Modalities for assessing visual exploration in people with unilateral spatial neglect with eye-tracking: a scoping review

Background Eye-tracking (ET) technology shows promise in improving the assessment of Unilateral Spatial Neglect (USN) by overcoming the limitations in sensitivity of traditional paper-and-pencil tests. This scoping review aimed to explore current trends in the use of ET for evaluating USN.Methods Seven databases were systematically searched. The methodology followed the Joanna Briggs Institute guidelines for scoping reviews.Results Twenty publications were included, involving 282 healthy adults and 457 post-stroke individuals. Left-sided USN was reported in 96% of participants, while right-sided USN was reported in 2%. ET was used alone in most studies (n = 15), while others combined it with virtual reality (VR) technologies. The most common task involved the free exploration of static scenes (n = 11). Far extra-personal space was explored in 4/20 studies, three of which used VR technology and a dynamic environment. Numerous eye movement measurements were analyzed. In six studies, correlations between ET measures and traditional tests were moderate to strong, particularly for gaze shift, and this applied to both right- and left-sided USN.Conclusions Eye movements measured by ET appear useful for detecting USN, including the less commonly assessed right-sided cases. Further studies are needed to assess the clinical feasibility of integrating this approach into standard practice.