Is there any relationship between inhibition demand and visual spatial neglect severity? The effects of different distractor inhibition conditions on gaze behavior during immersive virtual reality search tasks in healthy vs. post-stroke (with and without spatial attention deficits).

Sorrentino, Gregorio;et.al.
(2024) EUROPEAN SYMPOSIUM ON XR FOR SPATIAL NEGLECT AND RELATED DISORDERS

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Background: Hemineglect individuals, in addition to spatial attention impairments, can show distractor inhibition difficulties during visual search1,2. The possible relationship between these two cognitive impairments has already been proposed but not yet fully understood and explained3,4. Recently, we created an immersive virtual reality serious game named REAsmash5,6 to objectively identify spatial and distractor inhibition attention within the same visual search test, based on the feature integration theory of Treisman7 . Aim: This study, combining REAsmash with eye-tracking (ET) measures, add new understanding of how inhibition demands influence gaze behavior, tush contributing to identify and describe possible abnormal ET patterns in sub-populations of post-stroke subjects (i.e., with and without visual spatial neglect) relative to healthy controls. Materials and methods: The REAsmash was developed using Unity (C#) and the HTC Vive Pro eye-head mounted display for immersive virtual reality and gaze metric measures. The REAsmash consisted of a cartoon-like 3D garden containing 24 molehills from which a target mole and other distractor moles could emerge. In level 1, no distractor moles were presented, forming a baseline. Levels 2, 3 and 4 consisted of high saliency target-distractor contrasts and levels 5, 6 and 7 consisted of low saliency target-distractor contrasts, with each level increment having increased numbers of distractors. We tested three groups: (i) healthy participants, (ii) post-stroke with visual spatial neglect and (iii) post-stroke without visual spatial neglect. Each group was composed of 15 participants, and each target response was made using the dominant hand in the case of healthy controls and, in the case of post-stroke subjects, the less-impaired hand. The independent variables were age group, target-distractor contrast saliency (low vs high), number of distractors (11, 17 or 23) and target laterality (ipsi- vs contra-lateral to the dominant hand). The dependent variables were mean response time to hit the target and eye movement metrics (i.e., fixation number, duration and localization; capture/recapture fixation rate; path complexity and reaction time). Results: We found a significant response time main effect for target-distractor saliency and distractor number, and a significant interaction between these two variables. For the high salience condition, there were no differences between distractor number. However, for the low salience condition, response time increased with distractor number, replicating the Triesman effect. There was a significant group effect, and group salience and distractor interaction. This showed that the post-strokes groups had a bigger inhibition cost on performance relative to the control group. The eye-tracking analyses show consistent results. Discussions and Conclusions: As predicted, the REAsmash provides an excellent tool to investigate target-distractors inhibition performance. In post-stroke populations, we found overall longer exploration times prior to target selection, with scan paths particularly influenced (i.e., less organised) by low relative to high saliency conditions. Pre-target selection gaze behavior seems to contribute to determining the reasons for slower lateralised target selection performance in participants with visual spatial neglect. The REASmash with ET metrics provides a new tool for the clinical assessment of post-stroke, improving diagnosis with consequent impact on rehabilitation care.
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Sorrentino, G., & et al. (2024). Is there any relationship between inhibition demand and visual spatial neglect severity? The effects of different distractor inhibition conditions on gaze behavior during immersive virtual reality search tasks in healthy vs. post-stroke (with and without spatial attention deficits). EUROPEAN SYMPOSIUM ON XR FOR SPATIAL NEGLECT AND RELATED DISORDERS. https://hdl.handle.net/2078.5/238515