Simulated driving: The added value of dynamic testing in the assessment of visuo-spatial neglect after stroke

Lauriane A. Spreij, Antonia F. Ten Brink, Johanna M.A. Visser-Meily, Tanja C.W. Nijboer

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8 Citations (SciVal)


Background: Visuo-spatial neglect (VSN) is generally assessed with neuropsychological paper-and-pencil tasks, which are often not sensitive enough to detect mild and/or well-compensated VSN. It is of utmost importance to develop dynamic tasks, resembling the dynamics of daily living. Objective: A simulated driving task was used to assess (1) differences in performance (i.e., position on the road and magnitude of sway) between patients with left- and right-sided VSN, recovered VSN, without VSN, and healthy participants; (2) the relation between average position and VSN severity; and (3) its diagnostic accuracy in relation to traditional tasks. Methods: Stroke inpatients were tested with a cancellation task, the Catherine Bergego Scale and the simulated driving task. Results: Patients with left-sided VSN and recovered VSN deviated more regarding position on the road compared to patients without VSN. The deviation was larger in patients with more severe VSN. Regarding diagnostic accuracy, 29% of recovered VSN patients and 6% of patients without VSN did show abnormal performance on the simulated driving task. The sensitivity was 52% for left-sided VSN. Right-sided VSN was not well detected, probably due to the asymmetric layout. Conclusions: Based on these results, the simulated driving task should not be the only task to assess VSN, especially in its current form. Given the heterogenic nature of VSN, the assessment should always consist of several tasks varying in nature and complexity and include a dynamic task to detect mild and/or recovered VSN. A symmetric design should be used when designing novel tasks to assess right-sided VSN.

Original languageEnglish
Pages (from-to)28-45
Number of pages18
JournalJournal of Neuropsychology
Issue number1
Early online date16 Oct 2018
Publication statusPublished - 1 Mar 2020


  • computerized simulations
  • dynamic testing
  • neuropsychological tests
  • rehabilitation
  • stroke
  • virtual reality
  • visuo-spatial neglect

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience


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