Computer-enhanced route and survey spatial knowledge assessment in clinical neuropsychology

In the field of clinical neuropsychology, topographical disorientation represent one of the main consequences of brain injury. Different methodological approaches and different tools have been used in the assessment of brain injured patient’s navigational abilities. These procedures include auto-evaluation questionnaires, evaluation of general cognitive level, mental rotation tasks or specifically suited visual-spatial tasks. All these methodologies have shown a moderate correlation between the results of these kinds of evaluation and the navigational ability impairment observed in everyday contexts. Meanwhile, the evaluation of patient’s spatial orientation out of laboratory setting appears to be an unprofitable opportunity for clinicians. Thus the problem in designing an effective assessment tool is still open. A promising approach could be to integrate classical evaluation tools with computer-based interactive ones, such as virtual reality, in order to evaluate complex environments navigational capacity in neurological patients by observing the types of spatial representations that a patient is able to produce in order to adaptively interact with space within a given activity. In particular we propose patients’ active interaction with virtual reality simulations can help to understand whether the ability to organize spatial knowledge into a route or survey type cognitive map is preserved. According to this framework, we propose a combination of classical and virtual reality-based assessment, in which perceptive, memory and attentional functions (that combined each other are considered the hub for spatial orientation ability) will be evaluated with standardized neuropsychological tests and a more situated computer-based tools will allow the assessment of spatial orientation during the interaction with complex environments. Strictly linked with “paper and pencil” spatial disorientation neuropsychological evaluation, we propose two virtual reality tools based on Wisc-R Maze subtest and Road Map Test, customized to match interactive evaluation requirements. The first will provide the possibility to evaluate human ability of finding the best route to achieve a target goal while immersed in an empty environment. The second can be used to evaluate the ability in creating relationships between various points of the environment and in inferring, through the reasoning process, high level spatial organization knowledge. By providing the possibility to track user’s spatial behaviours, a virtual reality-based evaluation allows an effective and objective record of all the experimental variables. It also avoids the intervention of the experimenter, which may interfere with the actions of the agent-explorer. The main hypothesis of our research is that the integration of virtual reality-based tools with traditional evaluation methods will improve the evaluation of topographical disorientation in brain-injured patients