Feasibility of Eye Tracking Assisted Vestibular Rehabilitation Strategy Using Immersive Virtual Reality

Abstract

ObjectivesEven though vestibular rehabilitation therapy (VRT) using head-mounted display (HMD) has been highlighted recently as a popular virtual reality platform, we should consider that HMD itself do not provide interactive environment for VRT. This study aimed to test the feasibility of interactive components using eye tracking assisted strategy through neurophysiologic evidence.MethodsHMD implemented with an infrared-based eye tracker was used to generate a virtual environment for VRT. Eighteen healthy subjects participated in our experiment, wherein they performed a saccadic eye exercise (SEE) under two conditions of feedback-on (F-on, visualization of eye position) and feedback-off (F-off, non-visualization of eye position). Eye position was continuously monitored in real time on those two conditions, but this information was not provided to the participants. Electroencephalogram recordings were used to estimate neural dynamics and attention during SEE, in which only valid trials (correct responses) were included in electroencephalogram analysis.ResultsSEE accuracy was higher in the F-on than F-off condition (P=0.039). The power spectral density of beta band was higher in the F-on condition on the frontal (P=0.047), central (P=0.042), and occipital areas (P=0.045). Beta–event-related desynchronization was significantly more pronounced in the F-on (–0.19 on frontal and –0.22 on central clusters) than in the F-off condition (0.23 on frontal and 0.05 on central) on preparatory phase (P=0.005 for frontal and P=0.024 for central). In addition, more abundant functional connectivity was revealed under the F-on condition.ConclusionConsidering substantial gain may come from goal directed attention and activation of brain-network while performing VRT, our preclinical study from SEE suggests that eye tracking algorithms may work efficiently in vestibular rehabilitation using HMD.

Virtual Reality Vestibular Rehabilitation in 20 Patients with Vertigo Due to Peripheral Vestibular Dysfunction

“…A study by Micarelli et al assessing vestibular rehabilitation using VR goggles in home-based patients found that this method is safe and increases the patient’s quality of life [ 40 ]. Using goggles, together with tracking eyeball movement, was found by Park et al to improve vestibular rehabilitation [ 41 ]. There are also reports presenting a negative impact of VR on balance in healthy adults.…”

Revisión sobre la aplicación de la realidad virtual en la rehabilitación vestibular

“…Se necesitan más trabajos experimentales para valorar si los refinamientos de las gafas de realidad virtual mejorarán los resultados de la rehabilitación vestibular. Ya se han hecho pruebas en sujetos sanos con ejercicios de seguimiento ocular en los que al mismo tiempo se ofrece a la persona información de la dirección de su propia mirada [10].…”

Recent Advances in the Application of Artificial Intelligence in Otorhinolaryngology-Head and Neck Surgery

“…Performance [8][9][10]. As various methods of AI analysis have been developed and refined, the practical scope of AI in the otorhinolaryngological field has been broadened (e.g., virtual reality technology [11][12][13]). Therefore, it is essential for otorhinolaryngologists to understand the capabilities and limitations of AI.…”