Improvement of hemispatial neglect by a see-through head-mounted display: a preliminary study.

Jong Hun Kim,Kenneth M Heilman,Duk L Na,Seok Min Go,Sang Won Seo,Byung Hwa Lee

doi:10.1186/s12984-015-0094-5

Abstract

BackgroundPatients with right hemisphere damage are often unaware of, inattentive to and fail to interact with stimuli on their left side. This disorder, called hemispatial neglect, is a major source of disability. Inducing leftward ocular pursuit by optokinetic stimulation (OKS) relieves some of the signs of unilateral neglect. However, it is difficult to provide patients with a continuously moving background that is required for OKS. We studied whether OKS projected onto a see-through head-mounted display (HMD) would help treat neglect.Methods14 patients with neglect after cerebral infarction performed line bisections on a computer screen, both with and without OKS that was either delivered by the HMD or on the same screen that was displaying the lines that were to be bisected.ResultsThe line bisection performances were significantly different in the four conditions (P < 0.001). The post hoc analyses indicated that the rightward deviation observed in the control conditions on the line bisection tasks without OKS, improved significantly with the use OKS in both the HMD and screen conditions (α < 0.05). The results between the screen and HMD conditions were also different (α < 0.05). The OKS in the HMD condition corrected patients’ rightward deviation more toward the actual midline than did the OKS provided during the screen condition.ConclusionsOKS projected onto the see-through HMD improved hemispatial neglect. The development of a portable device may aid in the treatment of neglect.

Highlights

Patients with right hemisphere damage are often unaware of, inattentive to and fail to interact with stimuli on their left side
Disabilities caused by hemispatial neglect can persist in 30 % of patients [6, 11, 12], resulting in impairments when performing activities of daily living, such as eating as well as colliding with objects situated on the contralateral side of their body, missing words when reading and even being unaware of family and friends who are situated on their left side
We tested the effects of screen + optokinetic stimulation (OKS), screen –OKS, head-mounted display (HMD) + OKS and HMD –OKS on the line bisection tasks

Summary

Introduction

Patients with right hemisphere damage are often unaware of, inattentive to and fail to interact with stimuli on their left side. This disorder, called hemispatial neglect, is a major source of disability. Hemispatial neglect is defined as a patient’s failure to report or respond to stimuli presented in the space opposite to a brain lesion [1] This failure to report or respond to contralesional stimuli is often induced by inattention to stimuli located on the side of space that is contralateral to a brain lesion. Verbal cueing, sensory stimuli, phasic alerting, and sustained attention training methods were introduced [14, 15] These treatments train patients to look at stimuli in their left hemispace or pay more

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