Stroke Sequelae
Conditions
Keywords
stroke
Brief summary
There is an evidence gap on whether meditation may improve behaviorally measured attention after stroke, but preliminary research is promising. This study is the first-ever investigation of whether mantra meditation may improve chronic, severe impairment in attention after stroke.
Detailed description
The study is non-concurrent, multiple-baseline, across-subjects, single-case research design (SCRD). The central hypothesis is that mantra meditation (independent variable) will be associated with improvement on 1 or more tests of behaviorally measured sustained attention (dependent variable). The mantra in this study is the syllable um and is not assigned any spiritual, religious, or affective meaning. The mantra is repeated aloud together by the subject and the PI for a duration of 30 minutes in each session. This procedure constitutes meditation for the purposes of this study. There are 9 session of meditation (3 times per week for 3 weeks). Attention is measured in each of these sessions as well as in 3 separate testing sessions that precede the intervention period.
Interventions
BEHAVIORALmantra meditation
see study description
Sponsors
Cheryl Carrico
Study design
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
single-case research design involving a series of AB designs
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
. 1. Adults between the ages of 18 and 70 2. Chronic, non-lacunar, right-hemisphere stroke (i.e., sustained at \>12 months prior to date of clinical screen) 3. Severely impaired attention defined as 5 or more errors of commission on the SARTfixed 4. Intact consent capacity with no evidence of dementia, defined as a score of 100% correct answer rate on University of California, San Diego Brief Assessment of Capacity to Consent (UBACC). 5. Right-handed dominance as well as sufficient movement and vision function for testing (use of computer mouse, keyboard, and monitor) 6. English language fluency and reading comprehension at least at 6th grade level
Exclusion criteria
. 1. Depression defined as a score of \>10 on Beck Depression Inventory, Short Form (BDI-SF) 2. Current or significant history of substance abuse 3. In the 3 months preceding enrollment, change in medications that impact neuroplasticity 4. Current participation in any other research study, cognitive rehabilitation, meditation, or mental training program, including commercial brain-training programs 5. Neurological disorder other than stroke (e.g., Parkinson's disorder; multiple sclerosis; traumatic brain injury) 6. Spatial attention deficit (unilateral neglect) defined as a score of 51 or fewer cancellations on the Star Cancellation Test. 7. According to the clinical judgement of the PI or her authorized designee, any other functional impairment which would significantly deter comprehension and/or execution of the requirements of the trial, such as aphasia, hearing deficit, or mobility deficit restricting navigation to, from, and within the research site. Subjects must be able to provide their own transportation to and from the study site. 8. Uncontrolled or severe mental or cognitive disorder with low psychosocial functioning, such as untreated schizophrenia, bipolar disorder, or autism
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sustained Attention to Response Task, Fixed Version | through study completion; average of 4 weeks | SARTfixed is in the class of attention tests called continuous performance tests, a class which has a long history of use to measure sustained attention (Shaleva, Ben-Simon, Mevorachc, Cohen, & Tsald, 2011). SARTfixed is a 5-minute computerized test based on the standard version of the SART, which was developed to measure sustained attention in subjects with right-hemisphere acquired brain lesions (Robertson, Manly, Andrade, Baddeley, & Yiend,1997b). Manly and colleagues (2003) demonstrated that in subjects with neurological impairment, SARTfixed was a more pure measurement of sustained attention than standard SART. SARTfixed also had comparatively more likelihood than standard SART for accurately discriminating between healthy volunteers and individuals with neurological impairment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Trail-Making Test (TMT) | through study completion; average of 4 weeks | • TMT is a 5-minute pencil-and-paper test that has been extensively used as a measure of executive function as well as a measure of attention in a study of meditation to improve attention after stroke (Johansson, Bjuhr, & Rönnbäck, 2012). |
| Cognitive Failures Questionnaire | through study completion; average of 4 weeks | • CFQ is a 25-item pencil-and-paper questionnaire that uses a self-report scale 1-5 on which subjects identify difficulty in everyday cognitive functioning. CFQ measures 4 cognitive constructs (Distractibility, Memory, Blunders and Naming) and has been used in research, as well as clinically, to measure sustained attention after stroke (Shalev, Humphreys, & Demeyere, 2016). |
Countries
United States
Outcome results
None listed