Use of immersive virtual reality to explore visual search behaviour in individuals with visuospatial neglect after stroke

Abstract

Visuospatial neglect (VSN) is a common post-stroke disorder characterized by impaired attention toward the contralesional hemispace, affecting interaction with the environment. Traditional assessments (e.g., pen-and-paper tests) may not detect subtle deficits in visual search behaviour, particularly in complex, dynamic settings. This study introduces an immersive virtual reality (VR) visual search task designed to assess visual search behaviour across peri- and extra-personal spaces. By integrating eye-and-head tracking, we aimed to characterize search behaviour and evaluate group differences among individuals with stroke with VSN (VSN+, n = 11), those without VSN (VSN-, n = 10), and healthy controls (HC, n = 11). Additionally, we examined how task parameters (target position, spatial context, and difficulty) influenced search behaviour. Results show that VSN+ exhibited least efficient search strategies, with longer search times than VSN- and HC and more extended search paths than HC. Notably, VSN- also demonstrated visual search inefficiencies, suggesting that conventional assessments may overlook subtle visuospatial impairments. Search deficits were most pronounced in extra-personal space and under increased task demands. Despite a limited sample size, these findings highlight the potential of VR-tasks to characterize visual search behaviour. Further research on larger, more diverse samples is needed to evaluate its potential diagnostic utility.