Does visual search by neck motion improve hemispatial neglect?: An experimental study using an immersive virtual reality system

Unilateral spatial neglect (USN) is a higher cognitive dysfunction that can occur after a stroke. It is defined as an impairment in finding, reporting, reacting to, and directing stimuli opposite the damaged side of the brain. We have proposed a system to identify neglected regions in USN patients in three dimensions using three-dimensional virtual reality. The objectives of this study are twofold: first, to propose a system for numerically identifying the neglected regions using an object detection task in a virtual space, and second, to compare the neglected regions during object detection when the patient's neck is immobilized (`fixed-neck' condition) versus when the neck can be freely moved to search (`free-neck' condition). We performed the test using an immersive virtual reality system, once with the patient's neck fixed and once with the patient's neck free to move. Comparing the results of the study in two patients, we found that the neglected areas were similar in the fixed-neck condition. However, in the free-neck condition, one patient's neglect improved while the other patient's neglect worsened. These results suggest that exploratory ability affects the symptoms of USN and is crucial for clinical evaluation of USN patients.