Improvement of Navigation and Representation in Virtual Reality after Prism Adaptation in Neglect Patients

Abstract

Prism adaptation (PA) is responsible for an expansion of sensori-motor after-effects to cognitive domains for patients with spatial neglect. One important question is whether the cognitive after-effects induced by PA may also concern higher aspects of spatial cognition, such as navigation and topographic memory, which are critical in everyday life. The aim of this study was to assess whether multiple sessions of right PA can affect navigation and topographic memory. Seven right brain-damaged (RBD) patients with chronic neglect were included. We used a virtual supermarket named VAP-S which is an original paradigm, similar to the “shopping list test” during which patients had to purchase items from a list of eight products. Furthermore, in order to assess generalization of PA effects on constructing a spatial map from virtual information, each participant was then asked to draw the map of the virtual supermarket from memory. Regarding navigation performance, significant results were obtained: session duration reduction, fewer numbers of pauses and omissions, more items purchased on the left side and more items purchased over all. A long-lasting effect was noted, up to one month after PA. The representational task performance was also significantly increased for map drawing, with a reduction of the right shift of the symmetry axis of the map, more items drawn on the left side of maps and over all, and more items correctly located on the map. Some of these effects lasted for at least 7 days. These results suggest an expansion of PA benefit to a virtual environment. Crucially, the cognitive benefits induced by PA were noted for complex spatial cognition tasks required in everyday life such as navigation and topographic memory and this improvement was maintained for up to 1 month.

Virtual Reality in the Neurosciences: Current Practice and Future Directions

“…Virtual reality has been used extensively to aid in the rehabilitation of neurocognitive diseases, traumatic injuries, and cerebrovascular disorders due to its ability to recreate an immersive, interactive environment with real-time feedback. One unique area that VR is being applied is in the treatment of spatial neglect (110,111). Prior to VR, one way in which spatial neglect is being treated is using prism adaptation, a system in which a mismatch occurs between the perceived position of a target and its actual position by shifting the field of vision through prismatic googles (110,111).…”

“…One unique area that VR is being applied is in the treatment of spatial neglect (110,111). Prior to VR, one way in which spatial neglect is being treated is using prism adaptation, a system in which a mismatch occurs between the perceived position of a target and its actual position by shifting the field of vision through prismatic googles (110,111). VR can replicate this process and provide enhanced blinding due to its manipulatable immersive environment (110,111).…”

“…Prior to VR, one way in which spatial neglect is being treated is using prism adaptation, a system in which a mismatch occurs between the perceived position of a target and its actual position by shifting the field of vision through prismatic googles (110,111). VR can replicate this process and provide enhanced blinding due to its manipulatable immersive environment (110,111). VR's application in this area is of interest since the results of prism adaptation have been questionable at best (112).…”

Usability and Effectiveness of Immersive Virtual Grocery Shopping for Assessing Cognitive Fatigue in Healthy Controls: Protocol for a Randomized Controlled Trial

“…Traversing a shopping store requires visual attention (eg, looking for signs), spatial mapping, working memory, memory, and executive functioning [8,[73][74][75][76][77]. Virtual shopping environments have been used successfully among individuals with significant cognitive impairment [8,[78][79][80][81], and virtual shopping tasks correlate with real-life shopping activities [81,82].…”

Frontal lesions predict response to prism adaptation treatment in spatial neglect: A randomised controlled study

“…The BIT may also be less sensitive than the CBS to spatial-motor deficits associated with frontal lesions that are strongly linked to functional recovery. Nonetheless, other assessments that mimic real-life motor demands, such as virtual-reality based navigation, may also be effective and sensitive at detecting neglect (Buxbaum, Dawson, & Linsley, 2012), as well as at detecting spatial-motor improvements associated with concurrent exposure prism adaptation procedures in neglect treatment (Glize et al, 2017). Future studies establishing the external validity of virtual reality and other similar assessment procedures, in large, representative patient groups with spatial neglect, are needed.…”