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Completed

NCT Number: NCT07507383

Dynamic Auditory Cueing for Spatial Neglect in Stroke

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 for spatial neglect (DAC-SN) 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.

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Key information

Conditions

Stroke Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pathological Conditions, Signs and Symptoms Perceptual Disorders Signs and Symptoms Spatial Neglect Spatial Neglect After Stroke Vascular Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

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

Ankara, 06560, Turkey (Türkiye)

About this study

Spatial neglect is a common and disabling condition following stroke, characterized by reduced awareness of stimuli on one side of space. It is associated with impaired functional recovery and decreased independence in daily activities. Despite conventional rehabilitation approaches, spatial neglect may persist and continues to be a significant challenge in stroke rehabilitation. Dynamic auditory cueing for spatial neglect (DAC-SN) has been proposed as a method to facilitate attentional orientation by providing external sensory input directed toward the affected side. This approach may enhance spatial exploration and support recovery by promoting engagement with the neglected hemispace. The aim of this randomized controlled trial is to investigate the effect of dynamic auditory cueing in patients with stroke and spatial neglect. Participants are randomly assigned to receive either conventional rehabilitation alone or conventional rehabilitation combined with dynamic auditory cueing. The intervention is delivered in addition to standard rehabilitation in structured sessions over a four-week period. The control group receives conventional rehabilitation according to standard clinical practice. Spatial neglect severity and functional outcomes are assessed using standardized clinical measures at baseline and at predefined time points during and after the intervention period. The findings of this study are expected to provide evidence on the potential role of auditory-based interventions as an adjunct to conventional rehabilitation in improving spatial neglect and functional outcomes in patients with stroke.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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 Test (LBT), Star Cancellation Test (SCT))
  • Normal or corrected visual acuity
  • Absence of auditory extinction
  • Ability to understand and comply with study procedures
  • Provision of written informed consent

Exclusion criteria

  • 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

Treatment and study plan

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. Dynamic auditory cueing for spatial neglect (DAC-SN) is applied using sounds presented with a dynamic spatial movement pattern across the horizontal plane. The auditory stimulus 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 administered 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.

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 for spatial neglect (DAC-SN).

Primary outcomes

  1. Line Bisection Test (LBT) deviation score

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

    The Line Bisection Test (LBT) 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.

  2. Catherine Bergego Scale (CBS) score

    Time frame: Baseline and after 20 sessions (end of treatment)

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

Secondary outcomes

  1. Star Cancellation Test (SCT) score

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

    The Star Cancellation Test (SCT) is used to assess spatial neglect by measuring the number and spatial distribution of correctly identified targets. Omission of targets on the left side indicates more severe left-sided spatial neglect.

  2. Line Cancellation Test (LCT) score

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

    The Line Cancellation Test (LCT) evaluates spatial neglect by assessing the ability to detect and cancel target lines. Omission of lines on the left side indicates more severe left-sided spatial neglect.

  3. Functional Independence Measure (FIM) score

    Time frame: Baseline and after 20 sessions

    The Functional Independence Measure (FIM) assesses functional independence in activities of daily living. Higher scores indicate greater functional independence.

  4. Center of Cancellation (CoC) value

    Time frame: Baseline, after 1 session, after 10 sessions, and after 20 sessions

    The Center of Cancellation (CoC) quantifies spatial bias based on cancellation task performance. Higher absolute values indicate more severe spatial neglect.

Sponsors and collaborators

Lead sponsor

Gazi University

Other

Registry information

Official study title

The Effect of Dynamic Auditory Cueing on Spatial Neglect in Patients With Stroke: A Randomized Controlled Trial

Acronym: DAC-SN

Important dates

Study start
2024
Primary completion
2026
Study completion
2026
First posted
Apr 2, 2026
Registry last updated
Jul 23, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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