Use of virtual reality in improving poststroke neglect: Promising neuropsychological and neurophysiological findings from a case study

ABSTRACT After experiencing a stroke in the right hemisphere, almost 50% of patients show unilateral spatial neglect (USN). Virtual Reality technologies offer impressive opportunities for both the rehabilitation and assessment of different cognitive deficits, including USN. A 57-year-old woman, affected by subarachnoid hemorrhage presented a severe left hemiparesis with severe cognitive and behavioral alterations, including temporal and spatial disorientation, reduction of attention and memory process, slowing ideation, USN, and depression of mood. She underwent two different rehabilitation trainings, including standard cognitive training (SCT) in addition to semi-immersive virtual training with her shadow (S-IVT_s) and SCT in addition to a Semi- immersive virtual training, without her shadow (S-IVT). The patient was assessed before and after each of the two different trainings, by using a specific psychometric battery and the event related potential, P300. Only at the end of the use of the S-IVT, we observed a significant improvement in the motor and cognitive function, with regard to USN. SCT in addition to S-IVT with Bts-Nirvana System may be a promising approach in improving attention process, spatial cognition, and mood in patients with post stroke USN, as also demonstrated by the electrophysiological parameters.

[1]  Laurel J Buxbaum,et al.  Treatments of unilateral neglect: a review. , 2002, Archives of physical medicine and rehabilitation.

[2]  Philippe S. Archambault,et al.  Virtual reality treatment and assessments for post-stroke unilateral spatial neglect: A systematic literature review , 2017, Neuropsychological rehabilitation.

[3]  N A Borghese,et al.  Duckneglect: video-games based neglect rehabilitation. , 2013, Technology and health care : official journal of the European Society for Engineering and Medicine.

[4]  M. Bach,et al.  P300 in neglect , 2012, Clinical Neurophysiology.

[5]  H. Sasaki,et al.  Hemispatial sunglasses: effect on unilateral spatial neglect. , 1997, Archives of physical medicine and rehabilitation.

[6]  Andrea Gaggioli,et al.  A Virtual Reality Platform for Assessment and Rehabilitation of Neglect Using a Kinect , 2014, MMVR.

[7]  A. Berti,et al.  Effects of attentional and cognitive variables on unilateral spatial neglect , 2016, Neuropsychologia.

[8]  K. Bodin,et al.  RehAtt – scanning training for neglect enhanced by multi-sensory stimulation in Virtual Reality , 2016, Topics in stroke rehabilitation.

[9]  Roger Newport,et al.  Prisms and neglect: What have we learned? , 2012, Neuropsychologia.

[10]  Risa Sawaki,et al.  Distractor P3 is associated with attentional capture by stimulus deviance , 2008, Clinical Neurophysiology.

[11]  Thomas Schenk,et al.  Rehabilitation of neglect: An update , 2012, Neuropsychologia.

[12]  Georg Kerkhoff,et al.  Modulation and rehabilitation of spatial neglect by sensory stimulation. , 2003, Progress in brain research.

[13]  D Shapiro,et al.  Directing attention toward stimuli affects the P300 but not the orienting response. , 1980, Psychophysiology.

[14]  A. Kirk Spatial neglect , 2001, Current neurology and neuroscience reports.

[15]  J. Luauté,et al.  Rehabilitation of unilateral neglect: Evidence-based medicine. , 2017, Annals of physical and rehabilitation medicine.

[16]  N. Scott,et al.  Vitrectomy with internal limiting membrane (ILM) peeling versus vitrectomy with no peeling for idiopathic full-thickness macular hole (FTMH). , 2013, The Cochrane database of systematic reviews.

[17]  E. John,et al.  Evoked-Potential Correlates of Stimulus Uncertainty , 1965, Science.

[18]  A. Pollock,et al.  Cognitive rehabilitation for spatial neglect following stroke. , 2013, The Cochrane database of systematic reviews.

[19]  J. Deutsch,et al.  Virtual Reality for Stroke Rehabilitation , 2011, The Cochrane database of systematic reviews.

[20]  Masud Husain,et al.  Rehabilitation of neglect , 2015 .

[21]  Giuseppe Riva,et al.  Assessment and rehabilitation of neglect using virtual reality: a systematic review , 2015, Front. Behav. Neurosci..

[22]  Y. Rossetti,et al.  Semiology of neglect: An update. , 2017, Annals of physical and rehabilitation medicine.

[23]  N. Lincoln,et al.  Cognitive rehabilitation for spatial neglect following stroke. , 2007, The Cochrane database of systematic reviews.

[24]  Sabine Coquillart,et al.  Uses of Virtual Reality for Diagnosis, Rehabilitation and Study of Unilateral Spatial Neglect: Review and Analysis , 2009, Cyberpsychology Behav. Soc. Netw..

[25]  Min Ho Chun,et al.  The Effect of Virtual Reality Training on Unilateral Spatial Neglect in Stroke Patients , 2011, Annals of rehabilitation medicine.