Improving Measurement and Treatment of Post-stroke Neglect

Launched by VA OFFICE OF RESEARCH AND DEVELOPMENT · Oct 18, 2017

Keywords

ClinConnect Summary

This clinical trial is focused on improving the assessment and treatment of post-stroke neglect, a condition where a person may not be aware of one side of their body after having a stroke. The study will test a new approach that combines specific practice tasks with a technique called transcranial direct current stimulation, which uses a mild electrical current to stimulate brain activity. Researchers aim to see how effective this treatment is for individuals experiencing neglect and to develop a better way to measure the severity of this condition.

To participate in the trial, individuals must be between 65 and 74 years old and at least three months post-stroke, either from a blockage (ischemic) or bleeding (hemorrhagic) in the brain. They should have a specific range of upper arm movement ability and show signs of neglect on a particular test. Participants will be asked to attend sessions at a special research center in Charleston, South Carolina, where they will engage in the treatment and assessments. This study is currently recruiting participants and welcomes individuals of all genders who meet the criteria.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Ischemic or hemorrhagic stroke 3 months post stroke.
• • Fugl-Meyer Upper Extremity (FMA-Upper Extremity) score between 20-56/60
• • Inducible motor evoked potential (MEP) of the abductor pollicis brevis (APB) on the paretic stimulation (TMS)
• • Demonstrate the presence of unilateral neglect (Virtual Reality Lateralized Attention Test score \<18)
• Exclusion Criteria:
• • History of cortical hemorrhagic stroke
• * Presence of any MRI, TMS, tDCS risk factors including:
• • history of seizures
• • history of brain tumor
• • hardware in skull or spine (e.g. coils, clips)
• • implantable medical device (e.g. pacemaker)
• • metal in body (not compatible with MRI)
• • pregnancy
• • Severe spasticity (Modified Ashworth Scale score 3)
• • Severe aphasia or cognitive impairment limiting participants' comprehension (National Institutes of Health Stroke Scale Level of Consciousness Commands Item score 1 or Best Language Item score 2)
• • Unable to travel to UE Motor Function Laboratory at the Center for Rehabilitation Research in Neurological Conditions (a collaborative, MOU approved, research center Ralph H. Johnson VA Medical Center and the Medical University of South Carolina) for the study