Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: A Randomised Trial of Non-Invasive Brain Stimulation (NIBS) in Stroke Survivors
Brief Summary: After a stroke affecting the right side of the brain, many patients are affected by "spatial neglect": the damage to the brain causes them to ignore the left side of their surroundings. At its most extreme they may be unaware that they have a left side, or believe that it is moving normally when it is in fact paralysed. In milder cases, people may be unable to recognise touch on the left side if their right side is also being touched, or objects in their left visual field if something is visible to their right. Neglect alters peoples' quality of life profoundly, often renders them more dependent on others to undertake basic activities of daily living, and makes effective rehabilitation much more difficult.

The limited success of current treatment approaches indicates gaps in understanding of the underlying mechanisms of neglect and its recovery. Recent data suggest that the problems in responding to the left side are a result of an imbalance of activity in those parts of the brain responsible for deciding which side to pay attention to. It might therefore be possible to help people with neglect by "rebalancing" the brain either by increasing activity in the damaged side, or alternatively by reducing activity in the undamaged side. In this pilot study, the investigators will test whether they can help by doing the second of these things.

The investigators propose to conduct a pilot clinical trial to explore whether using electric currents to temporarily modify the activity of specific areas of the intact side of the brain, influences recovery from neglect, when used either alone, or in combination with a training method that has previously appeared promising as a treatment. Brain activity will be modified using a technique called "transcranial direct current stimulation (tDCS)", in which small electric currents are applied to the scalp with a wire covered in damp cotton pads. This will be done over the specific parts of the brain that are responsible for focusing attention to one side.

The investigators will compare the clinical outcomes of four interventions (1: behavioural, 2: tDCS, 3: a combination of both and 4: control).

The investigators hope that these studies will advance their understanding of what treatments may help people with neglect, and how they might work.


Options:
A: Arm Label: sensorimotor therapy; Type: EXPERIMENTAL; Interventions: Other: additional sensorimotor therapy for the upper limb | Arm Label: motor therapy; Type: ACTIVE_COMPARATOR; Interventions: Other: additional motor therapy for the upper limb after stroke | Intervention Type: OTHER; Name: additional sensorimotor therapy for the upper limb; Assigned to Arm(s): sensorimotor therapy | Intervention Type: OTHER; Name: additional motor therapy for the upper limb after stroke; Assigned to Arm(s): motor therapy
B: Arm Label: Action Training; Type: ACTIVE_COMPARATOR; Interventions: Other: Action Training | Arm Label: tDCS; Type: EXPERIMENTAL; Interventions: Other: Transcranial direct current stimulation | Arm Label: Action Training + tDCs; Type: EXPERIMENTAL; Interventions: Other: Transcranial direct current stimulation, Other: Action Training | Arm Label: Control training; Type: PLACEBO_COMPARATOR; Interventions: N/A | Intervention Type: OTHER; Name: Transcranial direct current stimulation; Assigned to Arm(s): Action Training + tDCs, tDCS | Intervention Type: OTHER; Name: Action Training; Assigned to Arm(s): Action Training, Action Training + tDCs
C: Arm Label: Mirror therapy; Type: EXPERIMENTAL; Interventions: Behavioral: Mirror therapy | Arm Label: Sham mirror; Type: SHAM_COMPARATOR; Interventions: Behavioral: Sham mirror | Arm Label: Covered mirror; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Covered mirror | Intervention Type: BEHAVIORAL; Name: Mirror therapy; Assigned to Arm(s): Mirror therapy | Intervention Type: BEHAVIORAL; Name: Sham mirror; Assigned to Arm(s): Sham mirror | Intervention Type: BEHAVIORAL; Name: Covered mirror; Assigned to Arm(s): Covered mirror
D: Arm Label: Family-Clinician Collaboration; Type: EXPERIMENTAL; Interventions: Behavioral: Family-Clinician Collaboration Program | Intervention Type: BEHAVIORAL; Name: Family-Clinician Collaboration Program; Assigned to Arm(s): Family-Clinician Collaboration

Answer: B