A virtual reality test battery for assessment and screening of spatial neglect

作者：Fordell H^*; Bodin K; Bucht G; Malm J

来源：Acta Neurologica Scandinavica, 2011, 123(3): 167-174.

DOI：10.1111/j.1600-0404.2010.01390.x

• perceptual disorder
• hemispatial neglect
• diagnosis
• neuro psychological tests
• task performance and analysis
• visual perception
• user computer interface
• stroke complications
• assessment

Background -
There is a need for improved screening methods for spatial neglect.
Aim -
To construct a VR-test battery and evaluate its accuracy and usability in patients with acute stroke.
Method -
VR-DiSTRO consists of a standard desktop computer, a CRT monitor and eye shutter stereoscopic glasses, a force feedback interface, and software, developed to create an interactive and immersive 3D experience. VR-tests were developed and validated to the conventional Star Cancellation test, Line bisection, Baking Tray Task (BTT), and Visual Extinction test. A construct validation to The Rivermead Behavioral Inattention Test, used as criterion of visuospatial neglect, was made. Usability was assessed according to ISO 9241-11.
Results -
Thirty-one patients with stroke were included, 9/31 patients had neglect. The sensitivity was 100% and the specificity 82% for the VR-DiSTRO to correctly identify neglect. VR-BTT and VR-Extinction had the highest correlation (r2 = 0.64 and 0.78), as well as high sensitivity and specificity. The kappa values describing the agreement between traditional neglect tests and the corresponding virtual reality test were between 0.47-0.85. Usability was assessed by a questionnaire; 77% reported that the VR-DiSTRO was 'easy' to use. Eighty-eight percent reported that they felt 'focused', 'pleased' or 'alert'. No patient had adverse symptoms. The test session took 15 min.
Conclusions -
The VR-DiSTRO quickly and with a high accuracy identified visuospatial neglect in patients with stroke in this construct validation. The usability among elderly patients with stroke was high. This VR-test battery has the potential to become an important screening instrument for neglect and a valuable adjunct to the neuropsychological assessment.

• 出版日期2011-3