Poster Session 04 Program Schedule
02/15/2024
12:00 pm - 01:15 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology
Final Abstract #105
Multimodule Virtual Reality Treatment for Spatial Neglect: A Case-Series Study
Manuela Soto Restrepo, Kessler Foundation, West Orange, United States
Madeleine Adams-Gurowitz, Kessler Foundation, West Orange, United States
Nemis Thomas, Kessler Foundation, West Orange, United States
Emma Kaplan, Kessler Foundation, West Orange, United States
Peii Chen, Kessler Foundation, West Orange, United States
Category: Visuospatial Functions/Neglect/Agnosia
Keyword 1: visuospatial neglect
Keyword 2: stroke recovery
Keyword 3: technology
Objective:
To examine a novel at-home virtual reality (VR) treatment designed specifically for addressing spatial neglect (SN).
Participants and Methods:
A multi-baseline experiment was conducted in three stroke survivors with left-sided SN due to right brain damage. The participants, all living in the community, included 3 females (age: 53-58 years, time post stroke: 77-893 days). Participants completed 3 Baseline assessment sessions (2-3 days apart) using the conventional subtests of the Behavioral Inattention Test (BIT-c), followed by 15 VR sessions within 5 weeks. During the Baseline timeframe, participants also completed two other spatial neglect assessments, Scene Copying and Baking Tray. Outcomes were measured using the BIT-c 3 times, and Scene Copying and Baking Tray once each within the week immediately after treatment, and then repeating each assessment two weeks post-treatment. During each VR session, participants completed a combination of treatment game modules of their own choosing, totaling approximately 60 minutes per session. The treatment game included 4 modules for the participant to choose from. Module 1 required reaching and touching the nose of each of 100 animals that ran toward and stood in front of the participant while the virtual and actual hands were decoupled so that the participant gradually reached toward the neglected side without becoming aware of the misalignment. Module 2 required the participant to move a pig from the non-neglected to the neglected side by turning their head using neck rotation. Module 3 required the participant to retrieve items (coins) at different heights in both sides of space, beginning with the neglected side. Module 4 required the participant to block fruits being thrown at them by a monkey from both sides of space.
Results:
The immediate post-treatment BIT-c score average was greater than the baseline average in 2 out of the 3 participants. All three participants’ two-week follow-up scores were greater than their own average baseline performance. The immediate post-treatment performance on the Scene Copying assessment improved for all three participants in relation to their baseline performance. 2 out of the 3 participants continued to show improvement two weeks post-treatment. Lastly, when it came to the Baking Tray assessment, all 3 participants improved from the initial baseline session to the immediate outcome session, and 2 of the participants sustained improvement two weeks post-treatment.
Conclusions:
We demonstrated the potential efficacy of the at-home VR treatment on SN improvement in this case-series study. 15 60-minute sessions of the multimodule VR treatment game may be sufficient for immediate improvement in chronic SN. VR technology enables the development of the novel treatment packaged into a game-like activity, which may be much more difficult to deliver in real-world than virtual environments. The findings encourage further large-sample investigations to unveil treatment efficacy and its neural mechanisms, as well as to explore the possibility of use in telerehabilitation.
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