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Virtual Reality Tools for Assessing Unilateral Spatial Neglect: A Novel Opportunity for Data Collection

Virtual Reality Tools for Assessing Unilateral Spatial Neglect: A Novel Opportunity for Data Collection

Published on: March 10, 2021

Electrostimulation mapping of spatial neglect.

Franck-Emmanuel Roux¹, Olivier Dufor, Valérie Lauwers-Cances

¹INSERM 825 et Service de Neurochirurgie, Hôpital Purpan, F-31059 Toulouse, France. franck_emmanuel.roux@yahoo.fr

|November 10, 2011

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Electrostimulation mapping in brain surgery precisely identifies areas controlling spatial awareness. This technique helps surgeons minimize spatial neglect by pinpointing critical brain regions during tumor removal.

Area of Science:

Neurosurgery
Cognitive Neuroscience
Neurophysiology

Background:

Electrostimulation mapping is crucial in awake brain surgery for tumor removal to reduce neurological deficits.
Understanding the neuronal basis of spatial awareness is vital for effective surgical planning.

Purpose of the Study:

To investigate the neuronal substrates underlying spatial awareness in humans using electrostimulation.
To map brain regions involved in spatial attention and neglect.

Main Methods:

Studied spatial neglect using a line bisection task combined with right hemisphere electrostimulation mapping in 50 patients.
Quantified behavioral effects, including eye movements and line deviations, comparing them to preoperative data and controls.
Utilized Talairach coordinates to identify stimulation sites and fiber tracking to delineate critical subcortical pathways.

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Virtual Reality Tools for Assessing Unilateral Spatial Neglect: A Novel Opportunity for Data Collection

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Randomized, Triple-Blind, and Parallel-Controlled Trial of Transcranial Direct Current Stimulation for Cognitive Rehabilitation after Stroke

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Main Results:

Generated individualized spatial neglect maps, demonstrating both rightward and leftward deviations induced by stimulation of distinct sites.
Identified specific cortical areas in the right temporal, parietal, and frontal lobes responsible for inducing line deviations (P < .05).
Fiber tracking revealed essential subcortical fascicles (fronto-occipital, superior longitudinal II) that should be preserved.

Conclusions:

Discrete, individually variable cortical areas, primarily around the right posterior Sylvian fissure, govern visuospatial attention direction.
Line bisection mapping is a reliable intraoperative tool for minimizing postsurgical spatial neglect, showing high specificity (94%) and sensitivity (83%).