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

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dc.contributor.authorda Silva, Taís Regina [UNESP]
dc.contributor.authorde Carvalho Nunes, Hélio Rubens [UNESP]
dc.contributor.authorMartins, Laís Geronutti [UNESP]
dc.contributor.authorda Costa, Rafael Dalle Molle [UNESP]
dc.contributor.authorde Souza, Juli Thomaz [UNESP]
dc.contributor.authorWinckler, Fernanda Cristina [UNESP]
dc.contributor.authorSartor, Lorena Cristina Alvarez [UNESP]
dc.contributor.authorModolo, Gabriel Pinheiro [UNESP]
dc.contributor.authorFerreira, Natalia Cristina [UNESP]
dc.contributor.authorda Silva Rodrigues, Josiela Cristina [UNESP]
dc.contributor.authorKanda, Rafael [UNESP]
dc.contributor.authorFogarolli, Marcelo Ortolani [UNESP]
dc.contributor.authorBorges, Guilherme Ferreira [UNESP]
dc.contributor.authorRizzatti, Gabriela Rizzo Soares [UNESP]
dc.contributor.authorRibeiro, Priscila Watson [UNESP]
dc.contributor.authorFavoretto, Diandra B.
dc.contributor.authordos Santos, Luan R. Aguiar
dc.contributor.authorBazan, Silméia Garcia Zanati [UNESP]
dc.contributor.authorBetting, Luiz Eduardo [UNESP]
dc.contributor.authorde Oliveira Antunes, Leticia Cláudia [UNESP]
dc.contributor.authorPereira, Vitor Mendes
dc.contributor.authorEdwards, Taiza G. S.
dc.contributor.authorPontes-Neto, Octávio Marques
dc.contributor.authorConforto, Adriana Bastos
dc.contributor.authorBazan, Rodrigo [UNESP]
dc.contributor.authorLuvizutto, Gustavo José
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.contributor.institutionUniversity of Toronto
dc.contributor.institutionFederal University of Triângulo Mineiro (UFTM)
dc.date.accessioned2023-03-01T20:52:56Z
dc.date.available2023-03-01T20:52:56Z
dc.date.issued2022-09-01
dc.description.abstractObjective: Rehabilitation top-down techniques based on brain stimulation present variable outcomes in unilateral spatial neglect (USN) after stroke. This study aimed to examine the effects of physical therapy after anodal and cathodal transcranial direct current stimulation (A-tDCS and C-tDCS, respectively) to improve visuospatial and functional impairments in individuals with USN after stroke. Methods: This double-blinded, pilot randomized clinical trial enrolled patients with USN after ischemic stroke. Randomization was stratified according to the Behavior Inattention Test–Conventional (BIT-C) and Catherine Bergego Scale (CBS). Outpatient physical therapy was conducted for 7.5 weeks after 20 minutes of tDCS. The primary outcome was the USN degree evaluated by the BIT-C. Secondary outcomes were the difference in CBS score, stroke severity (National Institutes of Health Stroke Scale [NIHSS]), disability (modified Rankin Scale), autonomy (Barthel Index, Functional Independence Measure), and quality of life (EuroQol Group 5-Dimension Self-Report Questionnaire). Outcomes were analyzed using an analysis of covariance model corrected by age, baseline NIHSS, and baseline BIT-C. Pairwise post hoc comparisons were performed using Bonferroni correction. Results: In the primary outcomes, A-tDCS led to greater improvement in BIT-C after intervention (mean difference [MD] = 18.4, 95% confidence interval [CI] = 3.9–32.8, p = 0.008) compared to sham. However, no significant differences were observed between A-tDCS and C-tDCS (MD = 13.9, 95% CI = −0.3 to 28.1, p = 0.057), or C-tDCS and sham (MD = 4.5, 95% CI = −9.7 to 18.8, p = 0.99). There were no significant differences between groups in terms of secondary outcomes. Interpretation: A-tDCS associated with physical therapy can decrease the severity of USN after stroke. However, these preliminary findings must be confirmed by collecting additional evidence in a larger phase 3 trial. ANN NEUROL 2022;92:400–410.en
dc.description.affiliationDepartment of Internal Medicine Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationDepartment of Public Health Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationDepartment of Rehabilitation Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationDepartment of Neurology Department of Psychology and Psychiatry Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationDepartment of Neurosciences and Behavioral Sciences Ribeirão Preto Medical School University of São Paulo (USP)
dc.description.affiliationDivision of Neurosurgery Department of Surgery St Michael's Hospital University of Toronto
dc.description.affiliationClinical Hospital São Paulo University (USP) and Hospital Israelita Albert Einstein
dc.description.affiliationDepartment of Applied Physical Therapy Federal University of Triângulo Mineiro (UFTM)
dc.description.affiliationUnespDepartment of Internal Medicine Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationUnespDepartment of Public Health Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationUnespDepartment of Rehabilitation Botucatu Medical School São Paulo State University (UNESP)
dc.description.affiliationUnespDepartment of Neurology Department of Psychology and Psychiatry Botucatu Medical School São Paulo State University (UNESP)
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipIdFAPESP: 2015/14231-0
dc.description.sponsorshipIdCNPq: 423924/2016-8
dc.format.extent400-410
dc.identifierhttp://dx.doi.org/10.1002/ana.26430
dc.identifier.citationAnnals of Neurology, v. 92, n. 3, p. 400-410, 2022.
dc.identifier.doi10.1002/ana.26430
dc.identifier.issn1531-8249
dc.identifier.issn0364-5134
dc.identifier.scopus2-s2.0-85132866848
dc.identifier.urihttp://hdl.handle.net/11449/241234
dc.language.isoeng
dc.relation.ispartofAnnals of Neurology
dc.sourceScopus
dc.titleNon-invasive Brain Stimulation Can Reduce Unilateral Spatial Neglect after Stroke: ELETRON Trialen
dc.typeArtigo
unesp.author.orcid0000-0001-6143-4249[13]
unesp.author.orcid0000-0002-6914-7225[26]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt
unesp.departmentClínica Médica - FMBpt

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Botucatu - FMB - Faculdade de Medicina
Artigos - Saúde Pública - FMB
Artigos - Neurologia, Psicologia e Psiquiatria - FMB