scholarly journals Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study

10.2196/24373 ◽  
2021 ◽  
Vol 23 (3) ◽  
pp. e24373
Author(s):  
Morgane Casanova ◽  
Anne Clavreul ◽  
Gwénaëlle Soulard ◽  
Matthieu Delion ◽  
Ghislaine Aubin ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eye Tracking ◽  
Brain Mapping ◽  
Eye Gaze ◽  
Standard Procedure ◽  
Naming Task ◽  
Evaluation Study ◽  
Awake Surgery ◽  
Brain Surgery ◽  
Language Mapping

Background Language mapping during awake brain surgery is currently a standard procedure. However, mapping is rarely performed for other cognitive functions that are important for social interaction, such as visuospatial cognition and nonverbal language, including facial expressions and eye gaze. The main reason for this omission is the lack of tasks that are fully compatible with the restrictive environment of an operating room and awake brain surgery procedures. Objective This study aims to evaluate the feasibility and safety of a virtual reality headset equipped with an eye-tracking device that is able to promote an immersive visuospatial and social virtual reality (VR) experience for patients undergoing awake craniotomy. Methods We recruited 15 patients with brain tumors near language and/or motor areas. Language mapping was performed with a naming task, DO 80, presented on a computer tablet and then in 2D and 3D via the VRH. Patients were also immersed in a visuospatial and social VR experience. Results None of the patients experienced VR sickness, whereas 2 patients had an intraoperative focal seizure without consequence; there was no reason to attribute these seizures to virtual reality headset use. The patients were able to perform the VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the virtual reality headset directly. Conclusions We found that it is possible and safe to immerse the patient in an interactive virtual environment during awake brain surgery, paving the way for new VR-based brain mapping procedures. Trial Registration ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943.

scholarly journals Immersive Virtual Reality and Ocular Tracking for Brain Mapping During Awake Surgery: Prospective Evaluation Study (Preprint)

2020 ◽  
Author(s):  
Morgane Casanova ◽  
Anne Clavreul ◽  
Gwénaëlle Soulard ◽  
Matthieu Delion ◽  
Ghislaine Aubin ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eye Tracking ◽  
Brain Mapping ◽  
Eye Gaze ◽  
Standard Procedure ◽  
Naming Task ◽  
Evaluation Study ◽  
Awake Surgery ◽  
Brain Surgery ◽  
Language Mapping

BACKGROUND Language mapping during awake brain surgery is currently a standard procedure. However, mapping is rarely performed for other cognitive functions that are important for social interaction, such as visuospatial cognition and nonverbal language, including facial expressions and eye gaze. The main reason for this omission is the lack of tasks that are fully compatible with the restrictive environment of an operating room and awake brain surgery procedures. OBJECTIVE This study aims to evaluate the feasibility and safety of a virtual reality headset equipped with an eye-tracking device that is able to promote an immersive visuospatial and social virtual reality (VR) experience for patients undergoing awake craniotomy. METHODS We recruited 15 patients with brain tumors near language and/or motor areas. Language mapping was performed with a naming task, DO 80, presented on a computer tablet and then in 2D and 3D via the VRH. Patients were also immersed in a visuospatial and social VR experience. RESULTS None of the patients experienced VR sickness, whereas 2 patients had an intraoperative focal seizure without consequence; there was no reason to attribute these seizures to virtual reality headset use. The patients were able to perform the VR tasks. Eye tracking was functional, enabling the medical team to analyze the patients’ attention and exploration of the visual field of the virtual reality headset directly. CONCLUSIONS We found that it is possible and safe to immerse the patient in an interactive virtual environment during awake brain surgery, paving the way for new VR-based brain mapping procedures. CLINICALTRIAL ClinicalTrials.gov NCT03010943; https://clinicaltrials.gov/ct2/show/NCT03010943.

scholarly journals Immersing Patients in a Virtual Reality Environment for Brain Mapping During Awake Surgery: Safety Study

2020 ◽  
Vol 134 ◽  
pp. e937-e943 ◽  
Author(s):  
Matthieu Delion ◽  
Evelyne Klinger ◽  
Florian Bernard ◽  
Ghislaine Aubin ◽  
Aram Ter Minassian ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Brain Mapping ◽  
Awake Surgery ◽  
Virtual Reality Environment ◽  
Safety Study

scholarly journals Language Assessment in Multilingualism and Awake Neurosurgery

2021 ◽  
Vol 15 ◽  
Author(s):  
Maria De Martino ◽  
Andrea Talacchi ◽  
Rita Capasso ◽  
Annapina Mazzotta ◽  
Gabriele Miceli
Keyword(s):  
Standardized Testing ◽  
Language Assessment ◽  
Naming Task ◽  
Awake Surgery ◽  
Linguistic Features ◽  
Language Mapping ◽  
Great Heterogeneity ◽  
Critical Issues ◽  
Worldwide Phenomenon ◽  
Cortical Regions

Multilingualism has become a worldwide phenomenon that poses critical issues about the language assessment in patients undergoing awake neurosurgery in eloquent brain areas. The accuracy and sensitivity of multilingual perioperative language assessment procedures is crucial for a number of reasons: they should be appropriate to detect deficits in each of the languages spoken by the patient; they should be suitable to identify language-specific cortical regions; they should ensure that each of the languages of a multilingual patient is tested at an adequate and comparable level of difficulty. In clinical practice, a patient-tailored approach is generally preferred. This is a necessary compromise since it is impossible to predict all the possible language combinations spoken by individuals and thus the availability of standardized testing batteries is a potentially unattainable goal. On the other hand, this leads to high inconsistency in how different neurosurgical teams manage the linguistic features that determine similarity or distance between the languages spoken by the patient and that may constrain the neuroanatomical substrate of each language. The manuscript reviews the perioperative language assessment methodologies adopted in awake surgery studies on multilingual patients with brain tumor published from 1991 to 2021 and addresses the following issues: (1) The language selected for the general neuropsychological assessment of the patient. (2) The procedures adopted to assess the dimensions that may constrain language organization in multilingual speakers: age and type of acquisition, exposure, proficiency, and use of the different languages. (3) The type of preoperative language assessment used for all the languages spoken by the patient. (4) The linguistic tasks selected in the intraoperative setting. The reviewed data show a great heterogeneity in the perioperative clinical workup with multilingual patients. The only exception is the task used during language mapping, as the picture naming task is highly preferred. The review highlights that an objective and accurate description of both the linguistic profile of multilingual patients and the specific properties of the languages under scrutiny can profitably support clinical management and decision making in multilingual awake neurosurgery settings.

Virtual Reality-assisted awake brain mapping. (Preprint)

2021 ◽  
Author(s):  
Florian Bernard ◽  
Morgane Casanova ◽  
Anne Clavreul ◽  
Ghislaine Aubin ◽  
Gwenaelle Soulard ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Social Cognition ◽  
Visual Field ◽  
Brain Mapping ◽  
Cognitive Functions ◽  
Total Duration ◽  
Spatial Neglect ◽  
Brain Surgery ◽  
Duration Of Surgery ◽  
The Mean

BACKGROUND Preserving major cognitive functions, such as visuo-spatial and social cognition in the surgical management of brain tumors could be decisive for the postoperative quality of life. Using virtual reality during awake brain surgery appears to be interesting for preserving complex cognitive functions. Developing neuropsychological tasks appropriate for use during awake brain surgery using virtual reality technology is challenging. OBJECTIVE In this paper, we describe our preliminary experience of extending progressively complex cognitive paradigms via dynamic VR environments during 68 peri-operative brain mapping. METHODS This is a single center, retrospective longitudinal study, concerning two cohorts. RESULTS A total of 65 patients (30 women, mean age 49.7, range 23-75) operated with VR-assisted Brain mapping were included. At least one VR task (VR-DO 80, VR Estermann or VR-TANGO task) during DES were done for all the patients. The mean duration of surgery was 4 h 30 min, the mean duration of the awake phase was 2 h 15 min. The mean intensity used for DES was 3 mA (Intensity from 0,5 to 8 mA). Mean total duration of VRH use per patient at 16 min (from 10 to 37 min). VR task allowed to preserve language, visual field, visuospatial and social cognition in our serie. CONCLUSIONS We show through illustrative cases how VR opens new possibilities for the mapping of complex cognitive functions within the operating theater. CLINICALTRIAL ClinicalTrials.gov NCT03010943Virtual reality; awake neurosurgery; visual field; social cognition; visuospatial cognition; unilateral spatial neglect. INTERNATIONAL REGISTERED REPORT RR2-10.2196/10332.

Cortical calculation localization using electrostimulation

2009 ◽  
Vol 110 (6) ◽  
pp. 1291-1299 ◽  
Author(s):  
Franck-Emmanuel Roux ◽  
Leila Boukhatem ◽  
Louisa Draper ◽  
Oumar Sacko ◽  
Jean-François Démonet
Keyword(s):  
Brain Mapping ◽  
Parietal Lobe ◽  
Naming Task ◽  
Brain Lesions ◽  
Awake Surgery ◽  
Mapping Procedure ◽  
Cortical Areas ◽  
Surgical Data ◽  
Calculation Task ◽  
Language Areas

Object A naming task has been used to spare cortical areas involved in language. In the present study, a calculation task was combined with electrostimulation mapping (awake surgery) to spare cortical areas involved in calculation in patients undergoing surgery for brain lesions. The organization of language and calculation areas was analyzed in relation to these surgical data. Methods Twenty patients with brain lesions close to areas possibly involved in calculation (dominant parietal lobe and F2) were prospectively studied over a 4-year period. Four patients had preoperative symptoms of acalculia and therefore were not included in the brain mapping procedure. Results In 16 patients, direct electrostimulation caused calculation interferences in localized small cortical areas (< 2 cm2). Of the 53 calculation interferences found, 23 were independent of language areas, especially those in the inferior left parietal lobule. Various patterns of interference were observed (11 complete acalculia, 5 acalculia with wrong answers, 2 hesitations, and 5 mixed responses), although error patterns were fairly similar across angular, parietal, and frontal stimulation sites. Calculation areas in 4 patients could not be spared for oncological reasons; postoperatively, 3 of these patients showed significant acalculia symptoms. In contrast, none of the patients whose calculation areas were spared had arithmetic difficulties 1 month after surgery. Improvements in acalculia symptoms after surgery were also found in 3 of the 4 patients with preoperative calculation difficulties. Conclusions To limit the risk of personal and professional disturbances caused by acquired anarithmetia in patients undergoing surgery for brain tumors or epilepsy, the authors think it is necessary to use a calculation task during brain mapping, especially when operating in the dominant parietal lobe.

scholarly journals Assessing expertise using eye tracking in a Virtual Reality flight simulation

2022 ◽  
Author(s):  
David Harris ◽  
Tom Arthur ◽  
Toby de Burgh ◽  
Mike Duxbury ◽  
Ross Lockett-Kirk ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eye Movements ◽  
Eye Tracking ◽  
Real World ◽  
Eye Gaze ◽  
Cost Effective ◽  
Flight Simulation ◽  
Training Tool ◽  
Gaze Patterns ◽  
Scaling Analyses

Objective: The aim of this work was to examine the fidelity and validity of an aviation simulation using eye tracking. Background: Commercial head-mounted virtual reality (VR) systems offer a convenient and cost-effective alternative to existing aviation simulation (e.g., for refresher exercises). We performed pre-implementation testing of a novel aviation simulation, designed for head-mounted VR, to determine its fidelity and validity as a training device. Method: Eighteen airline pilots, with varying levels of flight experience, completed a sequence of training ‘flows’. Self-reported measures of presence and workload and users’ perceptions of fidelity were taken. Pilots’ eye movements and performance were recorded to determine whether more experienced pilots showed distinct performance and eye gaze profiles in the simulation, as they would in the real-world. Results: Real-world expertise correlated with eye gaze patterns characterised by fewer, but longer, fixations and a scan path that was more structured and less random. Multidimensional scaling analyses also indicated differential clustering of strategies in more versus less experienced pilots. Subjective ratings of performance, however, showed little relationship with real-world expertise or eye movements. Conclusion: We adopted an evidence-based approach to assessing the fidelity and validity of a VR flight training tool. Pilot reports indicated the simulation was realistic and potentially useful for training, while direct measurement of eye movements was useful for establishing construct validity and psychological fidelity of the simulation.

Eye movements in sports research and practice: Immersive technologies as optimal environments for the study of gaze behaviour

2020 ◽  
Author(s):  
David Harris ◽  
Mark Wilson ◽  
Tim Holmes ◽  
Toby de Burgh ◽  
Samuel James Vine
Keyword(s):  
Virtual Reality ◽  
Eye Movements ◽  
Eye Tracking ◽  
Visual Information ◽  
Successful Performance ◽  
Experimental Control ◽  
Research And Practice ◽  
Gaze Behaviour ◽  
Immersive Technologies

Head-mounted eye tracking has been fundamental for developing an understanding of sporting expertise, as the way in which performers sample visual information from the environment is a major determinant of successful performance. There is, however, a long running tension between the desire to study realistic, in-situ gaze behaviour and the difficulties of acquiring accurate ocular measurements in dynamic and fast-moving sporting tasks. Here, we describe how immersive technologies, such as virtual reality, offer an increasingly compelling approach for conducting eye movement research in sport. The possibility of studying gaze behaviour in representative and realistic environments, but with high levels of experimental control, could enable significant strides forward for eye tracking in sport and improve understanding of how eye movements underpin sporting skills. By providing a rationale for virtual reality as an optimal environment for eye tracking research, as well as outlining practical considerations related to hardware, software and data analysis, we hope to guide researchers and practitioners in the use of this approach.

Neurocognitive and functional outcomes in patients with diffuse frontal lower-grade gliomas undergoing intraoperative awake brain mapping

2020 ◽  
Vol 132 (6) ◽  
pp. 1683-1691 ◽  
Author(s):  
Kazuya Motomura ◽  
Lushun Chalise ◽  
Fumiharu Ohka ◽  
Kosuke Aoki ◽  
Kuniaki Tanahashi ◽  
...  
Keyword(s):  
Working Memory ◽  
Brain Mapping ◽  
Functional Outcomes ◽  
Digit Span ◽  
Awake Surgery ◽  
Motor Deficit ◽  
Lower Grade ◽  
Superior Frontal Gyrus ◽  
Neurocognitive Functions ◽  
Motor Disturbances

OBJECTIVELower-grade gliomas (LGGs) are often observed within eloquent regions, which indicates that tumor resection in these areas carries a potential risk for neurological disturbances, such as motor deficit, language disorder, and/or neurocognitive impairments. Some patients with frontal tumors exhibit severe impairments of neurocognitive function, including working memory and spatial awareness, after tumor removal. The aim of this study was to investigate neurocognitive and functional outcomes of frontal LGGs in both the dominant and nondominant hemispheres after awake brain mapping.METHODSData from 50 consecutive patients with diffuse frontal LGGs in the dominant and nondominant hemispheres who underwent awake brain surgery between December 2012 and September 2018 were retrospectively analyzed. The goal was to map neurocognitive functions such as working memory by using working memory tasks, including digit span testing and N-back tasks.RESULTSDue to awake language mapping, the frontal aslant tract was frequently identified as a functional boundary in patients with left superior frontal gyrus tumors (76.5%). Furthermore, functional boundaries were identified while evaluating verbal and spatial working memory function by stimulating the dorsolateral prefrontal cortex using the digit span and visual N-back tasks in patients with right superior frontal gyrus tumors (7.1%). Comparing the preoperative and postoperative neuropsychological assessments from the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III) and Wechsler Memory Scale–Revised (WMS-R), significant improvement following awake surgery was observed in mean Perceptual Organization (Z = −2.09, p = 0.04) in WAIS-III scores. Postoperative mean WMS-R scores for Visual Memory (Z = −2.12, p = 0.03) and Delayed Recall (Z = −1.98, p = 0.04) were significantly improved compared with preoperative values for every test after awake surgery. No significant deterioration was noted with regard to neurocognitive functions in a comprehensive neuropsychological test battery. In the postoperative course, early transient speech and motor disturbances were observed in 30.0% and 28.0% of patients, respectively. In contrast, late permanent speech and motor disturbances were observed in 0% and 4.0%, respectively.CONCLUSIONSIt is noteworthy that no significant postoperative deterioration was identified compared with preoperative status in a comprehensive neuropsychological assessment. The results demonstrated that awake functional mapping enabled favorable neurocognitive and functional outcomes after surgery in patients with diffuse frontal LGGs.

scholarly journals Techniques Used for Eye Gaze Interfaces and Survey

2015 ◽  
Vol 1 (6) ◽  
pp. 276
Author(s):  
Maria Rashid ◽  
Wardah Mehmood ◽  
Aliya Ashraf
Keyword(s):  
Eye Tracking ◽  
Eye Gaze ◽  
3D Models ◽  
Image Process ◽  
Usability Problems ◽  
Software Algorithms ◽  
Pupil Detection ◽  
Eye Movement Tracking ◽  
2D And 3D ◽  
Movement Tracking

Eye movement tracking is a method that is now-a-days used for checking the usability problems in the contexts of Human Computer Interaction (HCI). Firstly we present eye tracking technology and key elements.We tend to evaluate the behavior of the use when they are using the interace of eye gaze. Used different techniques i.e. electro-oculography, infrared oculography, video oculography, image process techniques, scrolling techniques, different models, probable approaches i.e. shape based approach, appearance based methods, 2D and 3D models based approach and different software algorithms for pupil detection etc. We have tried to compare the surveys based on their geometric properties and reportable accuracies and eventually we conclude this study by giving some prediction regarding future eye-gaze. We point out some techniques by using various eyes properties comprising nature, appearance and gesture or some combination for eye tracking and detection. Result displays eye-gaze technique is faster and better approach for selection than a mouse selection. Rate of error for all the matters determines that there have been no errors once choosing from main menus with eye mark and with mouse. But there have been a chance of errors when once choosing from sub menus in case of eye mark. So, maintain head constantly in front of eye gaze monitor.

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