Dynamic Auditory Cueing for Spatial Neglect in Stroke

NCT07507383 | Active Not Recruiting

• 1 other identifier: GAZI-DAC-2026-01
• Study Type: interventional
• Target: 18
• Locations: 1 country
• Sites: 1

Brief Summary

Spatial neglect is a common condition after stroke and can make it difficult for people to pay attention to one side of space. This problem can negatively affect daily activities and functional independence. This study aims to evaluate whether dynamic auditory cueing can improve spatial neglect in people with stroke. Participants are randomly assigned to one of two groups. One group receives conventional rehabilitation, while the other group receives conventional rehabilitation combined with dynamic auditory cueing. Dynamic auditory cueing uses moving sounds to guide attention toward the affected side. The intervention is applied for about ten minutes per day, five days a week, for four weeks. Spatial neglect and functional outcomes are assessed using standardized clinical tests and scales at baseline and at predefined time points during and after the intervention. The results of this study may provide evidence for the use of auditory-based approaches in the rehabilitation of spatial neglect after stroke.

Conditions

Stroke; Perceptual Disorders; Spatial Neglect; Spatial Neglect After Stroke

Keywords

Spatial Neglect; Hemispatial Neglect; Stroke Rehabilitation; Dynamic Auditory Cueing; Auditory Stimulation; Spatial Attention; Unilateral Neglect; Visual Scanning; Neurorehabilitation; Cognitive Rehabilitation

Outcome Measures

Primary Outcomes (2)

• Line Bisection Test deviation score

  The Line Bisection Test is used to assess spatial bias by measuring deviation from the true midpoint of horizontal lines. Deviation toward the right side indicates more severe left-sided spatial neglect.

  Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)

• Catherine Bergego Scale score

  The Catherine Bergego Scale is used to assess the impact of spatial neglect on daily activities. Higher scores indicate greater severity of neglect in functional tasks.

  Baseline and after 20 sessions (end of treatment)

Secondary Outcomes (4)

• Star Cancellation Test score

  Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)

• Line Cancellation Test score

  Baseline, after 1 session, after 10 sessions, and after 20 sessions (end of treatment)

• Functional Independence Measure score

  Baseline and after 20 sessions

• Centre of Cancellation value

  Baseline, after 1 session, after 10 sessions, and after 20 sessions

Study Arms (2)

Dynamic Auditory Cueing Group

EXPERIMENTAL

Participants in this group receive dynamic auditory cueing in addition to their standard conventional rehabilitation program. The intervention involves exposure to moving environmental sounds (such as animal or transport noises) designed to redirect attention toward the neglected hemispace. This session lasts 10 minutes per day, 5 days a week, for a total of 4 weeks.

Other: Dynamic Auditory Cueing; Other: Conventional Rehabilitation

Conventional Rehabilitation Group

ACTIVE COMPARATOR

Participants in this group receive only the standard conventional rehabilitation program provided by the clinic. This group does not receive the dynamic auditory cueing intervention. The frequency and duration of the standard therapy are consistent with the experimental group to ensure a fair comparison of the additional effects of auditory cueing.

Other: Conventional Rehabilitation

Interventions

Dynamic Auditory Cueing OTHER

The intervention consists of structured 10-minute sessions using digitized environmental sounds (e.g., animal sounds, moving vehicles, or sirens) as auditory cues. These cues are presented with a dynamic spatial movement pattern across the horizontal plane. The sound is designed to move from the intact hemispace toward the neglected hemispace or to follow a continuous scanning trajectory to guide attention toward the affected side. Stimuli are delivered through a stereo headset to ensure clear perception of directional movement. The intervention is applied in standardized sessions over a four-week period (5 sessions per week). This approach aims to promote active spatial attention and scanning behavior and differs from conventional static auditory stimulation.

Dynamic Auditory Cueing Group

Conventional Rehabilitation OTHER

Participants receive standard stroke rehabilitation, including physical and occupational therapy focused on motor function, mobility, and activities of daily living. This group follows the same rehabilitation schedule as the experimental group but does not receive dynamic auditory cueing.

Conventional Rehabilitation Group; Dynamic Auditory Cueing Group

Eligibility Criteria

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

You may qualify if:

• Adults aged 18 years or older
• Subacute or chronic stroke
• Clinical diagnosis of left-sided spatial neglect confirmed by standardized tests (e.g., Line Bisection, Star Cancellation)
• Normal or corrected visual acuity
• Absence of auditory extinction
• Ability to understand and comply with study procedures
• Provision of written informed consent

You may not qualify if:

• Hearing impairment (Hearing Handicap Inventory score ≥ 26)
• Presence of hemianopia
• Impaired visual acuity due to ocular pathology (e.g., cataract, glaucoma)
• History of neurological disease (e.g., dementia, Parkinson's disease)
• Structural brain lesions unrelated to stroke
• Inability to participate in rehabilitation sessions or assessments

Sponsors & Collaborators

• Gazi University: lead

Study Sites (1)

Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Ankara, Ankara, 06560, Turkey (Türkiye)

Location

Related Publications (5)

• Kaufmann BC, Cazzoli D, Bartolomeo P, Frey J, Pflugshaupt T, Knobel SEJ, Nef T, Muri RM, Nyffeler T. Auditory spatial cueing reduces neglect after right-hemispheric stroke: A proof of concept study. Cortex. 2022 Mar;148:152-167. doi: 10.1016/j.cortex.2021.12.009. Epub 2022 Jan 19.

  PMID: 35176552 BACKGROUND

• Golay L, Hauert CA, Greber C, Schnider A, Ptak R. Dynamic modulation of visual detection by auditory cues in spatial neglect. Neuropsychologia. 2005;43(9):1258-65. doi: 10.1016/j.neuropsychologia.2004.12.006. Epub 2005 Feb 5.

  PMID: 15949510 BACKGROUND

• Barrett AM, Burkholder S. Monocular patching in subjects with right-hemisphere stroke affects perceptual-attentional bias. J Rehabil Res Dev. 2006 May-Jun;43(3):337-46. doi: 10.1682/jrrd.2005.01.0015.

  PMID: 17041819 BACKGROUND

• Van Vleet TM, DeGutis JM. Cross-training in hemispatial neglect: auditory sustained attention training ameliorates visual attention deficits. Cortex. 2013 Mar;49(3):679-90. doi: 10.1016/j.cortex.2012.03.020. Epub 2012 Apr 9.

  PMID: 22578712 BACKGROUND

• Long J, Zhang Y, Liu X, Gao Q, Pan M. Music-based interventions for unilateral spatial neglect: A systematic review. Neuropsychol Rehabil. 2023 Oct;33(9):1462-1487. doi: 10.1080/09602011.2022.2111314. Epub 2022 Aug 18.

  PMID: 35980394 BACKGROUND

MeSH Terms

Conditions

Stroke; Perceptual Disorders

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Neurobehavioral Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Gülçin Kaymak Karataş, MD

  Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

  STUDY DIRECTOR

• Elif E Kürtül, MD

  Gazi University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

  STUDY CHAIR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: Outcome assessors are blinded to group allocation. Due to the nature of the intervention, participants and therapists are not blinded.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Assistant, MD

Model Details: Participants are randomly assigned to one of two parallel groups. The experimental group receives dynamic auditory cueing in addition to conventional rehabilitation, while the control group receives conventional rehabilitation alone.

Study Record Dates

• First Submitted: March 27, 2026
• First Posted: April 2, 2026
• Study Start: August 21, 2024
• Primary Completion: April 10, 2026
• Study Completion: April 10, 2026
• Last Updated: April 2, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)