NDLI: Driving simulation in the clinic: testing visual exploratory behavior in daily life activities in patients with visual field defects.

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Driving simulation in the clinic: testing visual exploratory behavior in daily life activities in patients with visual field defects.

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Driving simulation in the clinic: testing visual exploratory behavior in daily life activities in patients with visual field defects.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hamel, Johanna Kraft, Antje Ohl, Sven De Beukelaer, Sophie Audebert, Heinrich J. Brandt, Stephan A.
Description	Country affiliation: Germany Author Affiliation: Hamel J ( Department of Neurology, Universitätsmedizin Charité, Germany.)
Abstract	Patients suffering from homonymous hemianopia after infarction of the posterior cerebral artery (PCA) report different degrees of constraint in daily life, despite similar visual deficits. We assume this could be due to variable development of compensatory strategies such as altered visual scanning behavior. Scanning compensatory therapy (SCT) is studied as part of the visual training after infarction next to vision restoration therapy. SCT consists of learning to make larger eye movements into the blind field enlarging the visual field of search, which has been proven to be the most useful strategy(1), not only in natural search tasks but also in mastering daily life activities(2). Nevertheless, in clinical routine it is difficult to identify individual levels and training effects of compensatory behavior, since it requires measurement of eye movements in a head unrestrained condition. Studies demonstrated that unrestrained head movements alter the visual exploratory behavior compared to a head-restrained laboratory condition(3). Martin et al.(4) and Hayhoe et al.(5) showed that behavior demonstrated in a laboratory setting cannot be assigned easily to a natural condition. Hence, our goal was to develop a study set-up which uncovers different compensatory oculomotor strategies quickly in a realistic testing situation: Patients are tested in the clinical environment in a driving simulator. SILAB software (Wuerzburg Institute for Traffic Sciences GmbH (WIVW)) was used to program driving scenarios of varying complexity and recording the driver's performance. The software was combined with a head mounted infrared video pupil tracker, recording head- and eye-movements (EyeSeeCam, University of Munich Hospital, Clinical Neurosciences). The positioning of the patient in the driving simulator and the positioning, adjustment and calibration of the camera is demonstrated. Typical performances of a patient with and without compensatory strategy and a healthy control are illustrated in this pilot study. Different oculomotor behaviors (frequency and amplitude of eye- and head-movements) are evaluated very quickly during the drive itself by dynamic overlay pictures indicating where the subjects gaze is located on the screen, and by analyzing the data. Compensatory gaze behavior in a patient leads to a driving performance comparable to a healthy control, while the performance of a patient without compensatory behavior is significantly worse. The data of eye- and head-movement-behavior as well as driving performance are discussed with respect to different oculomotor strategies and in a broader context with respect to possible training effects throughout the testing session and implications on rehabilitation potential.
File Format	HTM / HTML
e-ISSN	1940087X
DOI	10.3791/4427
Journal	Journal of Visualized Experiments
Issue Number	67
Language	English
Publisher	MyJove Corp.
Publisher Date	2012-09-18
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Physical Sciences Discipline Life Sciences Discipline Medicine Automobile Driving Computer Simulation Hemianopsia Physiopathology Activities Of Daily Living Case-control Studies Exploratory Behavior Physiology Eye Movement Measurements Eye Movements Head Movements Rehabilitation Psychomotor Performance Visual Fields Research Support, Non-u.s. Gov't Video-audio Media
Content Type	Text
Resource Type	Article

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