Validity of the immersive virtual reality lateralized attention test for the assessment of unilateral spatial neglect following right hemispheric stroke.

Abstract

Unilateral spatial neglect (USN) is a disabling syndrome that is prevalent following right hemisphere stroke. Clinicians must be able to identify the presence, characteristics, and severity of USN using psychometrically sound assessments. Virtual reality offers a standardized and rapid means of assessing for USN in a safe and controlled environment. Enabled by advances in technology, this study established the validity of a new, immersive version of a prior validated, reliable, and sensitive assessment tool, the Virtual Reality Lateralized Attention Test (VRLAT). This new version (VRLAT-2) is novel because it uses a head-mounted display to provide an immersive and more realistic experience where participants are free to turn their heads while participating. To examine the concurrent and discriminant validity of the immersive VRLAT-2 and to establish a preliminary cutoff score for determining USN. Criterion standard. Institutional laboratory. 37 adults with right hemisphere stroke and 16 age-matched neurotypical individuals. Not applicable. The primary outcome measure was the VRLAT-2. Additional outcome measures included the VRLAT-1, Catherine Bergego Scale, Behavioral Inattention Test, and Bells Test. The VRLAT-2 demonstrated moderate concurrent and discriminant validity. In comparison to the VRLAT-1, it classified a numerically greater number of individuals as having USN. These preliminary and exploratory findings provide initial support for the validity of the VRLAT-2, though further validation studies are warranted. Additional research is needed to examine the psychometric properties of the VRLAT-2 with broader samples (eg, left hemisphere lesions, acute/subacute stroke).