Post-stroke unilateral spatial neglect: virtual reality-based navigation and detection tasks reveal lateralized and non-lateralized deficits in tasks of varying perceptual and cognitive demands.
Tatiana Ogourtsova, Philippe S Archambault, Anouk Lamontagne
PMID 29685145WHAT IT FOUND
Stroke survivors with unilateral spatial neglect missed remembered or shifting left targets by larger distances and were slower to detect targets in a seated virtual-reality task.
Standard neglect tests did not track these navigation errors.
Key findings
01During seated virtual-reality navigation, the neglect group had larger endpoint errors to the far-left target in remembered and shifting conditions and took longer to reorient when the target shifted.
02The neglect group also took longer to detect targets at all tested locations than the stroke-without-neglect and healthy-control groups.
03The navigation task found larger endpoint errors in some participants who had a history of neglect but no neglect on current testing, and in some stroke participants without neglect on current testing.
STILL TO COME
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What it does not show
Only people with right-hemisphere stroke and left neglect were studied, so results may not apply to left-hemisphere stroke or right neglect. All participants could already walk independently, so it says little about people with more severe mobility limitations. The seated joystick task removed walking and body rotation, so it may not reflect actual locomotion. Visual field deficits were not consistently documented, so some neglect participants may have had them. The arm used for joystick control was not objectively assessed for motor function. Eye movements were not measured, so gaze strategies cannot be confirmed.
Declared interests
The work was supported by Fonds de Recherche du Québec - Santé, the Richard and Edith Strauss Fellowship in Rehabilitation Sciences, and the Canadian Institutes of Health Research.
The easy way to misread this
Do not conclude that this virtual-reality navigation task is a proven clinical assessment or treatment. The study measured performance differences in a laboratory task and did not test whether using the task improves rehabilitation outcomes.