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)

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: Learmonth, Dr Gemma and Harvey, Professor Monika and Barber, Dr Mark and Checketts, Dr Matthew and Maerker, Ms Gesine and Benwell, Mr Christopher and Muir, Professor Keith and Santosh, Dr Celestine and Walters, Professor Matthew
• 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 > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience; 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

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
190781		Non invasive brain stimulation in stroke patients	Monika Harvey	Chief Scientist Office (CSO)	ETM/353	Psychology