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Non-invasive Brain Stimulation Can Reduce Unilateral Spatial Neglect after Stroke: ELETRON Trial.

Taís Regina da Silva1, Hélio Rubens de Carvalho Nunes2, Laís Geronutti Martins1

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Anodal transcranial direct current stimulation (A-tDCS) combined with physical therapy improved unilateral spatial neglect (USN) after stroke. Further research is needed to confirm these findings in larger trials.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Neurology

Background:

  • Unilateral spatial neglect (USN) is a common post-stroke deficit.
  • Current rehabilitation techniques for USN show variable outcomes.
  • Brain stimulation techniques offer potential for novel therapeutic approaches.

Purpose of the Study:

  • To investigate the efficacy of physical therapy combined with anodal (A-tDCS) and cathodal (C-tDCS) transcranial direct current stimulation for improving visuospatial and functional impairments in stroke-induced USN.
  • To compare the effects of A-tDCS and C-tDCS against sham stimulation in patients with USN.

Main Methods:

  • A double-blinded, pilot randomized clinical trial was conducted with USN patients post-ischemic stroke.
  • Participants received 20 minutes of tDCS (anodal, cathodal, or sham) followed by 7.5 weeks of outpatient physical therapy.
  • The primary outcome measure was the degree of USN assessed by the Behavior Inattention Test-Conventional (BIT-C). Secondary outcomes included the Catherine Bergego Scale (CBS), stroke severity (NIHSS), disability (mRS, BI, FIM), and quality of life (EQ-5D).

Main Results:

  • A-tDCS significantly improved BIT-C scores compared to sham stimulation (MD = 18.4, p = 0.008).
  • No significant differences were found between A-tDCS and C-tDCS (p = 0.057), or C-tDCS and sham (p = 0.99).
  • No significant differences were observed between groups for any secondary outcome measures.

Conclusions:

  • Anodal transcranial direct current stimulation (A-tDCS) in conjunction with physical therapy demonstrates potential in reducing the severity of unilateral spatial neglect (USN) following a stroke.
  • These preliminary findings warrant confirmation through larger-scale phase 3 clinical trials to establish definitive efficacy.