The diagnostic accuracy and clinical feasibility of an immersive VR assessment for spatial attention after left- and...

Assessing post-stroke spatial neglect in immersive Virtual Reality (iVR) may improve diagnostic accuracy due to its ability to combine experimental control with increased ecological validity. This study investigated the diagnostic accuracy of an iVR spatial attention task relative to conventional and non-iVR digital tests. Stroke patients performed an iVR spatial attention task, conventional paper-pencil tests (3 cancellation tests and a line bisection test), and non-iVR digital tests (a digital cancellation test and a Posner test). A Bayesian statistical method was used to address diagnostic uncertainty. Additionally, feasibility was evaluated using recruitment and drop-out rates, sample characteristics, cybersickness and user experience. 54 stroke patients and 56 healthy controls completed the study. Both iVR and non-iVR digital tests had higher diagnostic accuracies than paper-pencil tests, although differences were not statistically significant due to high diagnostic uncertainty (resulting from inconsistencies across tests). For 6 patients, the iVR spatial attention task and Posner test indicated neglect, while paper-pencil tests did not. The iVR spatial attention task was feasible for most patients, with low cybersickness and positive evaluations. The iVR spatial attention task and Posner test identified spatial biases missed by conventional tests. Inconsistencies across tests highlight the complexity of neglect assessment, suggesting that future studies should explore crucial test characteristics needed for a precise and sensitive evaluation. Furthermore, results established adequate feasibility of iVR neglect assessment.