Cognitive training in an everyday-like virtual reality enhances visual-spatial memory capacities in stroke survivors with visual field defects

ABSTRACT

Objectives

Visual field defects due to hemi- or quadrantanopia after stroke represent an under-recognized neurological symptom with inefficient instruments for neurorehabilitation to date. We here examined the effects of training in a virtual reality (VR) supermarket on cognitive functions, depressive symptoms, and subjective cognitive complaints in patients with hemianopia/quadrantanopia and healthy controls.

Methods

During a 14-day rehabilitation program, 20 patients and 20 healthy controls accomplished a real-life-like shopping task in a VR supermarket. A comparison between pre- and post-training standard neuropsychological measures, depressive symptoms, and subjective memory complaints allowed us to assess a putative transfer of rehabilitation effects from the training tasks to specific cognitive functions.

Results

The results indicate that VR training may improve performance not only in the trained task but also in specific neuropsychological functions. After the training, both patients and controls showed improved performances in visual scanning, mental rotation, visuoconstruction, and cognitive flexibility. Moreover, depressive symptoms were attenuated in both groups. In the patient group compared to the control group, the training particularly resulted in improved visual memory retrieval and reduced memory complaints.

Conclusions

The results of the current study suggest that VR training can improve particularly visual-spatial skills in patients with hemianopia or quadrantanopia. Our study thus introduces an interesting novel treatment approach to improve cognitive functions relevant to daily life in stroke patients with visual field defects.

KEYWORDS:

• Stroke
• rehabilitation
• hemianopia
• neuropsychology
• cognition

Supplementary material

Supplemental data for this article can be accessed publisher’s website

Additional information

Funding

This work was supported by the project CITmed (Cognitive Interaction Technology in Medicine), funded by the EFRE (Europäischer Fonds für Regionale Entwicklung) program of Northrhine Westfalia, and the Cluster of Excellence Cognitive Interaction Technology (EXC 277) at Bielefeld University, funded by the German Research Foundation (DFG).