1995 VR Conference Proceedings

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Virtual Reality: A new way to design neurological tools

Rita Addison, M.A.
Internet: raddison@world.std.com
VoiceMail in U.S.: 1-800-674-8025 code 3024

ABSTRACT

What are the unique characteristics of virtual reality that make development of new neurological assessment and rehabilitation tools possible? How can this be used to help patients and their families, scientists, physicians and rehabilitation providers? How will the new applications differ (supplement/complement) current state-of-the-art brain trauma evaluation methods including multimodality medical imaging and neuropsychological testing?

The author, a traumatic brain injury survivor, explains how her experiences with creating virtual reality art environments convinced her that this unique medium can lead to new understanding of neuroperceptual states. When I spoke here last year about a virtual art environment I was building to learn more about my own brain injury, "DETOUR: Brain Deconstruction Ahead," I described the questions driving my efforts: 1. Since I could no longer pursue art as I had before, would I ever re-experience that state of “creative eye?” 2. As a patient, I was frustrated and demoralized at the inadequacy of medical testing to tell me what was wrong and how to go about either adapting, compensating, accepting or trying to rehabilitate my perceptual anomalies. 3. Fellow traumatic brain injury survivors shared their similar frustrations and fears. As a person with counseling academic degrees and training -how could I learn from my personal experience and build it into something that might help others?

Today I'll be showing a videotape of "DETOUR:" and describe how people reacted to it when I first showed it at SIGGRAPH '94. Here are a few of their comments: --"Now that I've experienced what it’s like to have my own senses temporarily impaired, I can understand my spouse (child, parent, friend, etc) who recently had a head trauma in a much deeper way." --"Finally, here's a way physicians can empathize with their patients. It should be in every medical school curriculum." I'm now working on a new virtual reality project entitled, "Synesthesia." at the Electronic Visualization Laboratory at the University of Illinois at Chicago. Directors Tom DeFanti and Dan Sandin created the "CAVE"- a room sized immersive environment with 3D graphics, ound, and interactivity. It is ideally suited to users with varying perceptual and physical capabilities. This is unencumbered vr-at its best: no headmounted display; no boom; just you interacting directly with your computer generated world.

While the CAVE is a powerfully enriched environment, there are still substantial audiovisual "gaps" which the user must recognize as "filled in" in order to achieve total perceptual engagement. I likened this to the situation in which a patient is undergoing brain injury assessment based solely on medical imaging and tests such as the neuropsychological battery. A prominent "gap" showed up between what they could measure vs. what the person with "moderate" brain injury reported as happening to them every hour of every day. Could there be a correlation between these two types of gaps: within vr and within the altered perceptual state of individual patients? Both deal with perceptual dynamics at a threshold below what current equipment is designed to measure. Secondly, they both deal with interactivity. What research and equipment would be required to explore this question? For example, efforts are underway in neurology to discover how to address interactivity as the pivotal dynamic in brain injury. While neurons are incapable of regenerating themselves, dendrites can grow new network connections. But exactly what stimulates these new connections? How can we measure them non-invasively? how can we create situations in which we can optimize their potential regrowth? Likewise, in virtual reality, how can we learn how people naturally fill in gaps? Is there a way to engineer vr as a diagnostic process in which we deliberately test for sub- threshold perceptual interactivity? How do we go about using this as a tool by which more effective patient care can be drawn? At the Milan Hospital in Italy, Cyberfunk Inc. is working on a prototype vr program, "The Castle" using a head mounted display.

Early observations confirm the possibility of testing cognitive abilities such as sequencing by designing an environment in which the patient has to pick up certain cues to move from one location to another. Dr. Albert Rizzo (Cyberpsych Associates, 1629 Steinhart Ave., Redondo Beach, CA 90278) has evaluated the "Castle" program and is currently working with industry to develop virtual reality training and rehabilitation environments. He is also a speaker at this conference. Dr. Guiseppe Riva,of the Centro Auxologico Italiano- I.R.C.C.S at Milan, Italy,(a speaker at this 1995 conference on VR & Disabilities) is involved in a project entitled, Virtual Reality Environments for Psychoneurophysiological Assessment and Rehabilitation (VREPAR) . Their proposal states that their main objective is to develop a virtual reality system (Virtual Reality All-purpose Modular Systen - VRAMS), based on a modular architecture to be used for psychoneurophysiological assessment and rehabilitation.

My co-presenter today, David Warner, M.D. (davew@well.sf.ca.us) from the Loma Linda Medical Center has worked over the past several years with the BioMuse, a product from BioControl Inc. (anthony@biomuse.netcom.com) in Palo Alto, California. It isconfigured somewhat like an EEG acquisition: electrodes measuring biosignals from the body. Dr. Warner has taught some of his pediatric patients how to utilize these programs to regain a degree of independence and environmental control. For example, a 3 year old quadraplegic can be hooked up to the BioMuse and then use any residual muscle electrical activity they still have to move a cursor on a computer monitor. From there they can rejoin other children in the critical activity of play. They can even "drive" a toy car because they can manipulate their brow.

Dr. Warner is now designing his own biosignal hardware and has started working with pediatric patients with cerebral palsy. In my work at the University of Illinois’ Electronic Visualization Laboratory my team includes neuropsychiatrists from the School of Health Sciences who are working on ways to create vr environments as catalysts to learn how to optimize dendrite re-growth. This investigation has led us to Eben Gay of Southboro, Massachusetts, (erg@world.std.com), an engineer who presently consults with a company involved in stroke rehabilitation. As an artist, the project "Synesthesia" which I’m building for presentation at SuperComputing '95 (Dec., California), is my attempt to demonstrate how cross modal perceptual events created in vr may contain substantive information hitherto unknown because of the absence of interactivity within the current model of discrete sensory evaluations. The data sets are then used to hypothesize a gestalt. This is in direct contrast to the perceptual gestalt experience created through virtual reality technology.

My wish is that Synesthesia can work as an art prototype of how detect and assess the gestalt of perception through virtual reality technology. How to utilize it to evaluate neurophysiological trauma and ultimately how use it as a rehabilitation tool. As a non-scientist, I hope this project can serve as a potential prototype, can assist others in the discovery of the process of "filling in the gaps;" and can facilitate new as well as ongoing work by researchers, l scientists, patients, artists, physicians. As for me, it's part of the my life's work that I cannot not do. It's how you and I emerge, evolve over and over again as we focus on this moment of living;-how it leads to empathy and connectedness with others as well as discovering one's own creativity and enlightenment. And healing.

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