Qualitative assessment for extrapersonal neglect in patients with stroke using a virtual reality system task

Figures & data

Table 1. Participant characteristics for the neglect group (NEG, n = 10), elderly healthy group (EH, n = 11), and young healthy group (YH, n = 15)

	NEG	EH	YH	Significant (NEG and EH)
Age (years)	67.8 ± 12.1	71.2 ± 4.0	27.9 ± 5.7	n.s.
Sex (M:F)	8:2	3:8	9:6	—
Education (years)	11.2 ± 2.6	11.3 ± 2.0	16.3 ± 1.2	n.s.
MMSE (score)	27.8 ± 2.1	28.9 ± 0.9	—	n.s.

n.s.: not significant; M: male; F: female; MMSE: Mini-Mental State Examination.

Figure 1. Photograph of a participant using the virtual reality apparatus and a scene in the virtual reality task.

Figure 2. Overview of the virtual reality task environment.

Figure 3. The 18 targets that appear in the virtual reality task.

Table 2. Clinical demographics and the neglect group test results

Case	Age/Sex	Etiology	Lesion site	TPO (months)	BIT (CS: total/146)	BIT (BS: total/81)	CBS (OS: total/30)	CBS (AS: total/30)	FSLCT (total/36)	VR test (total/18)	VFD
1	84/F	CI	Fr-P	1.6	77	36	16	11	10	7	–
2	74/F	CH	Th-BG	55.0	140	81	9	6	34	5	–
3	66/M	CI	Fr-P-T	33.5	111	64	6	2	36	10	+
4	57/M	CH	Fr-P-T-BG	1.1	122	65	16	9	36	13.5	–
5	72/M	CI	Fr-P-T-BG	133.4	120	67	12	6	24	14.5	–
6	49/M	CI	Fr-P-O-T-BG	1.9	110	61	15	13	36	12.5	+
7	79/M	CI	P-Th	22.7	127	72	11	10	36	9.5	–
8	52/M	CH	P-Th-BG	4.7	122	55	13	4	27	10.5	+
9	65/M	CH	Fr-BG	8.1	141	79	7	4	36	16	–
10	80/M	CH	P-O	20.2	117	65	13	6	36	11.5	+

F: female; M: male; CH: cerebral haemorrhage; CI: cerebral infarction; Fr: frontal; P: parietal; T: temporal; O: occipital; Th: thalamus; BG: basal ganglia; TPO: time post onset; BIT: Behavioural Inattention Test; CS: conventional subtests; BS: behavioural subtests; CBS: Catherine Bergego Scale; OS: observation score; AS: anosognosia score; FSLCT: Far Space Line Cancellation task; VR: virtual reality; VFD: visual field defect.

Table 3. The virtual reality task results [neglect (NEG), elderly healthy (EH), and young healthy (YH) groups]

Group	Total Score	Rt Error Number	Lt Error Number	Ave NRA(°)	Rt Max NRA(°)	Lt Max NRA(°)	Rt Rotation Time(s)	Lt Rotation Time(s)	Time(s)
NEG	11.00 ± 3.36^§§	2.00 ± 1.89**	6.80 ± 3.12^§§	10.31 ± 10.16^§	59.33 ± 15.25	46.73 ± 15.70	169.95 ± 106.03*	50.90 ± 44.50	492.65 ± 170.11
EH	17.73 ± 0.52	0.36 ± 0.67	0.00 ± 0.00	−1.13 ± 1.80	45.12 ± 12.00	47.13 ± 11.74	58.06 ± 36.72	70.88 ± 42.12	399.26 ± 25.90
YH	17.87 ± 0.35	0.13 ± 0.35	0.00 ± 0.00	−0.29 ± 2.01	53.48 ± 11.10	49.87 ± 9.65	88.02 ± 32.98	84.71 ± 37.19	421.86 ± 44.96

Rt: right; Lt: left; Ave: average; NRA: neck rotation angle

*Significantly different from EH group (p < 0.05); **Significantly different from YH group (p < 0.01); ^§Significantly different from EH and YH groups (p < 0.05); ^§§Significantly different from EH and YH groups (p < 0.001).

Figure 4. Lesion pattern of case 2 (magnetic resonance imaging fluid-attenuated inversion recovery).

Table 4. Detection percentage of each target (left-side stimulation or right-side stimulation) in the virtual reality task [neglect (NEG) and elderly healthy (EH) groups]

Position	Left	Detection Percentage (%)		p-value	Right	Detection Percentage (%)		p-value
		NEG	EH			NEG	EH
Front	Static Human	80.0	100	n.s	Static Human	90.0	100	n.s.
Front	Static Signal	0	100	***	Static Signal	70.0	90.9	n.s.
Front	Dynamic Human	40.0	100	**	Dynamic Human	100	100	n.s.
Front	Irregular Cat	40.0	100	**	Irregular Can	80.0	100	n.s.
Side	Static Car	10.0	100	***	Static Car	80.0	100	n.s.
Side	Dynamic Car	50.0	100	**	Dynamic Car	90.0	90.9	n.s.
Side	Irregular Car	40.0	100	**	Irregular Car	60.0	100	**

*Significantly different from EH group (p < 0.05); **Significantly different from EH group (p < 0.01); ***Significantly different from EH group (p < 0.001).

n.s.: not significant.

Table 5. Detection percentage of each target (both-sides stimulation) in the virtual reality task [neglect (NEG) and elderly healthy (EH) groups]

Position	Both Sides	Detection Percentage (%)		p-value
		NEG	EH
Front	Static Humans	50.0	100	**
Front	Dynamic Humans	30.0	100	***
Side	Static Cars	20.0	100	***
Side	Dynamic Cars	30.0	81.8	*

*Significantly different from EH group (p < 0.05); **Significantly different from EH group (p < 0.01); ***Significantly different from EH group (p < 0.001).

n.s.: not significant.

Table 6. Detection percentage of both-sides stimulation in the virtual reality task (neglect group)

Position	Both Sides	Detection Percentage (%)
		Left	Right
Front	Static Humans	50.0	90.0
Front	Dynamic Humans	30.0	100
Side	Static Cars	20.0	70.0
Side	Dynamic Cars	30.0	90.0