for training street-crossing. A comparative study in healthy, neglected and non-neglected stroke individuals

“…These VR outcomes are consistent with the severity of the attentional impairments and support the results of previous studies (Kim et al, 2010;Kim et al, 2004;Peskine et al, 2011;Jannink, Aznar, Kort, van de Vis, Veltink, & van der Kooij, 2009). Previous research has also demonstrated that head rotations and other parameters can distinguish stroke subjects with USN from those without neglect.…”

Sensorimotor training in virtual reality: A review

“…Hemispatial neglect has profound effects on the patient's ability to interact with and respond to their environments [86]. VR simulations have been employed with some success in several studies for both the assessment and treatment of visuo-spatial and visuo-motor neglect [87]. With manual exploration tasks, VR applications can detect small variations in performance undetectable by standard paper and pencil tests [88].…”

Recent advances in the understanding of neglect and anosognosia following right hemisphere stroke

“…A recent study by Jannink et al [25] assessed acute stroke patients with orientation and exploration tasks when immersed in a three-dimensional, virtual environment. Individuals with neglect could be differentiated from healthy controls with regard to total time spent on the test, mean response time left field of vision, mean response time in the left field of vision/environment, and scanning search pattern.…”