Unilateral spatial neglect affected by right-sided stimuli in a three-dimensional virtual environment: A preliminary proof-of-concept study

Unilateral spatial neglect (USN) is defined as the inability to attend and see on one side, which seriously interferes with daily life. Clinically, patients with left USN commonly demonstrate a striking immediate capture of attention from ipsilesional, right-sided items as soon as a visual scene unfolds (i.e., magnetic attraction [MA]). Therefore, this preliminary study utilized a three-dimensional (3D) virtual environment to evaluate the effects of eliminating stimuli in the rightward space and directing attention to the left on neglect symptoms. Methods: Seven patients with USN participated in this study, and two types of visual stimuli were created: the numbers and objects in the 3D virtual environment. To eliminate the visual stimuli on the right side, a moving slit was introduced in the virtual environment. During the experiment, patients were required to orally identify each object and number both in moving and nonmoving slit conditions. Results: A statistical comparison of scores with and without the moving slit in the 3D virtual space indicated significant changes in the object stimuli condition; however, no statistically significant difference was observed in the number stimuli condition. Conclusions: Masking the right side within the 3D virtual space increased the number of objects that can be recognized on the left side by patients with USN. The results may allow interventions in a virtual reality environment that closely resembles the patient’s real-life space.Clinical Relevance—Magnetic attraction is a symptom seen in patients in clinical practice, but there is no method of rehabilitation. The proposed moving slit method is expected to be effective because it enables attention guidance in a three-dimensional space.