ABSTRACT

It is important to distinguish patients in a minimally conscious state (MCS) from patients in a vegetative state (VS) when assessing disorders of consciousness (DOC) as prognosis, selection of therapy, and drug treatment could differ accordingly. Clinical evaluation of a patient’s eye movements, such as visual startle, visual fixation, and visual pursuit, provides valuable evidence but is often subject to misdiagnosis. To minimize such misdiagnosis caused by human judgment, a virtual reality (VR) technology-based quantitative assessment method with an eye-tracking system is proposed in this study. The new VR system presented 3 stimuli to 20 healthy participants, and visual response data were recorded to define valid responses to each stimulus. Further, the newly defined stimuli were presented to five chronic patients in VS, and the system classified three of them as showing visual fixations that could not be verified through clinical assessment beforehand. The proposed system, as verified through such experimentation, suggests quantitative and objective evaluation methods for examining three visual functions of patients with DOC.

摘要

在评估意识障碍 (DOC) 时，将处于最低意识状态 (MCS) 的患者与处于植物人状态 (VS) 的患者区分开来很重要，因为预后、治疗选择和药物治疗可能会相应不同。对患者眼球运动的临床评估，例如视觉惊吓、视觉固定和视觉追踪，提供了有价值的证据，但往往容易被误诊。为了尽量减少人为判断造成的误诊，本研究提出了一种基于虚拟现实（VR）技术的眼动追踪定量评估方法。新的 VR 系统向 20 名健康参与者呈现 3 种刺激，并记录视觉反应数据以确定对每种刺激的有效反应。此外，将新定义的刺激呈现给 VS 中的五名慢性患者，系统将其中三个分类为显示无法通过临床评估事先验证的注视。所提出的系统经此类实验验证，提出了用于检查 DOC 患者三种视觉功能的定量和客观评估方法。