Search

Virtual Reality (VR) offers the possibility to assess cognitive functioning in a dynamic environment resembling daily life. In this cross-sectional study, we used two user interfaces, namely non-immersive VR by using a computer monitor (CM) and immersive VR by using a head-mounted display (HMD). We investigated (1) potential differences in feasibility, user-experience, and a potential preference for one user interface over another between stroke patients and healthy controls; (2) potential differences in feasibility, user-experience, and preference between patients referred for inpatient rehabilitation care and patients referred for outpatient rehabilitation care; and (3) potential demographic and clinical characteristics that were related to patients' preference for one user interface over another. Stroke patients (n = 88) and healthy controls (n = 66) performed a VR-task with a CM and HMD. Both user interfaces were feasible to use, irrespective of clinical referral (in- or outpatient rehabilitation care). Patients reported an enhanced feeling of engagement, transportation, flow, and presence, but more negative side effects when tested with a HMD, compared to a CM. The majority of stroke patients had no preference for one user interface over the other, yet younger patients tended to prefer a HMD. VR seems highly feasible in stroke patients. [ABSTRACT FROM AUTHOR]

Numerous tests of visuo-spatial neglect (VSN) have been developed. In this study, we propose a clustering of VSN tests by making a distinction between static tests with low levels of cognitive demand (i.e. tests without movement or time-restrictions, such as paper-and-pencil tests) and dynamic tests with high levels of cognitive demand (i.e. tests incorporating movement and time-restrictions, such as virtual reality tests). The concepts of static and dynamic tests have not been systematically investigated so far. Here, we investigated (1) whether we would find dissociations between patients showing VSN on test within the static cluster but not on tests within the dynamic cluster, and vice versa; (2) whether differences in demographic or clinical characteristics could be identified between these groups of patients; and (3) whether the underlying factor structure would correspond to our proposed distinction between static and dynamic clusters of tests. Sixty-one patients with VSN completed three static tests (shape cancellation, line bisection, letter cancellation) and three dynamic tests (Catherine Bergego Scale, Mobility Assessment Course, simulated driving test). Thirteen percent of patients showed VSN on tests within the static cluster, 33% on tests within the dynamic cluster, and 54% on tests within both clusters. Patients with VSN on the dynamic tests (alone or in addition to static tests) had poorer motor function, poorer walking abilities and were more dependent in daily life than patients showing VSN on the static cluster alone. The underlying factor structure corresponded to our proposed conceptual distinction between static and dynamic clusters of tests. Static and dynamic tests compose different clusters and double dissociations are shown between clusters. Future research involving data-driven approaches might result in a better understanding on how different tests of VSN relate to each other, and, more importantly, a better understanding of VSN and its phenotypes. [ABSTRACT FROM AUTHOR]

Objectives: Stroke could lead to deficits in organization of visual search. Cancellation tests are frequently used in standard neuropsychological assessment and appear suitable to measure search organization. The current aim was to evaluate which cognitive functions are associated with cancellation organization measures after stroke. Methods: Stroke patients admitted to inpatient rehabilitation were included in this retrospective study. We performed exploratory factor analyses to explore cognitive domains. A digital shape cancellation test (SC) was administered, and measures of search organization (intersections rate and best r) were computed. The following cognitive functions were measured by neuropsychological testing: neglect (SC, line bisection; LB, Catherine Bergego Scale; CBS, and Balloons Test), visuospatial perception and construction (Rey Complex Figure Test, RCFT), psychomotor speed (Trail Making Test; TMT-A), executive functioning/working memory (TMT-B), spatial planning (Tower Test), rule learning (Brixton Test), short-term auditory memory (Digit Span Forward; DSF), and verbal working memory (Digit Span Backward; DSB). Results: In total, 439 stroke patients were included in our analyses. Four clusters were separated: “Executive functioning” (TMT-A, TMT-B, Brixton Test, and Tower Test), “Verbal memory” (DSF and DSB), “Search organization” (intersections rate and best r), and “Neglect” (CBS, RCFT copy, Balloons Test, SC, and LB). Conclusions: Search organization during cancellation, as measured with intersections rate and best r, seems a distinct cognitive construct compared to existing cognitive domains that are tested during neuropsychological assessment. Administering cancellation tests and analyzing measures of search organization could provide useful additional insights into the visuospatial processes of stroke patients. (JINS, 2018, 24, 424–436) [ABSTRACT FROM AUTHOR]

The dynamic Wisconsin Card Sorting Test (dWCST) examines the effects of brief training on test performance where pre- to post-test change reflects learning potential. The objective was to examine the validity of the dWCST as a measure of learning potential in patients with acquired brain injury (ABI). A total of 104 patients with ABI completed the dWCST at rehabilitation admission. Performance of a subgroup (n=63) was compared to patients (n=28) who completed a repeated administration of the conventional WCST (rWCST). Furthermore, dWCST performance was compared between patients with ABI (n=63) and healthy controls (n=30) matched on gender, age, and education. Three learning potential indices were used: post-test score, gain score, and a group classification (decliners, poor learners, strong learners, high achievers). The median dWCST administration time was 30 min. The dWCST showed no floor or ceiling effects and the post-test and gain score were significantly intercorrelated. The pre-test score showed no significant associations with other neuropsychological tests. The learning potential indices were significantly associated with language and/or memory. In contrast to the dWCST group, the rWCST group showed no significant pre- to post-test improvement. There were significantly more poor learners in the rWCST group. Compared to controls, patients obtained similar gains, but significantly lower pre- and post-test scores for the dWCST. The ratio of poor learners between-groups was not significantly different. The results support the validity of the dWCST for assessing learning potential in patients with ABI. Further research is needed to investigate the predictive validity of the dWCST. (JINS, 2014, 20, 1–11) [ABSTRACT FROM AUTHOR]