Non-invasive brain stimulation in stroke patients (NIBS): a prospective randomized open blinded end-point (PROBE) feasibility trial using transcranial direct current stimulation (tDCS) in post-stroke hemispatial neglect

Learmonth, G. , Benwell, C. S.Y., Märker, G., Dascalu, D., Checketts, M., Santosh, C., Barber, M., Walters, M. , Muir, K. W. and Harvey, M. (2021) Non-invasive brain stimulation in stroke patients (NIBS): a prospective randomized open blinded end-point (PROBE) feasibility trial using transcranial direct current stimulation (tDCS) in post-stroke hemispatial neglect. Neuropsychological Rehabilitation, 31(8), pp. 1163-1189. (doi: 10.1080/09602011.2020.1767161) (PMID:32498606)

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Abstract

Up to 80% of people who experience a right-hemisphere stroke suffer from hemispatial neglect. This syndrome is debilitating and impedes rehabilitation. We carried out a clinical feasibility trial of transcranial direct current stimulation (tDCS) and a behavioural rehabilitation programme, alone or in combination, in patients with neglect. Patients >4 weeks post right hemisphere stroke were randomized to 10 sessions of tDCS, 10 sessions of a behavioural intervention, combined intervention, or a control task. Primary outcomes were recruitment and retention rates, with secondary outcomes effect sizes on measures of neglect and quality of life, assessed directly after the interventions, and at 6 months follow up. Of 288 confirmed stroke cases referred (representing 7% of confirmed strokes), we randomized 8% (0.6% of stroke cases overall). The largest number of exclusions (91/288 (34%)) were due to medical comorbidities that prevented patients from undergoing 10 intervention sessions. We recruited 24 patients over 29 months, with 87% completing immediate post-intervention and 67% 6 month evaluations. We established poor feasibility of a clinical trial requiring repeated hospital-based tDCS within a UK hospital healthcare setting, either with or without behavioural training, over a sustained time period. Future trials should consider intensity, duration and location of tDCS neglect interventions.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Benwell, Mr Christopher and Walters, Professor Matthew and Barber, Dr Mark and Santosh, Dr Celestine and Learmonth, Dr Gemma and Muir, Professor Keith and Harvey, Dr Monika and Checketts, Mr Matthew and Maerker, Ms Gesine
Authors: Learmonth, G., Benwell, C. S.Y., Märker, G., Dascalu, D., Checketts, M., Santosh, C., Barber, M., Walters, M., Muir, K. W., and Harvey, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Science and Engineering > School of Psychology
Journal Name:Neuropsychological Rehabilitation
Publisher:Taylor & Francis
ISSN:0960-2011
ISSN (Online):1464-0694
Published Online:05 June 2020
Copyright Holders:Copyright © 2020 The Authors
First Published:First published in Neuropsychological Rehabilitation 31(8): 1163-1189
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
190781Non invasive brain stimulation in stroke patientsMonika HarveyChief Scientist Office (CSO)ETM/353Psychology