An immersive virtual reality tool for assessing left and right unilateral spatial neglect

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Human-Computer Interaction

Background:

• Unilateral spatial neglect (USN) diagnosis is challenging due to variable occurrence rates and limitations of classical assessment tools.
• Existing virtual reality (VR) assessments for USN often focus on near space and lack robust clinical validation.
• There is a need for sensitive and valid tools to assess USN, particularly in extra-personal space.

Purpose of the Study:

• To evaluate the clinical validity and sensitivity of a novel immersive VR task for assessing USN in extra-personal space.
• To investigate the neuronal correlates of far space exploration deficits using VR.
• To compare the diagnostic performance of the VR task against traditional paper-and-pencil assessments.

Main Methods:

• An immersive VR-based task was developed to assess USN in extra-personal space.
• The task was administered to patients with right (N=28) or left (N=11) hemispheric brain lesions and healthy controls.
• Voxel lesion-symptom mapping was used to identify brain regions associated with USN deficits detected by the VR task.

Main Results:

• The VR task identified 44% of neglect cases, compared to 31% with paper-and-pencil tests.
• 30% of patients without clear USN on standard tests showed deficits in the VR task.
• VR-detected deficits correlated with lesions in the insular and temporal cortex, key areas for spatial processing.

Conclusions:

• The immersive VR task demonstrates high efficiency and sensitivity in detecting USN in extra-personal space, including mild cases.
• The VR tool can identify USN manifestations missed by conventional methods.
• The study highlights the utility of VR for assessing spatial neglect and understanding its neural basis.