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NonInvasive Brain Stimulation in Stroke Patients (RTNIBS)

27. marts 2015 opdateret af: NHS Greater Glasgow and Clyde

A Randomised Trial of Non-Invasive Brain Stimulation (NIBS) in Stroke Survivors

After a stroke affecting the right side of the brain, many patients are affected by "spatial neglect": the damage to the brain causes them to ignore the left side of their surroundings. At its most extreme they may be unaware that they have a left side, or believe that it is moving normally when it is in fact paralysed. In milder cases, people may be unable to recognise touch on the left side if their right side is also being touched, or objects in their left visual field if something is visible to their right. Neglect alters peoples' quality of life profoundly, often renders them more dependent on others to undertake basic activities of daily living, and makes effective rehabilitation much more difficult.

The limited success of current treatment approaches indicates gaps in understanding of the underlying mechanisms of neglect and its recovery. Recent data suggest that the problems in responding to the left side are a result of an imbalance of activity in those parts of the brain responsible for deciding which side to pay attention to. It might therefore be possible to help people with neglect by "rebalancing" the brain either by increasing activity in the damaged side, or alternatively by reducing activity in the undamaged side. In this pilot study, the investigators will test whether they can help by doing the second of these things.

The investigators propose to conduct a pilot clinical trial to explore whether using electric currents to temporarily modify the activity of specific areas of the intact side of the brain, influences recovery from neglect, when used either alone, or in combination with a training method that has previously appeared promising as a treatment. Brain activity will be modified using a technique called "transcranial direct current stimulation (tDCS)", in which small electric currents are applied to the scalp with a wire covered in damp cotton pads. This will be done over the specific parts of the brain that are responsible for focusing attention to one side.

The investigators will compare the clinical outcomes of four interventions (1: behavioural, 2: tDCS, 3: a combination of both and 4: control).

The investigators hope that these studies will advance their understanding of what treatments may help people with neglect, and how they might work.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Forventet)

60

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 90 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Ischemic stroke affecting the right hemisphere, confirmed by CT or MRI.
  2. Persistent neglect for one month after ictus (confirmed by BIT).
  3. Prestroke functional independence (modified Rankin Scale score 0-2).
  4. Between 18-90 years of age

Exclusion Criteria:

  1. Patients younger than 18.
  2. Patients who do not understand verbal or written English (ie.need of translaters)
  3. bilateral infarcts (Confirmed by CT, MRI)
  4. Dementia (MOCA, Score <26).
  5. Neurological Disease (eg. Parkinson's Disease, epilepsy, MS)
  6. Significant morbidity (eg cancer, severe cardiac failure) likely to affect participation.
  7. Alcohol excess (more than 50/40 units a week for men/women respectively).
  8. Patients who fall under the exclusion criteria for TDCS which includes patients suffering from a stroke related seizure :

History of epilepsy, medications or psychoactive drugs that can lower seizure threshold [imipramine, amitriptyline, doxepine, nortriptyline, maprotiline, chlorpromazine, clozapine, foscarnet, ganciclovir, ritonavir, amphetamines, cocaine, (MDMA, ecstasy), phencyclidine (PCP, angel dust), ketamine, gammahydroxybutyrate (GHB), alcohol, theophylline]. Withdrawal from alcohol, barbiturates, benzodiazepines, meprobamate, chloral hydrate. Patients who are pregnant or have suffered from a stroke-related seizure.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Action Training
Training exercise which involves patients lifting up rods of different sizes and shifting their grip if this is too far to one side
Andet: Action Training
Eksperimentel: tDCS
A constant 1mA current will be applied to the left (undamaged) side of the scalp with an electrode covered with a damp cotton pad (25 cm2). The current will be applied for 15 minutes per day, with a total of 10 sessions over 3 weeks.
Andet: Transkraniel jævnstrømsstimulering
Andre navne:
  • tDCS
Eksperimentel: Action Training + tDCs
This will involve the same procedure as in action training only but with tDCS applied for 15 minutes during the rodlifting.
Andet: Transkraniel jævnstrømsstimulering
Andre navne:
  • tDCS
Andet: Action Training
Placebo komparator: Control training
For the control training, patients will be asked to simply reach for the right hand side of each rod with their right (unaffected) hand and lift it

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Change in Behavioural Inattention Test (BIT)
Tidsramme: 6 months post intervention
6 months post intervention

Sekundære resultatmål

Resultatmål
Tidsramme
Compliance as measured by adherence to task instructions (percentage of intervention sessions, BIT tests completed)
Tidsramme: baseline
baseline
Compliance as measured by adherence to task instructions (percentage of intervention sessions, BIT tests completed)
Tidsramme: 3 weeks
3 weeks
Compliance as measured by adherence to task instructions (percentage of intervention sessions, BIT tests completed)
Tidsramme: 6 months
6 months
Retention Numbers
Tidsramme: baseline
baseline
Retention Numbers
Tidsramme: 3 weeks
3 weeks
Retention Numbers
Tidsramme: 6 months
6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

NHS Greater Glasgow and Clyde

Samarbejdspartnere

University of Glasgow

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2015

Primær færdiggørelse (Forventet)

1. juni 2018

Studieafslutning (Forventet)

1. juni 2018

Datoer for studieregistrering

Først indsendt

10. marts 2015

Først indsendt, der opfyldte QC-kriterier

27. marts 2015

Først opslået (Skøn)

30. marts 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

30. marts 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

27. marts 2015

Sidst verificeret

1. marts 2015

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • GN13NE562

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Transkraniel jævnstrømsstimulering

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Sponsorer og samarbejdspartnere

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Betingelser

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Sponsor / samarbejdspartnere

Placeringer

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