Potentiation of the Effects of Prismatic Adaptation by Transcranial Direct Current Stimulation (tDCS) : Evaluation of Functional Interest in Negligence Rehabilitation

Hospices Civils de Lyon24 enrolled

Overview

Following stroke, over 50% of patients keep severe neurological deficiency whose unilateral neglect, mostly following a right hemispheric lesion. The prismatic adaptation involves to pointing movements toward visual targets wearing prismatic glasses. These prismatic glasses induce a shift to the right visual field for improving symptoms in short term. Transcranial direct stimulation (tDCS) has been evaluated for different types of deficiency resulting from stroke with encouraging results. The hypothesis of the study is to evaluate the usefulness of brain stimulation as an adjunctive intervention to optimize and increase the rehabilitation of unilateral neglect to long-term. Thus, the main objective is to evaluate the effectiveness of standard treatment with prismatic adaptation with anodal tDCS or sham tDCS.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Neurologic Neglect Syndrome

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Right-handed * All subjects must be between the ages of 18-80 * Patient with unilateral negligence consecutive to a right hemispheric stroke * Hospitalized in the Department of Physical Medicine and Rehabilitation (day or week) or external monitoring * Ischemic or hemorrhagic stroke with right hemispheric topography - evidenced by a radiological report * Diagnosis of negligence evidenced by Behavioural Inattention Test (BIT) : score ≤ 129 * Stroke \>1 month prior to study enrollment Exclusion Criteria: * Degenerative neurological complaint * Uncontrolled epilepsy * Temporo-spatial disorientation * Language disorders or psychiatric disorders preventing understanding instructions * History of prior stroke, multiple stroke * Medical condition not stabilized * Pregnancy * Implanted material (pacemaker, defibrillator, cochlear implant, surgical clips, metal object) * Intra-cranial material * Unweaned alcoholism

Outcomes

Primary Outcomes

Behavioural Inattention Test (BIT)

assessed at two baseline sessions before intervention (inclusion and week 3), and after the therapeutic intervention week (week 5), 2 weeks (week 7), 6 weeks (week 11) and 15 weeks (week 20) following the inclusion.

Time frame: Change in BIT score between the baseline sessions average and score measured at week 11

Secondary Outcomes

Negligence Battery Test (BTN)

Change in BTN scores between baseline measures before the therapeutic intervention week and scores obtained during each follow-up sessions

Time frame: before intervention (week 1 and week 3), and then again following the intervention (week 5), 2 weeks (week 7), 6 weeks (week 11) and 15 weeks (week 20)

Functional independence scale (MIF)

Change in MIF scores between baseline measures before the therapeutic intervention week and scores obtained during each follow-up sessions

Time frame: before intervention (week 1 and week 3), and then again following the intervention (week 5), 2 weeks (week 7), 6 weeks (week 11) and 15 weeks (week 20)

Catherine Bergego scale (ECB)

Change in ECB scores between baseline measures before the therapeutic intervention week and scores obtained during each follow-up sessions

Time frame: baseline session before intervention (week 1 and week 3), and then again following the intervention (week 5), 2 weeks (week 7), 6 weeks (week 11) and 15 weeks (week 20)

Jamar

Change in Jamar scores between baseline measures before the therapeutic intervention week and scores obtained during each follow-up sessions