Immersive virtual reality gameplay detects visuospatial atypicality, including unilateral spatial neglect, following brain injury: a pilot study.
David R Painter, Michael F Norwood, Chelsea H Marsh and 6 others
PMID 37996834WHAT IT FOUND
Immersive VR gameplay was feasible for acute inpatient brain injury, with minimal motion sickness and acceptable usability.
It detected visuospatial atypicality in 61.5% of patients versus 22.2% of controls, identifying attention problems missed by standard pen-and-paper neglect tests.
Key findings
01VR gameplay was feasible for acute inpatients, with no significant difference in motion sickness between patients and controls and overall acceptable system usability.
02Visuospatial atypicality was significantly more prevalent in patients (61.5%) than in controls (22.2%), and patients showed greater variance in attentional patterns.
03VR analysis detected all three patients with left-side neglect on pen-and-paper tests and identified three additional patients with atypical attention patterns that standard tests missed or under-described.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This was a pilot study with a very small, heterogeneous sample (13 patients, 9 controls), so the results are preliminary. The controls were a convenience sample of hospital clinicians, not matched for age or other factors, which biases the outlier cut-offs. The authors explicitly state that the 'atypicality' label cannot be used for clinical decision-making at this stage. Patients with history of epilepsy, visual field problems, or high motion sickness susceptibility were excluded, so feasibility in these common subgroups is unknown. The analysis did not categorise individuals as having neglect, only as showing atypical patterns that may or may not be pathological.
Declared interests
Funded by the National Health and Medical Research Council Ideas Grant and Metro South Health Research Support Scheme Project Grant. No commercial conflicts of interest are reported in the text.
The easy way to misread this
Do not use the VR 'atypicality' score to diagnose neglect or make clinical decisions. The authors state this label is not yet validated for clinical use, the sample was too small to establish efficacy, and the controls were unmatched clinicians rather than healthy community peers.