Assessment of post-stroke extrapersonal neglect using a three-dimensional immersive virtual street crossing program

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Virtual Reality Technology

Background:

• Extrapersonal neglect is a common and challenging deficit following stroke, impacting patients' spatial awareness and safety.
• Traditional assessment tools for neglect may not fully capture real-world functional limitations in extrapersonal space.
• Virtual reality (VR) offers immersive and controlled environments for simulating complex scenarios.

Purpose of the Study:

• To evaluate a novel three-dimensional immersive virtual reality (VR) program as an assessment tool for extrapersonal neglect in stroke survivors.
• To compare the performance of patients with and without neglect in a simulated street-crossing task within VR.

Main Methods:

• Thirty-two right-hemispheric stroke patients (16 neglect, 16 non-neglect) participated.
• Participants completed virtual street-crossing missions in a VR program, with metrics including deviation angle, reaction time, and failure rates recorded.
• Standardized line bisection and letter cancellation tests were also administered for comparison.

Main Results:

• The VR program demonstrated significant differences between neglect and non-neglect groups in deviation angle, reaction time ratios, cue rates, and failure rates (P < 0.05).
• Patients with neglect exhibited significantly higher left-sided parameters compared to right-sided parameters in the VR task (P < 0.05).
• The line bisection test showed a significant correlation with the VR deviation angle in the neglect group (P < 0.05).

Conclusions:

• The developed three-dimensional immersive VR street crossing program is a promising tool for easily and safely detecting and measuring post-stroke extrapersonal neglect.
• VR assessment may provide a more ecologically valid measure of spatial neglect compared to traditional paper-and-pencil tests.