Evidence map›Paper›PMID 29436486›Full record

Trial reportJournal of neurology, neurosurgery, and psychiatry2018

Randomised, double-blind, placebo-controlled crossover study of single-dose guanfacine in unilateral neglect following stroke.

Edwin S Dalmaijer, Korina M S Li, Nikos Gorgoraptis, Alexander P Leff, David L Cohen, Andrew D Parton, Masud Husain, Paresh A Malhotra

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neurology, neurosurgery, and psychiatry, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00955253 (A Trial of Guanfacine, an Alpha 2 Adrenergic Agonist, for Spatial Neglect and Impaired Vigilance Following Stroke and Focal Brain Damage), which is not on this map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00955253 phase2completednot on this map

A Trial of Guanfacine, an Alpha 2 Adrenergic Agonist, for Spatial Neglect and Impaired Vigilance Following Stroke and Focal Brain Damage

TypeinterventionalSponsorImperial College LondonRan2010 to 2014Enrolled13ConditionsStroke, Hemispatial NeglectArmsGuanfacine, Placebo
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Advances in the Rehabilitation of Hemispatial Inattention.Current neurology and neuroscience reports · 2023
    Review
  5. Reversing the Ruin: Rehabilitation, Recovery, and Restoration After Stroke.Current neurology and neuroscience reports · 2022
    Review
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 1 country.

Edwin S Dalmaijer *Department of Experimental Psychology, University of Oxford, Oxford, UK.ORCID 0000-0003-3241-0760
Korina M S Li *Centre for Restorative Neuroscience, Division of Brain Sciences, Imperial College London, London, UK.
Nikos GorgoraptisCentre for Restorative Neuroscience, Division of Brain Sciences, Imperial College London, London, UK.
Alexander P LeffInstitute of Cognitive Neuroscience, University College London, London, UK.
David L CohenHyper-acute Stroke Unit, Northwick Park Hospital, London, UK.
Andrew D PartonDivision of Psychology, Department of Life Sciences, Brunel University, Uxbridge, UK.
Masud HusainDepartment of Experimental Psychology, University of Oxford, Oxford, UK.
Paresh A MalhotraCentre for Restorative Neuroscience, Division of Brain Sciences, Imperial College London, London, UK.
Imperial College London · GBUniversity of Oxford · GBBrunel University of London · GBCharing Cross Hospital · GBNorthwick Park Hospital · GBUniversity College London · GB

Funding

Department of Health RP-2015-06-012Medical Research Council MC_UU_00005/2Wellcome Trust 206330/Z/17/Z
6 · The paper itself

Abstract

objectiveUnilateral neglect is a poststroke disorder that impacts negatively on functional outcome and lacks established, effective treatment. This multicomponent syndrome is characterised by a directional bias of attention away from contralesional space, together with impairments in several cognitive domains, including sustained attention and spatial working memory. This study aimed to test the effects of guanfacine, a noradrenergic alpha-2A agonist, on ameliorating aspects of neglect.

methodsThirteen right hemisphere stroke patients with leftward neglect were included in a randomised, double-blind, placebo-controlled proof-of-concept crossover study that examined the effects of a single dose of guanfacine. Patients were tested on a computerised, time-limited cancellation paradigm, as well as tasks that independently assessed sustained attention and spatial working memory.

resultsOn guanfacine, there was a statistically significant improvement in the total number of targets found on the cancellation task when compared with placebo (mean improvement of 5, out of a possible 64). However, there was no evidence of a change in neglect patients' directional attention bias. Furthermore, Bayesian statistical analysis revealed reliable evidence against any effects of guanfacine on search organisation and performance on our sustained attention and spatial working memory tasks.

conclusionsGuanfacine improves search in neglect by boosting the number of targets found but had no effects on directional bias or search organisation, nor did it improve sustained attention or working memory on independent tasks. Further work is necessary to determine whether longer term treatment with guanfacine may be effective for some neglect patients and whether it affects functional outcome measures. TRIAL REGISTRATION NUMBER: NCT00955253.

Indexed as

Adrenergic alpha-2 Receptor AgonistsAdultAgedAttentionCross-Over StudiesDouble-Blind MethodFemaleGuanfacineHumansMaleMemoryMiddle AgedPerceptual DisordersStrokeAdrenergic alpha-2 Receptor AgonistsGuanfacine

Identifiers

PMID29436486
PMCPMC6031270
OpenAlexW2785896426

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.