Reliability and validity of the Virtual Reality Lateralized Attention Test in assessing hemispatial neglect in right-hemisphere stroke.

Abstract

Many tests of hemispatial neglect are insensitive to subtle (but clinically relevant) forms of the disorder. This study provides additional reliability and validity data on the Virtual Reality Lateralized Attention Test (VRLAT), an easy-to-administer computerized measure of hemispatial neglect that mimics the attentional demands of real-world tasks, and has previously shown strong validity and sensitivity (Dawson, Buxbaum, & Rizzo, 2008). The present study assessed a large sample of patients with the aim of developing a clinically useful version of the test, and established the concurrent criterion validity of the VRLAT as measured by its association with performance in a real-world task. Seventy consecutively recruited right-hemisphere stroke patients were assessed with the VRLAT, which requires participants to name objects as they navigate (or are navigated) along a winding virtual path. They also performed a real-world navigation task, tests of sensory and motor function, and paper-and-pencil neglect tests. The VRLAT demonstrated strong sensitivity and specificity, minimal practice effects, and strong validity, and outperformed traditional paper-and-pencil tests in the prediction of real-world collisions. The VRLAT is a sensitive, valid, and reliable measure of hemispatial neglect that requires no specialized equipment, is easy to administer, and is useful for both clinical and research purposes. Moreover, a shortened version with a 5-min administration time has many of the desirable psychometric properties of the original full-length task.