Mirror Speech Entrainment for Aphasia

(MSE Trial)

Overseen By Gerald C Imaezue, Ph.D

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of South Florida

Disqualifiers: Dementia, Alzheimer's, Parkinsonism, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether using a digital clone of a participant's own voice can improve speech in individuals with aphasia, a language disorder often caused by a stroke. The trial compares this personalized voice technique, known as Mirror Speech Entrainment, to traditional methods where participants mimic another person's voice. Participants will use a mobile app at home to practice speaking with either their own digitally altered voice or another person's voice. This trial may suit English-speaking adults with aphasia due to a stroke who do not have other cognitive or sensory issues. As an unphased trial, it offers a unique opportunity to explore innovative speech therapy techniques that could enhance communication skills.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this technique is safe for persons with aphasia?

Research has shown that speech entrainment, where individuals copy a speech model, is safe for humans and is often used in speech therapy. The new approach involves using a person's own digitally altered voice as the model. This is part of a mobile health app treatment, allowing use at home.

Studies using artificial intelligence (AI) to create personalized voice models have not revealed any safety issues. Participants have tolerated it well, with no reports of negative side effects, suggesting it is safe. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about mirror speech entrainment for aphasia because it offers a fresh approach to language recovery. Unlike traditional speech therapy, which usually relies on auditory feedback alone, mirror speech entrainment incorporates both auditory and visual feedback, enhancing the brain's ability to rewire and learn. By engaging the senses more fully, this method could potentially speed up recovery and improve outcomes for people with aphasia, making communication easier and more effective.

What evidence suggests that mirror speech entrainment could be effective for aphasia?

This trial will explore the effectiveness of mirror speech entrainment for aphasia. In a study of individuals with Broca's aphasia, mirror speech entrainment significantly improved their fluency, with participants demonstrating more than a 20% improvement in speech. This technique uses a digitally altered version of the participant's own voice to guide speech practice. Research has shown that hearing one's own voice can be more effective than using another's voice for this purpose. Similarly, mirror therapy has helped stroke patients enhance their language skills. These findings suggest that mirror speech entrainment could be a promising method to help people with aphasia improve their speech. ^{3 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for individuals who have had a stroke and are experiencing nonfluent aphasia, which includes difficulty with speech production. Participants should be comfortable using a smartphone app at home for the treatment. There's no mention of specific exclusion criteria provided.

Inclusion Criteria

I have difficulty speaking due to a stroke in the left side of my brain.

I primarily speak English.

Exclusion Criteria

Persons with significant difficulties with language comprehension

English is not my first language.

Persons with concomitant cognitive disability

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive speech entrainment treatment using a mobile app, involving mirror speech entrainment and traditional speech entrainment techniques

6 weeks

Remote participation via mobile app

Follow-up

Participants are monitored for language production improvements and safety after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Mirror Speech Entrainment

Trial Overview The study is testing mirror speech entrainment, where participants speak along to their own digitally altered voice, against traditional methods using someone else's voice (with or without visual aid). The aim is to see if personalized voices can better improve language production in people with aphasia.

How Is the Trial Designed?

Group I: Experiment 3: Mirror SE versus Traditional SE (Auditory-visual) Experimental Treatment 2 Interventions

This arm will investigate the effect of mirror speech entrainment in the auditory-visual modality versus traditional speech entrainment in the auditory-visual modality.

Group II: Experiment 2: Mirror SE versus Traditional SE (Auditory-only) Experimental Treatment 2 Interventions

This arm investigates the use of mirror speech entrainment using auditory only feedback and traditional speech entrainment using auditory only feedback.

Group III: Experiment 1: Feasibility Study Experimental Treatment 1 Intervention

Participants will receive two treatments sequentially: mirror speech entrainment using the auditory-only modality followed by mirror speech entrainment using the auditory-visual modality.

Who Is Running the Clinical Trial?

University of South Florida

Lead Sponsor

Trials

433

Recruited

198,000+

Published Research Related to This Trial

Speech entrainment (SE) helps individuals with non-fluent aphasia improve their speech fluency by normalizing functional connectivity between key language regions in the brain, making it more similar to that of neurotypical speakers.

In a study involving 24 individuals with aphasia and 20 controls, SE was found to enhance connectivity patterns during speech production, suggesting that SE may be an effective therapeutic approach for improving speech output in aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional Connectivity and Speech Entrainment Speech Entrainment Improves Connectivity Between Anterior and Posterior Cortical Speech Areas in Non-fluent Aphasia. Johnson, L., Yourganov, G., Basilakos, A., et al.[2022]

The SpARc trial is a multicenter phase II clinical trial involving 80 adults with chronic post-stroke non-fluent aphasia, aiming to evaluate the effectiveness of speech entrainment therapy (SET) over different durations (3, 4.5, or 6 weeks) compared to a control group.

Previous pilot studies indicated that SET can significantly improve speech production, as measured by verbs per minute (VPM), suggesting that this therapy may enhance fluent spontaneous speech in individuals with non-fluent aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech Entrainment for Aphasia Recovery (SpARc) phase II trial design. Cassarly, C., Doyle, A., Ly, T., et al.[2023]

Individuals with non-fluent aphasia who preserved certain brain structures, like the posterior middle temporal gyrus and specific fasciculi, showed better speech fluency when using speech entrainment compared to spontaneous speech.

The study suggests that damage to the dorsal stream of the brain, while preserving ventral stream structures, may enhance the effectiveness of speech entrainment as a rehabilitation technique for improving speech output in non-fluent aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neural structures supporting spontaneous and assisted (entrained) speech fluency. Bonilha, L., Hillis, AE., Wilmskoetter, J., et al.[2020]

Speech entrainment, where patients with Broca's aphasia mimic audio-visual speech stimuli, significantly increases their speech output, allowing them to produce a greater variety of words compared to spontaneous speech.

Neuroimaging studies reveal that speech entrainment activates specific brain regions associated with language processing, and a 6-week treatment using this method improved speech production in patients, suggesting it could be an effective therapy for this challenging condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech entrainment enables patients with Broca's aphasia to produce fluent speech. Fridriksson, J., Hubbard, HI., Hudspeth, SG., et al.[2023]

In a study of 44 chronic patients with left hemisphere stroke, those with Broca's aphasia showed a significant increase in speech fluency when using speech entrainment (SE) compared to spontaneous speech, indicating SE's effectiveness in enhancing speech production.

Voxel-wise lesion-symptom mapping revealed that damage to the inferior frontal gyrus is a predictor of positive response to SE, suggesting that specific patterns of cortical damage can help identify which patients may benefit from this treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech entrainment compensates for Broca's area damage. Fridriksson, J., Basilakos, A., Hickok, G., et al.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8606333/

Speech Entrainment for Aphasia Recovery (SpARc) phase II ... Based on our findings from our pilot data, those with chronic non-fluent aphasia who participated in SET achieved greater than 20% improvement in VPM during ...

2. withpower.com withpower.com/trial/mirror-speech-entrainment-for-aphasia-b94f1

Mirror Speech Entrainment for Aphasia (MSE Trial) In a study of 44 chronic patients with left hemisphere stroke, those with Broca's aphasia showed a significant increase in speech fluency when using speech ...

3. bmcneurol.biomedcentral.com bmcneurol.biomedcentral.com/articles/10.1186/s12883-025-04218-0

Clinical feasibility and cortical effects of synchronous mirror ... Across all the ten times SMT interventions, participants' mean effective intervention time per session was 22.3 min (SD = 7.5), ranging from 9 ...

4. journals.plos.org journals.plos.org/plosone/article/file?type=printable&id=10.1371/journal.pone.0301468

Efficacy and safety of mirror therapy for post-stroke aphasia In one study, real MT was found to significantly improve language function in stroke patients compared to sham MT [15]. Mirror therapy has the ...

5. cdn.clinicaltrials.gov cdn.clinicaltrials.gov/large-docs/54/NCT04364854/Prot_001.pdf

Speech Entrainment for Aphasia Recovery SpARc ... baseline and outcome measure data will be linked to this number without any identifying ... Treatment efficacy: aphasia. Journal of speech ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11078370/

Efficacy and safety of mirror therapy for post-stroke aphasia This study will provide a basis for whether mirror therapy (MT) is effective and safe in the treatment of post-stroke aphasia.

7. clinicaltrials.gov clinicaltrials.gov/study/NCT06829420

Study Details | NCT06829420 | Mirror Speech Entrainment: ... The goal of this clinical trial is to test the use of voice personalization through artificial intelligence (AI) voice cloning on speech entrainment tasks to ...

8. nature.com nature.com/articles/s41597-024-03819-7

The Aphasia Recovery Cohort, an open-source chronic ... The first release of the Aphasia Recovery Cohort includes imaging data, demographics and behavioral measures from 230 chronic stroke survivors who experienced ...