A new large-scale research trial, led by academics at the University of East Anglia (UEA) and carried out at eight major stroke centers across the UK, is investigating the effects of stroke after a stroke, which affects around one in three survivors. The effectiveness of new treatments for physical disorders will be tested. This is thanks to a £1.26 million grant from the Efficacy and Mechanism Evaluation (EME) programme, a partnership between the National Institute for Health Research (NIHR) and the Medical Research Council (MRC).
The principal investigator was Dr. Stephanie Rossitto from the UEA Department of Psychology. Image credit: University of East Anglia
A stroke is caused when the blood supply to part of the brain is cut off, destroying brain cells. This can affect the brain’s ability to interpret information. In some cases, this can cause stroke survivors to lose attention to things on one side of their body. This means that even if your eyesight is good, your brain is unable to process information from the affected side, resulting in a disabling cognitive condition called “spatial inattention” or “spatial neglect.” I will.
Currently, there are no effective treatments for spatial inattention, and people affected by spatial inattention often have long-term disabilities that are difficult to recover from. However, an initial small trial led by UEA academics showed that a new treatment called SIGHT (Spatial Inattention Grasping Therapy) showed promise in improving symptoms.
Dr Stephanie Rossitto, lead investigator from UEA’s Department of Psychology, said:
“There are 1.3 million stroke survivors in the UK, and an estimated 390,000 of them suffer from spatial inattention. The condition is highly persistent, with 40% of stroke survivors still having symptoms a year after their stroke. Currently, there are no effective treatments for spatial inattention. This new trial helps fill a gap in the urgent search for a successful treatment.
“We are delighted that MRC-NIHR has funded this study, which is the largest study in the world to treat spatial inattention.”
SIGHT requires those who suffer from spatial neglect to grasp a rod with their unaffected hand for balance. This condition causes the rod to tilt on the first attempt, but feeling and seeing the rod tilt improves performance and increases attention to the impaired side.
The study will also explore why some people benefit more from treatment than others. To determine who will benefit most, the trial will measure grip strength, vision, cognition, stroke severity, and brain structure and function.
The large-scale trial, which will begin in January 2025 and run until February 2028, will split 206 stroke survivors with spatial inattention into two groups. One group will receive SIGHT and treatment as usual, and the other group will receive treatment as usual. Neither the participants nor the field research team were blinded to the type of treatment that would be administered. To compare the effectiveness of treatments, the team will assess patients’ ability to pay attention to objects and perform daily living tasks before treatment begins, after treatment, and three months after treatment ends.
According to the World Health Organization, 15 million people suffer a stroke each year, and one in three of these suffer from spatial inattention. This means that if this low-cost, portable treatment proves effective in improving inattention, it could potentially benefit millions of people around the world. .
Louise Flanagan, head of research at the Stroke Association, said:
“The Stroke Association is delighted that the EME Program has funded this important trial under the ‘Post-Stroke Rehabilitation and Care’ call. Spatial inattention is a significant cognitive challenge for many stroke survivors and their families, and research into effective stroke treatments for cognition is a priority by the James Lind Alliance and NHS England. The Stroke Association is excited to support dissemination of this research and patient and public engagement efforts. ”
The successful application was developed in collaboration with stroke survivors, family/carers and clinicians. Anne Bamford had first-hand experience of stroke and was actively involved in its application. She will also lead and collaborate with a group of stroke survivors and provide advice to the research team.
Ann said:
“As part of the research team, along with other patients and lay contributors with a wide range of backgrounds and experiences, I have worked with other patients and general contributors from a wide range of backgrounds and experiences to explore this vital part of stroke rehabilitation that has the potential to change the lives of people living with spatial inattention after stroke. I look forward to exploring this area.” It is especially rewarding to know that patient, carer and public engagement is a key element of SIGHT. ”
The grant will enable the SIGHT clinical trial to be carried out on an unprecedented scale, making it the largest clinical trial to date for people with post-stroke spatial neglect, and will be recruited and conducted by Norfolk University and It will be carried out at eight major stroke centers across England, including Norwich University. University Hospitals NHS Foundation Trust (NNUHFT).
As a practicing stroke consultant, I see the effects of this hidden stroke disorder (spatial neglect) every day. We apologize for the inconvenience this will cause to patients and their families. We are delighted that Norfolk and Norwich University Hospital is participating in this trial, which will benefit patients in the future. Until now, this area has been poorly understood and poorly researched. ”
Neil Metcalf, UEA Emeritus Associate Professor, NNUHFT Stroke Consultant
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University of East Anglia