The Effects of Offline Anosognosia For Spatial Neglect on Neglect Rehabilitation

NCT05145855 | Completed

• 1 other identifier: Gazi FTR Anosognosi-İhmal
• Study Type: observational
• Target: 85
• Locations: 1 country
• Sites: 1

Brief Summary

Anosognosia for hemispatial neglect is an intriguing phenomenon characterized by decreased awareness of spatial deficits, common in patients with right hemisphere stroke. However, it has not been examined as extensively as anosognosia for hemiplegia. In this study, we aim to investigate the relationship between the decrease in anosognosia for neglect and the improvement of spatial deficits.

Conditions

Hemispatial Neglect; Hemiplegia; Right Hemispheric Stroke; Anosognosia

Keywords

Anosognosia; Hemispatial neglect; Catherine Bergego Scale; Cognitive rehabilitation; Brain injury

Outcome Measures

Primary Outcomes (4)

• Catherine Bergego Scale score before rehabilitation

  Catherine Bergego Scale score, which was assigned before rehabilitation by an experienced rehabilitation nurse, will be obtained. CBS is a 10-item questionnaire based on direct observation of the patient's activities of daily living such as grooming, dressing, eating, cleaning mouth after a meal, gaze orientation, left limb knowledge, auditory attention, collide when moving, spatial orientation and, finding belongings. For each item, a 4-point scale ranging from 0 (no ignore) to 3 (severe ignore) is used. The sum of scores of all items ranges from zero to 30. Higher scores represent more severe spatial neglect behavior.

  Baseline (before rehabilitation)

• Score of anosognosia for neglect before rehabilitation

  Anosognosia score, which was calculated based on the Catherine Bergego Scale before rehabilitation, will be obtained. Catherine Bergego Scale is a parallel test that can be applied to patients by themselves or by observers. The score of anosognosia for HN will be calculated by subtracting the patient's self-assessment score from the rehabilitation nurse's assessment score. Higher scores show more severe anosognosia for hemispatial neglect.

  Baseline (before rehabilitation)

• Catherine Bergego Scale score after rehabilitation

  Catherine Bergego Scale score, which was assigned after rehabilitation by an experienced rehabilitation nurse, will be obtained. CBS is a 10-item questionnaire based on direct observation of the patient's activities of daily living such as grooming, dressing, eating, cleaning mouth after a meal, gaze orientation, left limb knowledge, auditory attention, collide when moving, spatial orientation and, finding belongings. For each item, a 4-point scale ranging from 0 (no ignore) to 3 (severe ignore) is used. The sum of scores of all items ranges from zero to 30. Higher scores represent more severe spatial neglect behavior.

  Immediately after the rehabilitation

• Score of anosognosia for neglect after rehabilitation

  Anosognosia score, which was calculated based on the Catherine Bergego Scale after rehabilitation, will be obtained. Catherine Bergego Scale is a parallel test that can be applied to patients by themselves or by observers. The score of anosognosia for HN will be calculated by subtracting the patient's self-assessment score from the rehabilitation nurse's assessment score. Higher scores show more severe anosognosia for hemispatial neglect.

  Immediately after the rehabilitation

Secondary Outcomes (8)

• Prevalence of the extinction on the visual double simultaneous stimulation test

  Baseline (before rehabilitation)

• Prevalence of the extinction on the auditory double simultaneous stimulation test

  Baseline (before rehabilitation)

• Prevalence of the extinction on the tactile double simultaneous stimulation test

  Baseline (before rehabilitation)

• Functional Ambulation Classification

  Baseline (before rehabilitation)

• Functional Independence Measurement

  Baseline (before rehabilitation)

Study Arms (2)

Anosognosia-positive group

Patients will be included in the anosognosia-positive group if they achieved at least one positive anosognosia score before rehabilitation. The anosognosia score for HN will be calculated by subtracting the patient's self-evaluation score from the score assigned by the rehabilitation nurse using the parallel Catherine Bergego Scale.

Other: Patient-tailored multimodal neglect rehabilitation

Anosognosia-negative group

Patients will be included in the anosognosia-negative group if they achieved zero or negative anosognosia score before rehabilitation.

Other: Patient-tailored multimodal neglect rehabilitation

Interventions

Patient-tailored multimodal neglect rehabilitation OTHER

Patient-tailored neglect rehabilitation program which comprises 30-45 minutes of sessions, five times per week includes a combination of reading, copying, and representational drawing tasks with visual or verbal cueing, visual scanning, mirror therapy, and allocation of attention to the neglected side using multimodal stimulus in daily activities.

Anosognosia-negative group; Anosognosia-positive group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients with subacute or chronic right hemisphere injury who have hemispatial neglect.

You may qualify if:

• Being older than 18 years of age
• Having subacute or chronic right hemisphere injury
• Having left-sided hemispatial neglect based on Catherine Bergego Scale assessment.

You may not qualify if:

• Acute cerebral injury (within the first two weeks of disease),
• Bilateral cerebral lesions
• Other neurological and psychiatric disorders that prevent evaluation of HN (e.g., severe cognitive or primer visual impairment)

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University Hospital, Department of Physical Medicine and Rehabilitation

Ankara, 06560, Turkey (Türkiye)

Location

Related Publications (5)

• Langer KG, Bogousslavsky J. The Merging Tracks of Anosognosia and Neglect. Eur Neurol. 2020;83(4):438-446. doi: 10.1159/000510397. Epub 2020 Sep 14.

  PMID: 32927461 BACKGROUND

• Ronchi R, Bolognini N, Gallucci M, Chiapella L, Algeri L, Spada MS, Vallar G. (Un)awareness of unilateral spatial neglect: a quantitative evaluation of performance in visuo-spatial tasks. Cortex. 2014 Dec;61:167-82. doi: 10.1016/j.cortex.2014.10.004.

  PMID: 25481474 BACKGROUND

• Chen P, Toglia J. Online and offline awareness deficits: Anosognosia for spatial neglect. Rehabil Psychol. 2019 Feb;64(1):50-64. doi: 10.1037/rep0000207. Epub 2018 Apr 12.

  PMID: 29648845 BACKGROUND

• Toglia J, Chen P. Spatial exploration strategy training for spatial neglect: A pilot study. Neuropsychol Rehabil. 2022 Jun;32(5):792-813. doi: 10.1080/09602011.2020.1790394. Epub 2020 Jul 20.

  PMID: 32684100 BACKGROUND

• Karatas L, Utkan Karasu A, Karatas GK. The effect of offline anosognosia for hemispatial neglect on neglect rehabilitation in patients with subacute and chronic right hemispheric brain injury. A retrospective cohort study. Neuropsychol Rehabil. 2024 Apr;34(3):453-468. doi: 10.1080/09602011.2023.2202862. Epub 2023 Apr 19.

  PMID: 37073753 DERIVED

MeSH Terms

Conditions

Perceptual Disorders; Hemiplegia; Agnosia; Brain Injuries

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Paralysis; Brain Diseases; Central Nervous System Diseases; Craniocerebral Trauma; Trauma, Nervous System; Wounds and Injuries

Study Officials

• Gülçin Kaymak Karataş, MD

  Gazi University Faculty of Medicine

  PRINCIPAL INVESTIGATOR

• Levent Karataş, MD

  Gazi University Faculty of Medicine

  PRINCIPAL INVESTIGATOR

• Ayça Utkan Karasu, MD

  Gazi University Faculty of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical Doctor, Principal Investigator

Study Record Dates

• First Submitted: November 11, 2021
• First Posted: December 6, 2021
• Study Start: November 29, 2021
• Primary Completion: December 15, 2021
• Study Completion: December 15, 2021
• Last Updated: December 2, 2022

Record last verified: 2022-11

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)