Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke.

Spatial neglect is a common and severe cognitive consequence of stroke, yet there is currently no effective rehabilitation tool. Virtual Reality (VR) telerehabilitation tools have the potential to provide multisensory and enjoyable therapies and remotely monitor adherence without the presence of a therapist at all times. Researchers and industry need to better understand end-user perspectives about these technologies to ensure these are acceptable and, ultimately, optimize adherence and efficacy. This study aims to explore end-user perspectives on the use of self-administered VR for spatial neglect in a university environment to identify barriers and facilitators prior to extending its use remotely as a telerehabilitation tool. We used a mixed-method design including focus groups, self-administered questionnaires and interviews with stroke survivors (N = 7), their carers (N = 3) and stroke clinicians (N = 6). End-user perspectives identified clarity of instructions, equipment (cost, available resources) and for some, level of experience with technology as barriers of use. Perceived facilitators were performance feedback, engagement and enjoyment, and psychological benefits associated with self-administered VR telerehabilitation. Overall, end-users were positive and interested in using VR telerehabilitation for spatial neglect. These perspectives enabled us to produce practical recommendations to inform development, enhance engagement and uptake of VR telerehabilitation and inform future studies.

Physical aggression and attentional bias to angry faces: An event related potential study.

This study aimed to identify the neural correlates of aggression-related attentional selectivity to angry faces in physical aggression. Physical aggression in a non-clinical sample of young men (N = 36) was measured using an aggression questionnaire. Visual attentional bias to angry faces was assessed using a dot-probe task during which angry and neutral faces were presented simultaneously, and EEG was recorded. Median split and correlational analyses were conducted to assess the relationship between physical aggression and attentional bias. Behavioural results indicated that higher levels of physical aggression were associated with greater attentional bias to angry faces. ERP results revealed an interaction where males with higher physical aggression had undifferentiated P3 amplitudes to angry and neutral trials, whereas low physical aggression males exhibited greater P3 amplitude to angry than to neutral trials (effect of probe congruency). Increased levels of physical aggression were also significantly correlated with increased P3 amplitude to probes replacing neutral faces, relative to angry faces. It was concluded that the aggressive males selectively attend to angry faces, and that attentional bias is characterized by undifferentiated P3 amplitude. We propose that this results from an inferior ability to downregulate competing angry face distractors when responding to probes replacing neutral faces (as reflected by the P3 response). These findings indicate that attentional bias to angry faces in individuals with higher physical aggression is characterized by a distinctive ERP signature; this could inform the development of therapeutic interventions seeking to reduce aggression.

WITHDRAWN: Physical aggression and attentional bias to angry faces: An event related potential study.

This article has been withdrawn at the request of the authors. The authors have opted to update their article and have resubmitted it to the journal as a new submission. The updated article has now been accepted and can be found here: https://doi.org/10.1016/j.brainres.2019.146387. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.