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What is Visual Neglect?

Sometimes, after a stroke, people develop a problem called visual neglect. Neglect after a stroke means that a person has difficulty looking at and responding to stimuli located on one side of space, usually on the left side.

Why is it important to try and treat visual neglect?

Visual neglect is present in 50-82% of patients in the acute period after a stroke, and one third of them will still suffer from the problem in the chronic phase. It is a disabling impairment because it impacts the ability to be aware of one side of space and the body. Therefore, it is an obstacle during neurorehabilitation as it affects patients’ ability to engage with therapy. Interventions which reduce the severity of neglect could help enable greater functional gains from Neurorehabilitation, reduce long term disability and the overall length of stay in hospital.

What is ATTEND?

ATTEND is a virtual reality game designed to help improve visual neglect. Eye scanning exercises after stroke can help the brain to recover its attention to the left side. Virtual reality games played on a tablet or computer can be an enjoyable way to exercise these eye movements. We are studying the effects of a new computer-based scanning therapy called ‘ATTEND’ to see if we can improve scanning to the left.

How is ATTEND being tested?

ATTEND is a phase II randomized controlled trial, being tested in a group of stroke and rehabilitation inpatients across 5 hospitals, including University College London Hospital, St. Pancras’ Rehabilitation Unit, Charing Cross Hospital, St. George’s Hospital and Luzerne Hospital, Switzerland.

What does the trial involve?

Suitable patients are identified by members of the clinical team, and screened in using traditional pen and paper based tests for visual neglect. They are then randomized into either the Therapy or Control arm of the trial. Each of the arms receives a separate type of Virtual reality stimulation. Each participant then receives daily sessions of Virtual Reality stimulation for a total of 40 minutes per day (4 x 10 minute sessions), for a total of 15 days. Their performance is assessed by outcome measures which include functional and impairment-based measures. There is a follow-up at the 3 month time point to assess long-term effects.

Results and Outcomes

As this is an ongoing inpatient trial, our referrals come from the clinical teams in the Stroke or Rehabilitation Units in the hospitals mentioned above. The trial is nearing completion with recruitment concluding in autumn 2024.

If you want to learn more about the study contact us (see the contact box).