Virtual reality gameplay classification illustrates the multidimensionality of visuospatial neglect.

Autor: Painter DR; The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia., Norwood MF; The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia., Marsh CH; The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia.; School of Applied Psychology, Griffith University, Gold Coast, Queensland, 4215, Australia., Hine T; The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia.; School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, 4215, Australia., Woodman C; Neurosciences Rehabilitation Unit, Gold Coast University Hospital, Gold Coast, Queensland, 4215, Australia., Libera M; Psychology Department, Logan Hospital, Logan, Queensland, 4131, Australia., Harvie D; The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia.; Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health (IIMPACT in Health), University South Australia, Adelaide, 5001, South Australia, Australia., Dungey K; School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, 4215, Australia., Chen B; Allied Health and Rehabilitation, Emergency and Specialty Services, Gold Coast Health, Gold Coast, Queensland, 4215, Australia., Bernhardt J; Florey Institute of Neuroscience and Mental Health, Austin Campus, Heidelberg, 3084, Victoria, Australia., Gan L; Rehabilitation Unit, Logan Hospital, Meadowbrook, Queensland, 4131, Australia., Jones S; School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, 4215, Australia., Zeeman H; The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, 4111, Australia.
Jazyk: angličtina
Zdroj: Brain communications [Brain Commun] 2024 May 03; Vol. 6 (4), pp. fcae145. Date of Electronic Publication: 2024 May 03 (Print Publication: 2024).
DOI: 10.1093/braincomms/fcae145
Abstrakt: Brain injuries can significantly impact mental processes and lead to hidden disabilities not easily detectable. Traditional methods for assessing these impacts are imprecise, leading to unreliable prevalence estimates and treatments with uncertain effectiveness. Immersive virtual reality has shown promise for assessment, but its use as a standalone tool is rare. Our research focused on developing and validating a standalone immersive virtual reality classification system for unilateral spatial neglect, a condition common following brain injury characterized by inattention to one side of space. Our study involved 51 brain injury inpatients and 30 controls, all engaging with 'The Attention Atlas', an immersive virtual reality game for testing visual search skills. Our classification system aimed to identify patients with neglect, 'minor atypicality' (indicative of inattention not consistent enough to be labelled as neglect) or non-neglect. This categorization was based on a simple mathematical definition, utilizing gameplay to describe spatial orientation (to the left or right side) and attentional challenge (indicative of search inefficiency). These metrics were benchmarked against a normative model to detect atypical visual search, which refers to gameplay beyond the usual bounds. The combination of neglected side, orientation and challenge factors was used to categorize neglect. We discovered a strong correlation between atypical visual search patterns and neglect risk factors, such as middle cerebral artery stroke, parietal injuries and existing neglect diagnoses (Poisson regression incidence rate ratio = 7.18, 95% confidence interval = 4.41-11.90). In our study, immersive virtual reality-identified neglect in one-fourth of the patients ( n = 13, 25.5%), minor atypicality in 17.6% ( n = 9) and non-neglect in the majority, 56.9% ( n = 29). This contrasts with standard assessments, which detected neglect in 17.6% ( n = 9) of cases and had no intermediate category. Our analysis determined six categories of neglect, the most common being left hemispace neglect with above-median orientation and challenge scores. Traditional assessments were not significantly more accurate (accuracy = 84.3%, P = 0.06) than a blanket assumption of non-neglect. Traditional assessments were also relatively insensitive in detecting immersive virtual reality-identified neglect (53.8%), particularly in less severe cases and those involving right-side inattention. Our findings underline the effectiveness of immersive virtual reality in revealing various dimensions of neglect, surpassing traditional methods in sensitivity and detail and operating independently from them. To integrate immersive virtual reality into real-world clinical settings, collaboration with healthcare professionals, patients and other stakeholders is crucial to ensure practical applicability and accessibility.
Competing Interests: The authors declare a potential perceived competing financial interest. The Attention Atlas and independent neglect classifier have been the topic of discussions for potential commercialization during the Bionics Queensland Challenge 2020, within Griffith University and within the Gold Coast University Hospital.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain.)
Databáze: MEDLINE