tDCS + Speech Therapy for Aphasia

Overseen By Sidney Schoenrock

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Medical College of Wisconsin

Disqualifiers: Alzheimer's, Epilepsy, Schizophrenia, others

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

Compensation: Varies

Number of Visits: 22

Duration: 10 weeks

25 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This study will investigate the effects of mild electrical stimulation in conjunction with speech therapy for people with post-stroke aphasia to enhance language recovery.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

Is tDCS safe for use in humans?

Research shows that transcranial direct current stimulation (tDCS) is generally safe for humans, with no serious adverse events reported in studies involving people with aphasia. It is a noninvasive brain stimulation method that has been safely combined with speech therapy over extended periods. ^{1 2 3 4 5}

How does the tDCS + Speech Therapy treatment for aphasia differ from other treatments?

The tDCS + Speech Therapy treatment for aphasia is unique because it combines transcranial direct-current stimulation (tDCS), which uses a low-intensity electrical current to modulate brain activity, with traditional speech therapy. This combination aims to enhance the effectiveness of speech therapy by improving brain function and excitability, offering a promising approach for those with aphasia, especially when standard speech therapy alone has limited effectiveness. ^{2 3 5 6 7}

What data supports the effectiveness of the treatment tDCS + Speech Therapy for Aphasia?

Research shows that transcranial direct-current stimulation (tDCS) combined with speech therapy can improve language abilities in people with aphasia after a stroke. Studies found that active tDCS led to greater language improvements compared to a placebo, and it was safely used over extended periods. ^{2 3 5 8 9}

Who Is on the Research Team?

Sara Pillay, Ph.D

Principal Investigator

Medical College of Wisconsin

Are You a Good Fit for This Trial?

This trial is for adults who have language difficulties due to brain damage like a stroke. They must speak English fluently and be able to undergo an MRI scan. People with advanced neurodegenerative diseases, severe psychiatric conditions, uncorrectable hearing or vision issues, developmental disabilities, or contraindications to MRI are not eligible.

Inclusion Criteria

You are able to have an MRI scan.

I am an adult who speaks and understands English fluently.

I have language difficulties due to a stroke or brain tumor.

Exclusion Criteria

You have a serious mental illness like schizophrenia, bipolar disorder, or severe depression.

I have an advanced stage of a brain condition like Alzheimer's, epilepsy, Parkinson's, or ALS.

I do not have uncorrectable hearing, vision problems, or learning disabilities.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive targeted or active-control anodal-tDCS with speech therapy for 10 therapy sessions

10 weeks

10 visits (in-person)

Crossover Treatment

Participants crossover to receive the alternative tDCS intervention within the same speech therapy arm

10 weeks

10 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

6 months

2 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Active Control Transcranial Direct Current Stimulation
• Targeted Transcranial Direct Current Stimulation

Trial Overview The study tests if mild electrical stimulation (tDCS) combined with speech therapy can help improve language in people who've had a stroke causing aphasia. There are two types of tDCS being tested alongside two kinds of speech therapies focused on different aspects of language.

How Is the Trial Designed?

Group I: Targeted tDCS with Semantic-Focused Speech Therapy Experimental Treatment 2 Interventions

Participants will receive semantic-focused speech therapy with targeted anodal-tDCS for 10 therapy sessions.

Group II: Targeted tDCS with Phonologic-Focused Speech Therapy Experimental Treatment 2 Interventions

Participants will receive phonologic-focused speech therapy with targeted anodal-tDCS for 10 therapy sessions before.

Group III: Active Control tDCS with Phonologic-Focused Speech Therapy Active Control 2 Interventions

Participants will receive phonologic-focused speech therapy with active control tDCS for 10 therapy sessions.

Group IV: Active Control tDCS with Semantic-Focused Speech Therapy Active Control 2 Interventions

Participants will receive semantic-focused speech therapy with active control tDCS for 10 therapy sessions.

Who Is Running the Clinical Trial?

Medical College of Wisconsin

Lead Sponsor

Trials

645

Recruited

1,180,000+

Published Research Related to This Trial

Transcranial direct current stimulation (tDCS) combined with speech and language treatment (SLT) is safe for stroke survivors with aphasia, showing no serious adverse events during a six-week treatment involving 30 sessions.

Participants receiving active tDCS exhibited greater improvements in functional language compared to those receiving sham treatment, suggesting that tDCS may enhance the effectiveness of SLT, although the superiority of one stimulation polarity over another remains unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial. Cherney, LR., Babbitt, EM., Wang, X., et al.[2021]

In a study of 37 stroke patients, speech therapy combined with transcranial direct current stimulation (tDCS) significantly improved language function, with an average increase in aphasia quotient (AQ%) of 14.94% after treatment.

Patients with less severe, fluent types of aphasia who started treatment within 30 days of their stroke showed the best responses, and those with hemorrhagic strokes had a higher likelihood of improvement compared to those with infarctions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Factors Associated with Good Responses to Speech Therapy Combined with Transcranial Direct Current Stimulation in Post-stroke Aphasic Patients. Jung, IY., Lim, JY., Kang, EK., et al.[2021]

In a study involving 11 chronic stroke patients with aphasia, dual transcranial direct current stimulation (tDCS) showed a significant improvement in naming response times compared to baseline, suggesting enhanced efficacy over single tDCS.

Both single and dual tDCS improved the number of correct responses in naming tasks, but dual tDCS, which targeted both the left and right inferior frontal gyri, may offer greater benefits for language recovery in stroke patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of dual transcranial direct current stimulation for aphasia in chronic stroke patients. Lee, SY., Cheon, HJ., Yoon, KJ., et al.[2021]

In a study of 58 right-handed English speakers with subacute aphasia, transcranial direct-current stimulation (tDCS) did not significantly enhance picture naming accuracy compared to sham treatment, indicating limited efficacy for this specific outcome.

However, tDCS was associated with greater improvements in discourse skills, which are important for communication, and no adverse events were reported, suggesting it is a safe adjunct to language therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial Direct-Current Stimulation in Subacute Aphasia: A Randomized Controlled Trial. Stockbridge, MD., Elm, J., Breining, BL., et al.[2023]

Transcranial direct-current stimulation (tDCS) significantly improved articulatory accuracy in patients with aphasia after stroke, indicating its potential effectiveness in enhancing speech production.

While tDCS showed qualitative improvements in naming and syllable repetition tasks, these results were not statistically significant, suggesting that further research is needed to fully understand its impact.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Anodal tDCS on Articulatory Accuracy, Word Production, and Syllable Repetition in Subjects with Aphasia: A Crossover, Double-Blinded, Sham-Controlled Trial. Vila-Nova, C., Lucena, PH., Lucena, R., et al.[2021]

A systematic review of 25 studies involving 471 participants found that Transcranial Direct Current Stimulation (tDCS) did not improve overall functional communication in stroke patients, indicating limited efficacy for this primary outcome.

However, anodal tDCS, especially when applied over the left inferior frontal gyrus, showed a significant improvement in noun naming performance, suggesting it may be a promising targeted treatment for specific language deficits after stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial direct current stimulation (tDCS) for improving aphasia after stroke: a systematic review with network meta-analysis of randomized controlled trials. Elsner, B., Kugler, J., Mehrholz, J.[2020]

In a study involving 10 individuals undergoing standard aphasia therapy, 70% expressed interest in and were eligible for transcranial direct current stimulation (tDCS), which was administered during therapy sessions.

Data from four participants showed a large effect size (Cohen's d = 1.32) favoring active tDCS over sham stimulation, suggesting that tDCS may enhance communication outcomes in aphasia therapy, although one participant with severe deficits did not benefit.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Clinical Feasibility of Combining Transcranial Direct Current Stimulation with Standard Aphasia Therapy. Duncan, ES., Nakkawita, SG.[2022]

Transcranial direct current stimulation (tDCS) applied to the left inferior frontal gyrus significantly improved language abilities in patients with nonfluent poststroke aphasia when combined with speech language therapy, as shown by a higher Aphasia Quotient in the A-tDCS group compared to the sham group (72.99 vs. 46.18).

The study involved 18 patients over four weeks, with results indicating that tDCS enhances the effectiveness of speech language therapy, particularly in areas other than comprehension, suggesting a beneficial mechanism of action for language recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of Anodic Transcranial Direct Current Stimulation Combined With Speech Language Therapy on Nonfluent Poststroke Aphasia. Zhao, Q., Wang, J., Li, Z., et al.[2022]

A systematic review of 21 trials involving 421 participants found no evidence that transcranial direct current stimulation (tDCS) improves functional communication in people with aphasia after stroke, indicating low effectiveness for this purpose.

However, there is moderate evidence that tDCS may enhance noun naming accuracy, suggesting it could have some benefits in specific language tasks, although it did not show similar effects for verb naming.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. Elsner, B., Kugler, J., Pohl, M., et al.[2023]

Citations

1. Switzerland pubmed.ncbi.nlm.nih.gov

Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial. [2021]

2. Korea (South) pubmed.ncbi.nlm.nih.gov

The Factors Associated with Good Responses to Speech Therapy Combined with Transcranial Direct Current Stimulation in Post-stroke Aphasic Patients. [2021]

3. Korea (South) pubmed.ncbi.nlm.nih.gov

Effects of dual transcranial direct current stimulation for aphasia in chronic stroke patients. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Transcranial Direct-Current Stimulation in Subacute Aphasia: A Randomized Controlled Trial. [2023]

5. New Zealand pubmed.ncbi.nlm.nih.gov

Effect of Anodal tDCS on Articulatory Accuracy, Word Production, and Syllable Repetition in Subjects with Aphasia: A Crossover, Double-Blinded, Sham-Controlled Trial. [2021]

6. England pubmed.ncbi.nlm.nih.gov

Transcranial direct current stimulation (tDCS) for improving aphasia after stroke: a systematic review with network meta-analysis of randomized controlled trials. [2020]

7. India pubmed.ncbi.nlm.nih.gov

Clinical Feasibility of Combining Transcranial Direct Current Stimulation with Standard Aphasia Therapy. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Effect of Anodic Transcranial Direct Current Stimulation Combined With Speech Language Therapy on Nonfluent Poststroke Aphasia. [2022]

9. England pubmed.ncbi.nlm.nih.gov

Transcranial direct current stimulation (tDCS) for improving aphasia in adults with aphasia after stroke. [2023]