Involvement of the Posterior Visual Pathway Correlates With Higher-Order Visual Impairment in Childhood Stroke Participants Detected by Virtual Reality/Eye-Tracking Paradigm

IF 2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2026-01-01 Epub Date: 2025-10-08 DOI:10.1016/j.pediatrneurol.2025.10.001

Emily Da Cruz BS , Diana Tambala MD , Anna Lynch BA , Claire Manley BA , Melissa Bambery BS , Daniel Kelly BS , Carrie Chui MD , Kenda Alhadid MD, MSc , Alyssa W. Sullivan PhD , Julie Grieco PsyD , Benjamin Ondeck BS , Arne Lauer MD , Lotfi B. Merabet OD, PhD, MPH , Patricia L. Musolino MD, PhD

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引用次数: 0

Abstract

Background

Cerebral injury due to stroke in childhood increases the risk of higher-order visual processing (HOVP) deficits, which can lead to behavioral and learning disabilities if left untreated. Using a virtual reality-based search task and structural magnetic resonance imaging analysis, we assess the extent of functional vision deficits in childhood stroke participants and potential anatomical correlates.

Methods

Twenty childhood stroke participants and 38 unimpaired controls completed a dynamic visual search task using a virtual reality/eye-tracking (VR/ET) paradigm to quantify functional vision abilities. Virtual reality assessment measures, stroke imaging characteristics, and neuropsychological outcomes were analyzed.

Results

All childhood stroke participants completed the VR/ET task with success rates and task compliance in equal measure to controls, and the task demonstrated association with neuropsychological testing measures of processing speed. Less accurate search, slower fixation rates, less sensitivity to task load changes, and greater delays initiating a response to a target were observed in our stroke cohort. On magnetic resonance imaging lesion analysis, injury involving the posterior visual pathways, specifically the optic radiations, inferior longitudinal fasciculus, or superior longitudinal fasciculus, correlated with slower reaction time when controlling for age at time of testing.

Conclusions

Bedside VR/ET assessment in children affected by stroke can detect signs of HOVP deficits identified in neuropsychological testing. Imaging demonstrating involvement of the posterior visual pathway is strongly correlated with impaired visual tracking ability development. Our study demonstrates that injury pattern on imaging at stroke diagnosis can help identify children at risk of HOVP deficits, enabling early monitoring and accommodations facilitating functional vision development.

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虚拟现实/眼动追踪模式检测儿童脑卒中患者后视通路参与与高阶视觉障碍的关系

背景：儿童期脑卒中导致的脑损伤会增加高阶视觉处理（HOVP）缺陷的风险，如果不及时治疗，可能导致行为和学习障碍。使用基于虚拟现实的搜索任务和结构磁共振成像分析，我们评估了儿童中风参与者功能性视力缺陷的程度和潜在的解剖学相关性。方法：20名儿童中风参与者和38名未受损的对照组使用虚拟现实/眼动追踪（VR/ET）范式完成了一项动态视觉搜索任务，以量化功能性视觉能力。分析了虚拟现实评估措施、脑卒中成像特征和神经心理学结果。结果：所有儿童卒中参与者完成VR/ET任务的成功率和任务依从性与对照组相当，任务显示与处理速度的神经心理测试测量相关联。在我们的卒中队列中观察到搜索的准确性较低，注视速度较慢，对任务负荷变化的敏感性较低，对目标启动反应的延迟较大。在磁共振成像病变分析中，当控制测试时的年龄时，涉及后视通路的损伤，特别是视光辐射、下纵束或上纵束，与较慢的反应时间相关。结论：脑卒中患儿床边VR/ET评估可以发现神经心理测试中发现的HOVP缺陷的迹象。影像显示后视通路受累与视觉追踪能力发展受损密切相关。我们的研究表明，卒中诊断时的损伤模式可以帮助识别有HOVP缺陷风险的儿童，从而实现早期监测和促进功能视力发展的调节。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.