Computer-based assessment of unilateral spatial neglect: A systematic review

Abstract

BackgroundTo date, no gold standard exists for the assessment of unilateral spatial neglect (USN), a common post-stroke cognitive impairment, with limited sensitivity provided by currently used clinical assessments. Extensive research has shown that computer-based (CB) assessment can be more sensitive, but these have not been adopted by stroke services yet.ObjectiveWe conducted a systematic review providing an overview of existing CB tests for USN to identify knowledge gaps and positive/negative aspects of different methods. This review also investigated the benefits and barriers of introducing CB assessment tasks to clinical settings and explored practical implications for optimizing future designs.MethodologyWe included studies that investigated the efficacy of CB neglect assessment tasks compared to conventional methods in detecting USN for adults with brain damage. Study identification was conducted through electronic database searches (e.g., Scopus), using keywords and standardized terms combinations, without date limitation (last search: 08/06/2022). Literature review and study selection were based on prespecified inclusion criteria. The quality of studies was assessed with the quality assessment of diagnostic accuracy studies tool (Quadas-2). Data synthesis included a narrative synthesis, a table summarizing the evidence, and vote counting analysis based on a direction of effect plot.ResultsA total of 28 studies met the eligibility criteria and were included in the review. According to our results, 13/28 studies explored CB versions of conventional tasks, 11/28 involved visual search tasks, and 5/28 other types of tasks. The vote counting analysis revealed that 17/28 studies found CB tasks had either equal or higher sensitivity than conventional methods and positive correlation with conventional methods (15/28 studies). Finally, 20/28 studies showed CB tasks effectively detected patients with USN within different patient groups and control groups (17/28).ConclusionsThe findings of this review provide practical implications for the implementation of CB assessment in the future, offering important information to enhance a variety of methodological issues. The study adds to our understanding of using CB tasks for USN assessment, exploring their efficacy and benefits compared to conventional methods, and considers their adoption in clinical environments.

Advancements in brain-computer interfaces for the rehabilitation of unilateral spatial neglect: a concise review

“…However, no consensus exist on their efficiency to diagnose USN given the challenges in detecting and identifying underlying types of motor and visual neglect ( Williams et al, 2021 ). Numerous developments have explored the use of computerized assessment tasks (notably involving virtual reality) ( Ogourtsova et al, 2018 ) to address the limitations of existing methods ( Giannakou et al, 2022 ), such as their lack of ecological validity and inability to detect compensatory strategies ( Azouvi, 2017 ; Williams et al, 2021 ). In particular, standard pen-and-paper tests batteries have been translated to VR with comparable or improved performance, and new USN management platforms have emerged ( Fordell et al, 2016 ; Knobel et al, 2020 ).…”

“…While recent enthusiasm surrounds computer-based USN therapy with promising results ( Cavedoni et al, 2022 ; Giannakou et al, 2022 ), further research into BCI technology potential in this field is still needed. Recent reviews ( Durfee and Hillis, 2023 ; Singh and Leff, 2023 ) examining modern technologies and current methods for USN management mention the increasing interest in neurotechnologies, such as augmented and virtual reality, but do not delve into BCI-based interventions.…”

Impact of Virtual Reality Cognitive and Motor Exercises on Brain Health

“…Many researchers point to the need to test and validate innovative virtual reality environments and tasks for use in basic and clinical neuroscience [75,95], and thus to formulate recommendations for the design and implementation of VR in clinical screening, diagnosis and therapeutic rehabilitation [96][97][98][99][100]. It should be noted that virtual reality-based assessment can be a good alternative to classical or computer-based neuropsychological assessment due to its greater ecological validity [67,76,101,102]. The basis of physiotherapy is systematic physical exercises adapted to both the severity of the disease and the patient's effort tolerance.…”

Virtual reality tasks with eye tracking for mild spatial neglect assessment: a pilot study with acute stroke patients

“…The use of computer-based methods has been suggested to enhance diagnostic accuracy ( Bonato, 2012 ; Bonato et al, 2012 ) because they can improve sensitivity and psychometric properties of USN assessment ( Giannakou et al, 2022 ). Computer-based assessment with large field of view and especially with a dual task have been reported to uncover contralesional visual attention deficits more precisely than traditional USN tests ( Villarreal et al, 2020 ).…”