PFI-RP: Use of Augmented Reality and Electroencephalography for Visual Unilateral Neglect Detection, Assessment and Rehabilitation in Stroke Patients

这个创新研究伙伴关系（PFI-RP）项目的更广泛的影响/商业潜力是为中风患者开发视觉单侧忽视检测，评估和康复工具。 根据疾病控制和预防中心的数据，中风是导致严重长期残疾的主要原因，包括医疗保健服务，药物和误工的费用。在美国，中风相关的费用每年约为500亿美元。单侧空间忽略（忽视）是一种致残性神经认知障碍的中风患者发生在28.60%的中风人口。 此外，忽视是残疾的一个强有力的预测因素，与没有忽视的人相比，有忽视的中风患者住院时间更长，接受物理和职业治疗师的直接治疗时间更长，最终导致医疗费用显着增加。 然而，目前还没有针对忽视的发现、评估和康复的商业产品。目前的临床金标准忽视检测方法的补偿策略的影响，并不敏感的变化，忽视的严重程度和康复技术是不能有效地减少残疾与忽视。 该项目将通过一个多学科小组解决这些问题，同时开发拟议的忽视检测、评估和康复技术。拟议项目将开发一种忽视检测、评估和康复工具，该工具结合刺激，通过脑电图测量的神经生理学自动检测忽视，从而刺激中风患者负责空间注意力和感知处理的神经网络，从而将注意力吸引到身体和环境的受影响一侧。在日常活动中需要高水平的重复刺激，以促进内隐学习，支持学习和独立性的泛化。 目前的检测和康复方法缺乏必要的精确性，突出性和重复性，以促进这种类型的学习。由于与这些方法相关的局限性，在常规临床实践中没有忽视的黄金评估或忽视康复的护理标准。拟议的项目为这些问题提供了一个潜在的解决方案，结合了康复干预研究的最佳做法和最先进的技术，在康复诊所实施具有成本效益。所提出的技术结合了忽视严重程度的客观和可靠的量化以及定制的感官刺激，即：（i）技术驱动的（准确、可靠、重复、成本效益高）; ㈡多模式：视觉、听觉、触觉刺激（优化感知处理）;（iii）个性化的可用视野;和（iv）与“现实世界”的日常生活活动同时进行。该奖项反映了NSF的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

The broader impact/commercial potential of this Partnerships for Innovation Research Partnership (PFI-RP) project is in the development of a visual unilateral neglect detection, assessment, and rehabilitation tool for stroke patients. According to the Center for Disease Control and Prevention, stroke is a leading cause of serious long-term disability, including the cost of healthcare services, medicines and missed days of work. Stroke related costs in the United States are around $50 billion every year. Unilateral spatial neglect (neglect) is a disabling neurocognitive impairment for stroke patients occurring in 28.60% of the stroke population. Moreover, neglect is a strong predictor of disability, and stroke patients with neglect have longer hospital stays and receive more direct treatment time from physical and occupational therapists than individuals without neglect, culminating in significantly higher healthcare costs. However, there is currently no commercial product targeting neglect detection, assessment and rehabilitation. Current clinical gold standard neglect detection methods are affected by compensatory strategies and are not sensitive to changes in the severity of neglect; and rehabilitation techniques are not effective in reducing disability associated with neglect. This project, through a multidisciplinary team, will address these issues while developing the proposed neglect detection, assessment, and rehabilitation technology. The proposed project will develop a neglect detection, assessment and rehabilitation tool that incorporates stimulation to draw attention to the affected side of the body and environment based on the automatic detection of neglect through neurophysiology measured through electroencephalography, thereby stimulating neural networks responsible for spatial attention and perceptual processing for stroke patients. Stimulation during everyday activities with high levels of repetition is needed to promote implicit learning that supports generalization of learning and independence. Current detection and rehabilitation methods lack the necessary precision, salience, and repetition to promote this type of learning. Due to limitations associated with these methods, there is no gold assessment for neglect or standard of care for rehabilitation of neglect in routine clinical practice. The proposed project offers a potential solution to these problems, incorporating best practices from rehabilitation intervention research and state-of-the-art technologies that will be cost-effective to be implemented in rehabilitation clinics. The proposed technology incorporates objective and reliable quantification of neglect severity and tailored sensory stimulation that is: (i) technology-driven (accurate, reliable, repetitive, cost-effective); (ii) multimodal: visual, auditory, haptic stimulation (optimizes perceptual processing); (iii) individualized to the available field of vision; and (iv) simultaneous with ``real-world'' activities of daily living .This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.