Dynamic Auditory Cueing for Spatial Neglect in Stroke (DAC-SN)

July 21, 2026 updated by: Elif Ezgi Kurtul, MD, Gazi University

The Effect of Dynamic Auditory Cueing on Spatial Neglect in Patients With Stroke: A Randomized Controlled Trial

Spatial neglect is a common condition after stroke and can make it difficult for people to pay attention to one side of space. This problem can negatively affect daily activities and functional independence. This study aims to evaluate whether dynamic auditory cueing for spatial neglect (DAC-SN) can improve spatial neglect in people with stroke. Participants are randomly assigned to one of two groups. One group receives conventional rehabilitation, while the other group receives conventional rehabilitation combined with dynamic auditory cueing. Dynamic auditory cueing uses moving sounds to guide attention toward the affected side. The intervention is applied for about ten minutes per day, five days a week, for four weeks. Spatial neglect and functional outcomes are assessed using standardized clinical tests and scales at baseline and at predefined time points during and after the intervention. The results of this study may provide evidence for the use of auditory-based approaches in the rehabilitation of spatial neglect after stroke.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Spatial neglect is a common and disabling condition following stroke, characterized by reduced awareness of stimuli on one side of space. It is associated with impaired functional recovery and decreased independence in daily activities. Despite conventional rehabilitation approaches, spatial neglect may persist and continues to be a significant challenge in stroke rehabilitation. Dynamic auditory cueing for spatial neglect (DAC-SN) has been proposed as a method to facilitate attentional orientation by providing external sensory input directed toward the affected side. This approach may enhance spatial exploration and support recovery by promoting engagement with the neglected hemispace. The aim of this randomized controlled trial is to investigate the effect of dynamic auditory cueing in patients with stroke and spatial neglect. Participants are randomly assigned to receive either conventional rehabilitation alone or conventional rehabilitation combined with dynamic auditory cueing. The intervention is delivered in addition to standard rehabilitation in structured sessions over a four-week period. The control group receives conventional rehabilitation according to standard clinical practice. Spatial neglect severity and functional outcomes are assessed using standardized clinical measures at baseline and at predefined time points during and after the intervention period. The findings of this study are expected to provide evidence on the potential role of auditory-based interventions as an adjunct to conventional rehabilitation in improving spatial neglect and functional outcomes in patients with stroke.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
18

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkey (Türkiye), 06560
        • Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 years or older
  • Subacute or chronic stroke
  • Clinical diagnosis of left-sided spatial neglect confirmed by standardized tests (e.g., Line Bisection Test (LBT), Star Cancellation Test (SCT))
  • Normal or corrected visual acuity
  • Absence of auditory extinction
  • Ability to understand and comply with study procedures
  • Provision of written informed consent

Exclusion Criteria:

  • Hearing impairment (Hearing Handicap Inventory score ≥26)
  • Presence of hemianopia
  • Impaired visual acuity due to ocular pathology (e.g., cataract, glaucoma)
  • History of neurological disease (e.g., dementia, Parkinson's disease)
  • Structural brain lesions unrelated to stroke
  • Inability to participate in rehabilitation sessions or assessments

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Dynamic Auditory Cueing Group
Participants in this group receive dynamic auditory cueing for spatial neglect (DAC-SN) in addition to their standard conventional rehabilitation program. The intervention involves exposure to moving environmental sounds (such as animal or transportation noises) designed to redirect attention toward the neglected hemispace. The intervention is administered for 10 minutes per day, 5 days per week, over a total period of 4 weeks.
Other: Dynamic Auditory Cueing
The intervention consists of structured 10-minute sessions using digitized environmental sounds (e.g., animal sounds, moving vehicles, or sirens) as auditory cues. Dynamic auditory cueing for spatial neglect (DAC-SN) is applied using sounds presented with a dynamic spatial movement pattern across the horizontal plane. The auditory stimulus is designed to move from the intact hemispace toward the neglected hemispace or to follow a continuous scanning trajectory to guide attention toward the affected side. Stimuli are delivered through a stereo headset to ensure clear perception of directional movement. The intervention is administered in standardized sessions over a four-week period (5 sessions per week). This approach aims to promote active spatial attention and scanning behavior and differs from conventional static auditory stimulation.
Other: Conventional Rehabilitation
Participants receive standard stroke rehabilitation, including physical and occupational therapy focused on motor function, mobility, and activities of daily living. This group follows the same rehabilitation schedule as the experimental group but does not receive dynamic auditory cueing for spatial neglect (DAC-SN).
Active Comparator: Conventional Rehabilitation Group
Participants in this group receive only the standard conventional rehabilitation program provided by the clinic. This group does not receive dynamic auditory cueing for spatial neglect (DAC-SN). The frequency and duration of the standard therapy are matched to those of the experimental group to ensure a fair comparison of the additional effects of auditory cueing.
Other: Conventional Rehabilitation
Participants receive standard stroke rehabilitation, including physical and occupational therapy focused on motor function, mobility, and activities of daily living. This group follows the same rehabilitation schedule as the experimental group but does not receive dynamic auditory cueing for spatial neglect (DAC-SN).

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Line Bisection Test (LBT) deviation score
Time Frame: Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)
The Line Bisection Test (LBT) is used to assess spatial bias by measuring deviation from the true midpoint of horizontal lines. Deviation toward the right side indicates more severe left-sided spatial neglect.
Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)
Catherine Bergego Scale (CBS) score
Time Frame: Baseline and after 20 sessions (end of treatment)
The Catherine Bergego Scale (CBS) is used to assess the impact of spatial neglect on daily activities. Higher scores indicate greater severity of neglect in functional tasks.
Baseline and after 20 sessions (end of treatment)

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Star Cancellation Test (SCT) score
Time Frame: Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)
The Star Cancellation Test (SCT) is used to assess spatial neglect by measuring the number and spatial distribution of correctly identified targets. Omission of targets on the left side indicates more severe left-sided spatial neglect.
Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)
Line Cancellation Test (LCT) score
Time Frame: Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)
The Line Cancellation Test (LCT) evaluates spatial neglect by assessing the ability to detect and cancel target lines. Omission of lines on the left side indicates more severe left-sided spatial neglect.
Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)
Functional Independence Measure (FIM) score
Time Frame: Baseline and after 20 sessions
The Functional Independence Measure (FIM) assesses functional independence in activities of daily living. Higher scores indicate greater functional independence.
Baseline and after 20 sessions
Center of Cancellation (CoC) value
Time Frame: Baseline, after 1 session, after 10 sessions, and after 20 sessions
The Center of Cancellation (CoC) quantifies spatial bias based on cancellation task performance. Higher absolute values indicate more severe spatial neglect.
Baseline, after 1 session, after 10 sessions, and after 20 sessions

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Gazi University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Gulcin Kaymak Karatas, MD, Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation
  • Study Director: Elif E Kurtul, MD, Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
August 21, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 10, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 10, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 27, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 27, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 2, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 23, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 21, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • GAZI-DAC-2026-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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