Study: First Effective Scalable Intervention for Common Post-Stroke Deficits
SAN FRANCISCO, May 08, 2019 (GLOBE NEWSWIRE) -- In a first of its kind study, computerized brain training was found to improve hemi-spatial neglect, which is a common and often intractable problem after stroke or other acquired brain injury. The brain training studied was from Posit Science, maker of BrainHQ online brain exercises and assessments, and was presented today at the annual meeting of the American Academy of Neurology.
About a third of patients with a brain injury exhibit a complex and debilitating array of neurological deficits known as the “neglect syndrome” (sometimes called, “hemi-spatial neglect” or “neglect”). The most apparent symptom of neglect is the inability of patients to efficiently process information on the side of space opposite the injury. For example, a patient may be unable to navigate, detect food on half their plate, or even safely cross the street. Patients often suffer higher rates of disability and respond poorly to conventional forms of rehabilitation, compared to patients without neglect.
To date, there’s been no widely-applicable intervention for addressing neglect.
In a new study, conducted at Washington University, Spalding Rehabilitation Hospital, and the Boston Veterans Administration Medical Center, researchers (from Harvard, Washington University, and Posit Science) found a relatively small number of hours of computerized brain training (self-administered by the patients in their homes) can drive significant neurological and functional improvements.
While rehabilitation efforts have previously tended to focus on simple interventions (e.g. repeatedly reminding patients to look toward the neglected side), this brain training takes a unique approach by focusing on underlying post-injury deficits in both general alertness and momentary heightened attention. The training makes increasing demands on both general and momentary alertness by having the patient respond to non-matching stimuli and withhold response to an infrequently-presented target stimulus. This is referred to in the literature as Tonic and Phasic Alertness Training (TAPAT), and, notably, does not target spatial attention.
This was a multi-site, double-blind, randomized controlled trial, in which 49 patients were randomized into either (1) an intervention group asked to complete 12 hours of TAPAT training, or (2) an active control group asked to complete an equal number of hours training on computerized causal games.
The researchers found a significant improvement in the primary outcome, a validated measure of spatial bias (Posner cueing task), and in the secondary composite measure of functional ability, as compared to the active control.
“Patients with neglect exhibited a significant reduction in spatial bias, as well as improvements in functional outcomes following a simple, at-home exercise,” summarized Dr. Tom Van Vleet, who presented the data.
“This is a breakthrough result in an area where there aren’t many treatment options,” observed Dr. Henry Mahncke, CEO of Posit Science. “This demonstration that plasticity-based training can personalize to the patient and can be administered at home is important for access and affordability. We expect to work with clinicians, payors, and regulators to make this widely available, as quickly as possible.”
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