Navigation ability in patients with acquired brain injury: A population-wide online study

Abstract

The ability to travel independently is a vital part of an autonomous life. It is important to investigate to what degree people with acquired brain injuries (ABI) suffer from navigation impairments. The aim of this study was to investigate the prevalence and characteristics of objective and subjective navigation impairments in the population of ABI patients. A large-scale online navigation study was conducted with 435 ABI patients and 7474 healthy controls. Participants studied a route through a virtual environment and completed 5 navigation tasks that assessed distinct functional components of navigation ability. Subjective navigation abilities were assessed using the Wayfinding questionnaire. Patients were matched to controls using propensity score matching. Overall, performance on objective navigation tasks was significantly lower in the ABI population compared to the healthy controls. The landmark recognition, route continuation and allocentric location knowledge tasks were most vulnerable to brain injury. The prevalence of subjective navigation impairments was higher in the ABI population compared to the healthy controls. In conclusion, a substantial proportion (39.1%) of the ABI population reports navigation impairments. We advocate the evaluation of objective and subjective navigation ability in neuropsychological assessments of ABI patients.

Wayfinding and path integration deficits detected using a virtual reality mobile app in patients with traumatic brain injury

“…Beyond this initial encoding difficulty, it is possible TBI cases may have difficulty with a range of 'on-the-fly' processing required to actively navigate, such as mentally tracking travel compared to a plan, spotting the correct goal locations, avoiding recently encountered dead-ends etc. Our findings also agree with the results of van der Kuil and colleagues who found that individuals with ABI show impairments in landmark recognition and allocentric location knowledge and route-based path knowledge [26]. Taken together, there seems to be a consistent pattern of deficits in wayfinding / route finding in TBI patients for both active "game play" navigation (in this current study) and passive "video watching" navigation [26].…”

“…Our findings also agree with the results of van der Kuil and colleagues who found that individuals with ABI show impairments in landmark recognition and allocentric location knowledge and route-based path knowledge [26]. Taken together, there seems to be a consistent pattern of deficits in wayfinding / route finding in TBI patients for both active "game play" navigation (in this current study) and passive "video watching" navigation [26].…”

“…As the Santa Barbara Sense of Direction (SBSOD) scale was developed as a reliable and valid measure of self-reported spatial navigation ability [34], we aimed to determine whether there were differences in mean SBSOD scores between participants with a history of TBI and control participants. Despite previous evidence demonstrating that individuals with a history of TBI scored significantly worse on self-report navigation and orientation, and distance estimation measures [26], no significant difference between TBI patients and a control group on the SBSOD was identified. Rather, results indicated that both participant groups demonstrated 'good' self-inferred spatial navigational ability on the SBSOD scale.…”

“…This raises questions over the intuitive impact of brain injury severity, but also the impact of clinical symptoms which may directly impact upon performance by moderating VR engagement. A recent study found that forced choice decisions regarding landmark location and route direction were impaired in patients with acquired brain injury [26]. The study used a desktop virtual reality paradigm where patients viewed a series of first-person perspective wayfinding videos.…”