Validation of immersive virtual reality line and baguette bisection tasks for the assessment of unilateral spatial neglect.

Objective: Unilateral spatial neglect (USN) assessment is commonly based on paper-and-pencil tests, including the line bisection task. However, this task lacks sensitivity and does not reflect the symptomatic heterogeneity of USN patients, such as difficulties in extrapersonal space or encountered in daily life. Immersive virtual reality (VR) could be a promising way to improve the line bisection task by developing versions that better reflect the difficulties experienced by patients. This study investigated the feasibility and the psychometric qualities of different immersive VR bisection tasks.

Method: 22 right-brain damaged patients with confirmed left USN (USN++) on conventional USN assessment tools, signs of left USN (USN+), or without USN (USN-), and 39 healthy participants were recruited and performed three different immersive VR bisection tasks-a proximal and a distal line bisection task and an ecological baguette bisection task.

Results: Correlational analyses with conventional USN assessment tools supported the validity of the immersive VR bisection tasks. Group and individual analyses emphasized the better sensitivity of the immersive VR proximal and ecological tasks compared with the paper-and-pencil line bisection task. The immersive VR proximal bisection task showed high sensitivity to detecting USN++ patients (detection rate: 75.0%) but not USN+ patients, while the immersive VR ecological bisection task showed good sensitivity for detecting both (detection rate: 62.5%), supporting its relevance for diagnosing mild USN.

Conclusions: The immersive VR bisection tasks appear relevant for USN diagnosis, especially the ecological one, which supports the need for more ecological assessment tools to assess USN and plan rehabilitation better. (PsycInfo Database Record (c) 2025 APA, all rights reserved).