Name: virtual prism adaptation therapy: protocol for validation in healthy adults
Uploaded: 2020-02-12T12:30:00
Description: Watch this Scientific Journal Video about Virtual Prism Adaptation Therapy: Protocol for Validation in Healthy Adults at JoVE.com

这项研究得到了首尔国立大学邦当医院研究基金（14-2015-022）和韩国贸易产业和能源部（韩国交通部）、科学与信息通信技术部（MSIT，韩国）以及韩国厚生劳动省（MOHW，韩国）的支持。）根据AI-生物机器人-医学融合技术发展计划（20001650）。我们要感谢朴素斌、金努丽和张叶琳帮助准备和继续拍摄录像。

所有程序都经过首尔国立大学邦当医院机构审查委员会（IRB）的审查和批准。为了招募健康的参与者，医院周围都使用海报做广告。
1. 实验设置
<ol><li>参与者招聘<ol>
<li>使用以下包含标准执行受试者筛选过程：1） 健康，年龄在 18 到 50 岁之间;2）右手，经爱丁堡手部库存评估14;3） 能够佩戴用于 VR 的头部安装显示屏并检测 VR 中的物体;4） 没有影响大脑的?...

<ol>
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Y., Zhou, D., Chung, R. C., Li-Tsang, C. W., Fong, K. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Rehabilitation interventions for unilateral neglect after stroke: a systematic review from 1997 through 2012. , (2013).</li><li>Rossetti, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prism+adaptation+to+a+rightward+optical+deviation+rehabilitates+left+hemispatial+neglect.">Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect.</a> Nature. 395 (6698), 166-169 (1998).</li><li>Barrett, A., Goedert, K. M., Basso, J. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prism+adaptation+for+spatial+neglect+after+stroke:+translational+practice+gaps.">Prism adaptation for spatial neglect after stroke: translational practice gaps.</a> Nature Reviews Neurology. 8 (10), 567-577 (2012).</li><li>Maxton, C., Dineen, R., Padamsey, R., Munshi, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Don't+neglect+'neglect'-an+update+on+post+stroke+neglect.">Don't neglect 'neglect'-an update on post stroke neglect.</a> International Journal of Clinical Practice. 67 (4), 369-378 (2013).</li><li>Gammeri, R., Turri, F., Ricci, R., Ptak, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adaptation+to+virtual+prisms+and+its+relevance+for+neglect+rehabilitation:+a+single-blind+dose-response+study+with+healthy+participants.">Adaptation to virtual prisms and its relevance for neglect rehabilitation: a single-blind dose-response study with healthy participants.</a> Neuropsychol Rehabilitation. , 1-14 (2018).</li><li>Saj, A., Cojan, Y., Assal, F., Vuilleumier, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prism+adaptation+effect+on+neural+activity+and+spatial+neglect+depend+on+brain+lesion+site.">Prism adaptation effect on neural activity and spatial neglect depend on brain lesion site.</a> Cortex. 119, 301-311 (2019).</li><li>Redding, G. M., Wallace, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Generalization+of+prism+adaptation.">Generalization of prism adaptation.</a> Journal of Experimental Psychology: Human Perception and Performance. 32 (4), 1006-1022 (2006).</li><li>Caplan, B., Mendoza, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Encyclopedia of Clinical Neuropsychology. , 928 (2011).</li><li>Kim, W. S., Paik, N. J., Cho, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> 2017 International Conference on Virtual Rehabilitation (ICVR). , 1-2 (2017).</li><li>Munafo, J., Diedrick, M., Stoffregen, T. 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本研究在VR环境中采用翻译的手部运动，实施棱镜适应疗法。它调查了所实施的偏差是否会导致角度过冲和行为适应，如在传统的棱镜适应疗法中。
在中值点误差结果（图5）和第一个指向误差结果中，当相位切换时，指针误差显著变化。虽然消除了一些手识别错误，但可能仍然存在错误检测。使用中值消除系统误差（如错误跟踪）表明平均指向误差结?...

空间忽视，影响感知反向空间视场的能力，是中风1，2后常见的损伤。虽然后空间忽视的康复是重要的，由于其与不良的功能和社会结果的联系，康复往往没有得到充分利用在实际临床实践3，4。
在建议对肝空间忽视的各种现有康复方法中，棱镜适应（PA）疗法已证明对亚急性或慢性中风患者5、6、7、8的康复和改善其忽视效果。然而，传统的PA没有得到充分利用，由于几个缺点9，10。其中包括1）由于棱镜镜头需要改变以调整到偏差程度而要求高的成本和时间要求;2） 需要设置额外的材料，以指向和掩盖手轨迹;3） PA 只能由可以坐并控制头部位置的患者使用。
最近一项复制虚拟现实（VR）环境中适应效果的研究表明，虚拟棱镜适应疗法（VPAT）可能有不同的效果，这取决于忽略11的亚型。还有人建议，PA的皮质活化可能因脑病变12而异。然而，在VR诱导的PA中看到的皮质激活模式知之甚少。
为了克服这些障碍并促进在临床环境中使用PA，我们开发了一个新的PA治疗系统，使用一种称为虚拟棱镜适应疗法（VPAT）的沉浸式VR技术，通过使用深度感应相机。我们设计了一个身临其境的VR系统，能够提供有关虚拟肢体位置的视觉反馈，以促进空间调整13。使用这种模仿传统PA效果的沉浸式VR技术，我们设计了一个实验，在健康的参与者中验证VPAT系统。
通过执行可视化实验协议，我们研究了新的VPAT系统是否能诱导行为适应，类似于传统的PA。此外，我们还要探讨VPAT系统是否能诱导与视点感知相关的皮质区域激活，或者在中风后恢复空间忽视。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>EASYCAP</td>
			<td>Easycap</td>
			<td>C-SAMS</td>
			<td>Platform to accommodate fNIRS optodes</td>
		</tr>
		<tr>
			<td>Leap Motion 3D Motion Controller</td>
			<td>Ultrahaptics</td>
			<td>FBA_LM-C01-US</td>
			<td>Hand detection device attached HMD</td>
		</tr>
		<tr>
			<td>Leap Motion VR Developer Mount for VR Headset</td>
			<td>Ultrahaptics</td>
			<td>VR-UAZ</td>
			<td></td>
		</tr>
		<tr>
			<td>Matlab R2015a</td>
			<td>Mathworks</td>
			<td></td>
			<td>Programming language running with NIRStar</td>
		</tr>
		<tr>
			<td>NIRScout</td>
			<td>Medical Technology LLC</td>
			<td>NSC-CORE</td>
			<td>fNIRS system</td>
		</tr>
		<tr>
			<td>nirsLAB v201605</td>
			<td>Medical Technology LLC</td>
			<td></td>
			<td>Software for analyzing data collected with NIRScout</td>
		</tr>
		<tr>
			<td>NIRStar 14.1</td>
			<td>Medical Technology LLC</td>
			<td></td>
			<td>NIRScout Acquisition Software</td>
		</tr>
		<tr>
			<td>Occulus Rift DK2</td>
			<td>Occulus</td>
			<td></td>
			<td>VR HMD</td>
		</tr>
		<tr>
			<td>PowerMate USB Multimedia Controller</td>
			<td>Griffin Technology</td>
			<td>NA16029</td>
			<td>Push Button in task</td>
		</tr>
		<tr>
			<td>SuperLab 5.0</td>
			<td>Cedrus Corp.</td>
			<td></td>
			<td>Synchronize the stimulus presentations allied to NIRScout</td>
		</tr>
	</tbody>
</table>

virtual prism adaptation therapy: protocol for validation in healthy adults

行程后，空间忽视是常见的损伤。它与不良的功能和社会结果有关。因此，对空间忽视的成功管理，必须进行适当的干预。然而，各种干预措施的临床使用在实际临床实践中是有限的。棱镜适应疗法是治疗空间忽视的最循证康复方式之一。为了克服棱镜治疗可能出现的任何缺点，我们开发了一套使用沉浸式虚拟现实和深度感应相机的新系统，以创建虚拟棱镜适应疗法 （VPAT）。为了验证VPAT系统，我们设计了一个实验协议，通过VPAT系统调查皮质激活中的行为错误和变化。皮质活化是通过功能近红外光谱（fNIRS）测量的。实验包括四个阶段。这四个包括点击，指向或休息适用于右手健康的人。单击与指向用于调查与总电机任务相关的皮质区域，使用 VPAT 与无 VPAT 指向的指针用于调查与视空间感知相关的皮质区域。四个健康的参与者的初步结果显示，VPAT系统的指向误差类似于传统的棱镜适应疗法。可能需要对更多的参与者和fNIRS数据进行进一步分析，以及对中风患者的研究。

使用4名健康参与者（1男3女）的数据作为代表性结果。点向误差如图5A所示，每个指向任务的子阶段中中位数为10个试验的平均值，持续30小时。 每个阶段第一块中值指向误差的平均值为 0.45 ± 0.92（VPAT 前）、4.69 ± 3.08 （VPAT 10°）、5.43 ± 2.22 （VPAT 20°） 和 -5.17 ± 1.60（VPAT 后）。通过重复度量方差分析，指向误差变化的趋势具有统计显著性（p = 0.001）。<strong clas...

Watch this Scientific Journal Video about Virtual Prism Adaptation Therapy: Protocol for Validation in Healthy Adults at JoVE.com

Virtual Prism Adaptation Therapy: Protocol for Validation in Healthy Adults

该实验方案演示了虚拟棱镜适应疗法（VPAT）在健康成人中的应用，以及VPAT与功能近红外光谱学之间的关联，以确定VPAT对皮质活化的影响。结果表明，VPAT是可行的，可以诱导类似的行为适应作为传统的棱镜适应疗法。

虚拟棱镜适应疗法：健康成人验证协议

Hemispatial neglect is a common impairment after stroke. It is associated with poor functional and social outcomes. Therefore, an adequate intervention is ...

我们的实验方案可以解决棱镜适应疗法是否对肝空间忽视患者有效，以及我们的虚拟棱镜适应治疗系统是否促进空间调整和皮质激活。与传统的棱镜适应疗法相比，虚拟棱镜适应疗法的成本更低、设置更快、更容易调整。这种技术可以用来取代传统的棱镜疗法在患者的半空间忽视，因为它可以模仿传统的棱镜适应的影响。这种方法暗示了将虚拟现实用于中风治疗的潜力，并可能深入了解虚拟康复领域的肝空间忽视康复。虽然该系统是基于虚拟现实游戏引擎，因此很容易使用。一定要做好准备。对于功能性近红外光谱测量设置，请让学员坐在一张直背的椅子上，确认参与者的手在伸出手时不会撞到桌子。接下来，根据参与者的头部周长选择适当的功能近红外光谱大小，并在参与者的头上放置盖，使顶点位于 inion 和 nasion 之间的中点和左前线区域和右前线区域之间的中点交汇处。在屏幕上显示蒙太奇，将 15 个源和 24 个探测器连接到蒙太奇。在插入视光器之前，使用导电凝胶改善光源的增益（如果关键的话）并将固定盖放在参与者上。要设置软件，运行功能近红外光谱系统软件，并加载忽略蒙太奇。屏幕上显示蒙太奇时，根据蒙太奇设置 15 个源和 24 个探测器，然后单击校准。要校准虚拟棱镜自适应治疗系统，首先将虚拟现实头安装显示屏安装在功能近红外光谱帽上，注意避免干扰盖。当显示屏就位时，打开虚拟棱镜适应治疗软件并输入参与者的信息。单击"开始"并确认显示屏中虚拟手的可视化效果。启动两步校准，并指示学员观看屏幕中央的红色十字标记。然后按 R 键校准屏幕。指示学员用右手指向目标。然后按 O 键校准手部位置。应提供足够的空间用于手部范围内的校准，并且手不应拉伸得太远，无法设定目标位置。在校准结束时，确认参与者是否准备好开始实验，并在没有棱镜模式的情况下启动系统。单击开始键以启动具有四个阶段的实验，同时进行功能性近红外光谱记录，并指示参与者在出现或休息相应图标的三秒内用右手食指指向或单击。在虚拟棱镜自适应模式下，设置的偏差角度会导致虚拟手部偏差。绿色手是实际的手识别位置，不显示给用户。蓝色手是向用户显示的偏离手。在偏差模式下，用户的手向左伸展，以保持用户的手越来越接近目标。对于单击块，指示参与者按下按钮。每个阶段将由用于指向、单击或休息的块组成。在此代表性图表中，显示四个健康参与者的指向误差，每个指向任务持续 30 秒的子阶段中 10 个试验的中位数平均值。在这里，每个主题的指向误差被呈现在虚拟棱镜适应治疗阶段和后棱镜适应阶段演示适应。使用屏幕校准将虚拟空间放在用户的视觉范围前面，并使用目标距离校准将目标放在用户触手可及的位置。我们研究了健康的成人志愿者，但这项技术可以用于临床患者。此外，将数据与实棱镜类进行比较可能很有意义。

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As new techniques are developed to image adipose tissue, methods to validate such protocols are becoming increasingly important. Phantoms, experimental ...

Multi-Modal Home Sleep Monitoring in Older Adults

老年人多式家庭睡眠监测

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...