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Citation

Learmonth G, Benwell C, M?rker 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

• 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