Effects of a stimulus response task using virtual reality on unilateral spatial neglect: a randomized controlled trial

Abstract

ObjectiveWe investigated the effects of a stimulus response task using virtual reality (VR) for unilateral spatial neglect (USN). DesignDouble-blind randomized controlled trial ParticipantsThe participants were 42 patients with right-hemisphere cerebral damage who had been experiencing USN in their daily lives. They were randomly assigned to three groups: a stimulus response task with a background shift (SR + BS group), a stimulus response task without a background shift (SR group), and an object gazing task (control group). InterventionsThe stimulus response task was to search for balloons that suddenly appeared on the VR screen. A background shift was added to highlight the search in the neglected space. The control task was to maintain a controlled gaze on a balloon that appeared on the VR screen. The intervention period was 5 days. Main Outcome MeasureThe primary outcome was the participants’ scores on a stimulus-driven attention test (SAT) using the reaction time. The stimuli of the SAT were divided into six blocks of three lines on each side (-3 to +3). The secondary outcomes were their scores on the Behavioral Intention Test (BIT-c), Catherine Bergego Scale (CBS), and Straight ahead pointing (SAP) tests. ResultsIn the SAT, there were significant interaction effects of reaction time between time and group factors in left-2, right+2, and right+3. The SR + BS and SR groups showed significant improvements in the reaction time of left-2 and right+3 compared with the control group. Moreover, the SR + BS group showed a significant improvement in the reaction time of left-2, which was the neglected space, compared with the SR group. However, there were no significant interaction effects of BIT-c, CBS, and SAP. ConclusionOur results suggest that the use of stimulus response tasks using VR combined with background shifts may improve left sided USN.