Early tablet-assisted cognitive rehabilitation for aneurysmal subarachnoid hemorrhage: feasibility of a single-center randomized controlled trial (P3.227)

Objective: We aimed to assess the feasibility of applying early tablet-assisted cognitive rehabilitation (TACR) to aSAH patients in an acute stroke unit. Background: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant cognitive deficits. Computer-assisted cognitive rehabilitation was shown to improve attention deficits, visual perception and executive functions. Design/Methods: This was a single-center (Montreal Neurological Hospital) randomized controlled trial. Participants were enrolled up to three weeks after aSAH. They were assigned to receive either daily TACR (BrainHQ®) while hospitalized and following discharge plus guideline-based care (intervention group) or guideline-based care alone (control group). The main expected outcomes were the difference in performance on the Posit Science cognitive assessment, digit span test, and MoCA between baseline and clinic visit. Results: From January to July 2017, 36 aSAH patients were screened (20 assigned to intervention group and 16 to control group), 14 enrolled, and 5 completed the experiment. The mean delay from aSAH to initiating TACR in the intervention group was 10.5 days (95% confidence interval [CI]: 4.3 – 16.7). The mean duration of hospitalization was 13.1 days (95%CI: 4.7 – 21.5) for the intervention group and 13.8 days (0 – 36.0) for the control group. Only the MoCA, Posit Science cognitive assessment and digit span test were fully administered to all participants. The mean rate of TACR completion was 0.237 (95%CI: 0 – 0.795). Conclusions: We demonstrated that delivering early TACR to aSAH patients in an acute setting was partially feasible. The main challenges in conducting this trial were the low rate of participants completing the experiment due to short admission period, various delays in the experimental protocol, practical issues associated with cognitive assessments, and to lesser extent, completion of daily TACR. Prior to conducting a larger trial, securing human resources and assessing the validity and feasibility of cognitive assessments should be addressed. Disclosure: Dr. Chen has nothing to disclose. Dr. Aldhukair has nothing to disclose. Dr. Cote has nothing to disclose. Dr. Flinois has nothing to disclose. Dr. Hoang has nothing to disclose. Dr. Shen has nothing to disclose. Dr. Xu has nothing to disclose. Dr. Laverdure has nothing to disclose. Dr. Tong has nothing to disclose. Dr. Nolan has nothing to disclose. Dr. Li has nothing to disclose. Dr. Cattelan has nothing to disclose. Dr. Audi has nothing to disclose. Dr. La Haye-Caty has nothing to disclose. Dr. Danielova Gueorguieva has nothing to disclose. Dr. Brailovski has nothing to disclose. Dr. Lalavi has nothing to disclose. Dr. Benjamin has nothing to disclose. Dr. De Villers-Sidani has nothing to disclose.