A context-based interactive evaluation of neglect syndrome in virtual reality

A classical approach to neglect syndrome evaluation is generally based on visual scanning tasks. Due to its laboratory-based approach, neglect assessment generally failed to individuate patient's behavior impairments in everyday contexts. Simultaneously, the introduction of computer-based interactive simulations provides the possibility to have a context-based assessment linked with rigorous methodological procedure validity. According to this vision, the present work aims in introducing the use of virtual reality scenarios for the assessment of attentional-spatial deficits in unilateral neglect patients both in indoor and outdoor daily situations. For this purpose, two virtual reality environments were developed and four brain-damaged patients were requested to immersively explore them in order to memorize, replace and recognize familiar objects. Patient included in the study were previously evaluated with "paper and pencil" neuropsychological assessment and they presented, respectively, a neglect syndrome, an overcome neglect, a unilateral right brain damage without neglect and a bilateral frontal brain injury with slight spatial neglect. Quantitative and qualitative analysis revealed as patients in virtual reality assessment provide perceptive and explorative behaviors congruent with neurological and neuropsychological evaluation. Virtual reality-based evaluation will also provide evidences of neglect induced biases in coping with everyday contexts that could be unclear detectable in paper and pencil assessment. Those results will support the use of virtual reality for situated neglect assessment and provide guidelines for rehabilitation trials in more ecologically-like contexts.