Table 3.
Main data of the included studies
| Study | Study design | Experimental conditions | Sample (N) | Stimulation site | Intensity and duration of tDCS | Number of sessions | Assessment measures | Reported results | Improvement in line bisection | Improvement in cancelation task |
|---|---|---|---|---|---|---|---|---|---|---|
| Turgut et al. [68] |
Parallel No randomization No blinding |
-Dual tDCS + Optokinetic intervention + Conventional treatment -Conventional treatment alone |
32 | PPC |
1.5–2.0 mA 20 min |
8 sessions |
- Barthel Index - Body orientation on the wheelchair - Eye, head and trunk orientation (with and without cueing) - Fim/IVAR Early Rehabilitation - Line Bisection Test - The Apples Cancellation Task - The Clock Drawing Test |
Combination intervention (dual tDCS + optokinetic + conventional treatment) reduces neglect for ipsilesional spontaneous body orientation and improves performance on the Clock Drawing Test compared to standard treatment | No | No |
| Bornheim et al. [11] |
Crossover within-subjects Case Reports Randomized Double blinding |
-a-tDCS + Physical therapy + Occupational therapy + Neuropsychological therapy -Sham tDCS + Physical therapy + Occupational therapy + Neuropsychological therapy |
4 | M1 |
2 mA 20 min |
20 sessions |
- Catherine Bergego Scale - Line Bisection Test - The Star Cancellation Test |
Active tDCS improves performance in the four patients in Catherine Bergego Scale, Line Bisection Test, and The Star Cancellation Test, expressed in percentage of change, compared to sham | Yes | Yes |
| O'Shea et al. [57] |
Crossover within-subjects 3 cases study Longitudinal Randomized No blinding |
-a-tDCS + Prism adaptation -c-tDCS + Prism adaptation -Sham tDCS + Prism adaptation |
3 | M1 |
1 mA 20 min |
P1: 3 active and 5 sham sessions P 2: 1 active and 1 sham sessions |
-Balloons tests -Coloring, reading and filling in a mock administrative form -Copy Drawing -Letter Cancellation, star cancellation test, object cancellation (dense and sparse search array) -Line Bisection Test -Ota test -The Bells test -Percent correct scores across the tests were combined to compute the overall neglect score for each patient (6 tests for P1; 10 tests for P2 and 3) |
Improvement in neglect score after M1 tDCS + prism adaptation compared to sham The improvement in neglect score lasted throughout follow-up (18–46 days) |
Yes | Yes |
| Yi et al. [74] |
Parallel Randomized No blinding |
-a-tDCS + Conventional physical therapy -c-tDCS + Conventional physical therapy -Sham tDCS + Conventional physical therapy |
30 | PPC |
2 mA 30 min |
15 sessions |
- Catherine Bergego Scale - Functional Ambulation Classification (basic motor skills) - K-MMSE - Korean Modified Barthel Index - Line Bisection Test - Motor-Free Visual Perception Test - The Star Cancellation Test |
Improvement in motor-free visual perception test, line bisection, star cancellation, Catherine Bergego Scale, Barthel Index, and Functional Ambulation Classification in all 3 groups (a-tDCS, c-tDCS, sham) Improvements in the motor-free visual perception test, start cancellation, and line bisection were greater in a-tDCS and c-tDCS compared to sham |
Yes | Yes |
| Bang and Bong [5] |
Parallel Randomized No blinding |
-tDCS + Feedback training -Feedback training alone |
12 | PPC |
1 mA 20 min |
15 sessions |
- Barthel index - Line Bisection Test - Motor-Free Visual Perception Test |
Improvement in Barthel index, line bisection test and motor-free visual perception test in the two groups Combined tDCS + feedback intervention show greater improvement compared to feedback training alone in all tests |
Yes | Not assessed |
| Smit et al. [64] |
Crossover within-subjects No randomized Double blinding |
-Dual tDCS -Sham dual tDCS |
5 | PPC |
2 mA 20 min |
5 sessions |
Behavioral Inattention Test (BIT-C): - Figure and Shape Copying - Letter Cancellation - Line Bisection Test - Line Crossing - Representational Drawing - The Star Cancellation Test |
No tDCS-related effects were observed for the BIT subtests | No | No |
| Làdavas et al. [47] |
Parallel Randomized Double blinding |
-a-tDCS + Prism adaptation -c-tDCS + Prism adaptation -Sham tDCS + Prism adaptation |
30 | PPC |
2 mA 20 min |
10 sessions |
Behavioral Inattention Test (BIT-C): - Figure and Shape Copying - Letter Cancellation - Line Bisection Test - Line Crossing - Representational Drawing - The Star Cancellation Test |
a-tDCS PPC boosted neglect amelioration after prism adaptation c-tDCS suppresses neglect improvement after prism adaptation |
Yes | Yes |
| Brem et al. [12] |
Crossover within-subjects No randomized Double blinding |
-Dual tDCS + Conventional cognitive therapy -Sham tDCS + conventional cognitive therapy |
1 | PPC |
1 mA 20 min |
6 sessions |
Test for Attentional Performance: - Alertness - Covert Attention - Visual field From Neglect-Test German version of BIT: - Cancellation - Copying figures - Line Bisection Test Transfer effects on ADL |
Combined intervention (dual tDCS + cognitive therapy) showed greater improvement compared to sham in cover attention, line bisection, and coping ADLs showed improvement at the 3 month follow-up |
Yes | No |
| Sunwoo et al. [67] |
Crossover within-subject Randomized Double blinding |
-Dual tDCS -a-tDCS -Sham tDCS |
10 | PPC |
1 mA 20 min |
3 days Dual tDCS (1) a-tDCS (1) |
- Line Bisection Test - The Star Cancellation Test |
Significant improvements in line bisection after both dual and single tDCS, but not after sham, being stronger the effect after dual tDCS No significant change in star cancellation |
Yes | No |
| Sparing et al. [66] |
Crossover within-subjects No randomized No blinding |
-a-tDCS contralesional PPC -c-tDCS contralesional PPC -a-tDCS lesioned PPC -Sham tDCS lesioned PPC |
10 | PPC |
1 mA 10 min |
2 days |
- Line Bisection Test (computerized version) - Neglect subtest of Test Battery of Attentional Performance’ (TAP) |
Both a-tDCS (ipsilesional) and c-tDCS (contralesional) improved line bisection compared to sham No significant changes were detected in neglect subtest of TAP (only a tendency of contralesional c-tDCS) |
Yes | Not assessed |
| Ko et al. [46] |
Crossover within-subjects No randomized Double blinding |
-a-tDCS -Sham tDCS |
15 | PPC |
2 mA 20 min |
2 sessions |
- Letter-Structured Cancellation Test - Line Bisection Test - Shape-Unstructured Cancellation Test |
a-tDCS showed significant improvement in cancellation tests and line bisection tests compared to sham | Yes | Yes |