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

Citation

Learmonth G, Benwell C, Märker G, Dascalu D, Checketts M, Santosh C, Barber M, Walters M, Muir K & 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, pp. 1163-1189. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85086854524&doi=10.1080%2f09602011.2020.1767161&partnerID=40&md5=0ceb5bfb9ae0c887e661a2ada5e04881; https://doi.org/10.1080/09602011.2020.1767161

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.

Journal
Neuropsychological Rehabilitation: Volume 31

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Dr Gemma Learmonth

Lecturer in Psychology, Psychology