Remediation of Spatial Neglect Trial

NCT ID: NCT01965951

Last Updated: 2020-07-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

96 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-07-31

Study Completion Date

2017-03-31

Brief Summary

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Problems with attention are a common and debilitating consequence of brain injury. Studies show that poor attention is the number one predictor of poor cognitive functioning one year post-injury. This is due to the fact that attention is a necessary component of more complex cognitive functions such as learning \& memory, multi-tasking and problem solving. In many cases, individuals may exhibit problems with spatial attention known as 'hemi-spatial neglect syndrome' or simply 'neglect'. Many studies now show that the processing machinery of the brain is plastic and remodeled throughout life by learning and experience, enabling the strengthening of cognitive skills or abilities. Research has shown that brief, daily computerized cognitive training that is sufficiently challenging, goal-directed and adaptive enables intact brain structures to restore balance in attention and compensate for disruptions in cognitive functioning. The study aims to understand how our computer program can affect cognition and attention in those with acquired brain injury.

Detailed Description

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Following consent, participants will engage in an assessment process to determine eligibility. Once eligibility is confirmed, participants will be scheduled for another assessment session to determine current level of cognitive function. This process consists of paper-pencil surveys and computerized tests. Following the assessment process, participants will engage in an Internet browser-delivered training sessions conducted on any internet-accessible computer. The computerized training sessions can be done up to 7 times a week (once a day) or at participant's convenience (we recommend 5 times a week). Following the completion of training, the participant's cognitive function will be re-assessed and again after 3-month no-contact period. Participation is voluntary and participants may withdraw from the study at any time.

Conditions

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Stroke Acquired Brain Injury Hemispatial Neglect

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Experimental Treatment

Computerized Plasticity-based Adaptive Cognitive Training requiring a total maximum of 39 treatment sessions, 4-5 times weekly, \~30 mins each session.

Group Type EXPERIMENTAL

Computerized Plasticity-based Adaptive Cognitive Training

Intervention Type OTHER

Computerized Plasticity-based Adaptive Cognitive Training requiring a total maximum of 39 treatment sessions, 4-5 times weekly, \~30 mins each session.

Active Comparator

Commercially available computerized training requiring a total maximum of 39 treatment sessions, 4-5 times weekly, \~30 mins each session.

Group Type ACTIVE_COMPARATOR

Commercially available computerized training

Intervention Type OTHER

Commercially available computerized training requiring a total maximum of 39 treatment sessions, 4-5 times weekly, \~30 mins each session.

Interventions

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Computerized Plasticity-based Adaptive Cognitive Training

Computerized Plasticity-based Adaptive Cognitive Training requiring a total maximum of 39 treatment sessions, 4-5 times weekly, \~30 mins each session.

Intervention Type OTHER

Commercially available computerized training

Commercially available computerized training requiring a total maximum of 39 treatment sessions, 4-5 times weekly, \~30 mins each session.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* 18 years of age or older
* Diagnosis of an acquired brain injury (which may be in the form of a stroke or brain tumor removal) and
* Evidence of deficit on at least 2 out of 4 assessment measures of Spatial Neglect: Mesulam Cancelation task (ages 50 and younger \> 0 omissions; 51-80 \> 4 omissions), Dual task (\>19% difference in accuracy for right - left target trials), Tone Counting task (\< 94% total accuracy), or Landmark task (deviation from objective center as determined by the 95% confidence interval, with neglect indicated with 'Y' and no neglect with 'N' following completion of task).
* Must be at least 3 months out from their most recent acquired brain injury, stroke, or brain tumor removal
* Fluent English speakers
* Adequate sensorimotor capacity to participate in the trial, including visual capacity adequate to read from a computer screen at a normal viewing distance, auditory capacity adequate to understand normal speech, and motor capacity adequate to control a computer mouse

Exclusion Criteria

* A conjunction of prior acquired brain injury and score \>8 on Blessed Scale - Short Form
* Diagnosis of severe depression (a score of \>29 on Beck Depression Inventory (BDI-II)
* Diagnosis of chronic psychiatric disorders with associated cognitive impairments, eg. Schizophrenia
* Diagnosis of illness, condition or treatment with known cognitive consequences, eg. chemotherapy
* Active Suicidal Ideation with Specific Plan and Intent or any suicide-related behaviors within 2 months of consent
* A current or significant past history of substance abuse
* Difficulty completing assessments and/or comprehending requirements of trial
* Enrollment in a concurrent clinical trial involving an investigational pharmaceutical, nutraceutical, medical device or behavioral treatment that could affect the outcome of this study
* Complete primary visual field deficit, score of 3 on NIH Stroke Scale - Visual Field Subscale
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Washington University School of Medicine

OTHER

Sponsor Role collaborator

VA Boston Healthcare System

FED

Sponsor Role collaborator

Spaulding Rehabilitation Hospital

OTHER

Sponsor Role collaborator

Posit Science Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas Van Vleet, PhD

Role: PRINCIPAL_INVESTIGATOR

Posit Science Corporation

Locations

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Washington University School of Medicine

St Louis, Missouri, United States

Site Status

Countries

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United States

References

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Friedrich FJ, Egly R, Rafal RD, Beck D. Spatial attention deficits in humans: a comparison of superior parietal and temporal-parietal junction lesions. Neuropsychology. 1998 Apr;12(2):193-207. doi: 10.1037//0894-4105.12.2.193.

Reference Type BACKGROUND
PMID: 9556766 (View on PubMed)

Husain M, Kennard C. Visual neglect associated with frontal lobe infarction. J Neurol. 1996 Sep;243(9):652-7. doi: 10.1007/BF00878662.

Reference Type BACKGROUND
PMID: 8892067 (View on PubMed)

Heilman KM, Bowers D, Valenstein E, Watson RT. Disorders of visual attention. Baillieres Clin Neurol. 1993 Aug;2(2):389-413. No abstract available.

Reference Type BACKGROUND
PMID: 8137006 (View on PubMed)

Mort DJ, Malhotra P, Mannan SK, Rorden C, Pambakian A, Kennard C, Husain M. The anatomy of visual neglect. Brain. 2003 Sep;126(Pt 9):1986-97. doi: 10.1093/brain/awg200. Epub 2003 Jun 23.

Reference Type BACKGROUND
PMID: 12821519 (View on PubMed)

Posner MI, Walker JA, Friedrich FJ, Rafal RD. Effects of parietal injury on covert orienting of attention. J Neurosci. 1984 Jul;4(7):1863-74. doi: 10.1523/JNEUROSCI.04-07-01863.1984.

Reference Type BACKGROUND
PMID: 6737043 (View on PubMed)

Vleet TV, DeGutis J, Dabit S, Chiu C. Randomized control trial of computer-based rehabilitation of spatial neglect syndrome: the RESPONSE trial protocol. BMC Neurol. 2014 Feb 7;14:25. doi: 10.1186/1471-2377-14-25.

Reference Type DERIVED
PMID: 24502769 (View on PubMed)

Provided Documents

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Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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PSC-1004-13

Identifier Type: -

Identifier Source: org_study_id

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