Speech Entrainment for Aphasia

Overseen By Shauna Zodrow, BA

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Albert Einstein Healthcare Network

Disqualifiers: Learning disabilities, Neurological impairments

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

Compensation: Varies

Number of Visits: Unknown

Duration: Varies per participant

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how various speech practices, including Audiovisual Speech Entrainment Practice, can aid people with aphasia in improving their speaking skills. Aphasia, a condition that impairs speech after a brain injury like a stroke, challenges communication. Participants will practice speaking alongside a recorded voice, using either sound alone or both sound and visuals. The study seeks individuals who have experienced aphasia for over six months and are willing to participate in multiple sessions.

As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance speech therapy techniques for aphasia.

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 these speech entrainment practices are safe for aphasia treatment?

Research shows that speech entrainment, where patients copy a speech model, significantly improves speech fluency in people with aphasia. Researchers are studying two types of speech entrainment: audiovisual and auditory. Both involve practicing speech with a recorded model.

Studies on speech entrainment have not reported any major safety concerns, suggesting that the treatment is generally safe for people with aphasia. Additionally, research shows that speech entrainment therapy is well-tolerated, with no significant negative effects reported.

Overall, available evidence indicates that these speech entrainment practices are safe and could help improve speech in individuals with aphasia. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about speech entrainment practices for aphasia because these methods provide a fresh approach to improving speech in individuals with this condition. Unlike traditional speech therapy, which often relies on repetition and exercises without dynamic cues, these new techniques use synchronized practice with recorded models. The Audiovisual Speech Entrainment offers both visual and auditory cues, while the Auditory Speech Entrainment focuses on auditory cues alone. This innovative method could enhance the brain's ability to reorganize and improve speech more naturally and efficiently.

What evidence suggests that this trial's treatments could be effective for aphasia?

Research shows that speech entrainment, where people match their speech to a model, can help those with aphasia improve their speaking skills. In this trial, participants will join different treatment arms to evaluate the effectiveness of these methods. Studies have found that using both sound and visual cues, as in the Audiovisual Speech Entrainment Practice arm, can make speech flow more smoothly and easily. For people with non-fluent aphasia, practicing with auditory speech entrainment, as in the Auditory Speech Entrainment Practice arm, led to over a 20% improvement in using verbs. Audiovisual speech entrainment helps those with fluent aphasia better imitate speech patterns. These treatments hold promise for making speech clearer and more efficient for people with aphasia. ^{1 2 6 7 8}

Who Is on the Research Team?

Marja-Liisa Mailend, PhD

Principal Investigator

Albert Einstein Healthcare Network

Are You a Good Fit for This Trial?

This trial is for English-speaking adults aged 18-80 with aphasia, which affects their ability to communicate. They must be more than six months post-onset and have a specific score on the Western Aphasia Battery - Revised test. Participants need to commit to multiple sessions either at the testing site or at home.

Inclusion Criteria

More than six months since symptoms started.

English is my first language.

You have difficulty speaking and understanding language.

Exclusion Criteria

You have a history of struggling with learning.

I have a history of neurological problems.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in speech entrainment practice, including auditory and audiovisual modalities, to enhance independent speech production.

Varies per participant

Multiple sessions (in-person)

Follow-up

Participants are monitored for speech production effectiveness one day post-treatment.

1 day

What Are the Treatments Tested in This Trial?

Interventions

• Audiovisual Speech Entrainment Practice
• Auditory Speech Entrainment Practice
• Speech Entrainment Practice

Trial Overview The study tests two types of speech entrainment practices: audiovisual and auditory, to improve independent speech in people with aphasia. It measures how informative and efficient their speech is after treatment when telling stories.

How Is the Trial Designed?

Group I: Auditory Speech Entrainment Practice Experimental Treatment 2 Interventions

Auditory Speech Entrainment includes repeated practice of speaking synchronously with a recorded model, which provides contextual, temporal, and auditory cues for speaking.

Group II: Audiovisual Speech Entrainment Practice Experimental Treatment 2 Interventions

Audiovisual Speech Entrainment includes repeated practice of speaking synchronously with a recorded model, which provides contextual, temporal, and audiovisual cues for speaking.

Who Is Running the Clinical Trial?

Albert Einstein Healthcare Network

Lead Sponsor

Trials

65

Recruited

869,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Published Research Related to This Trial

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]

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]

Healthy individuals adjust their speaking rate and pitch when interacting with speakers who have dysarthria, indicating a phenomenon called rhythmic entrainment during communication.

Despite these adjustments, the speech produced by healthy interactants still differed significantly from the disordered speech, suggesting that while entrainment occurs, it does not fully compensate for the speech impairment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rhythm as a coordinating device: entrainment with disordered speech. Borrie, SA., Liss, JM.[2021]

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]

Speech entrainment significantly improves speech fluency in individuals with non-fluent aphasia, as shown by better timing adjustments in their speech compared to spontaneous speech, based on a study of 31 stroke survivors.

The study found that while most acoustic measures of speech timing improved with speech entrainment, the adjustments made by non-fluent speakers led to more typical speech patterns, which could enhance their perceived naturalness and social acceptance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech timing changes accompany speech entrainment in aphasia. Feenaughty, L., Basilakos, A., Bonilha, L., et al.[2021]

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]

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]

Citations

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

Speech Entrainment for Aphasia Recovery (SpARc) phase II ... This therapy uses an audiovisual computer system to guide (entrain) the speech of the person with aphasia, i.e., the person with aphasia verbally mimics the ...

2. clinicaltrial.be clinicaltrial.be/en/details/188856?per_page=20&recruiting=1&enrolling_by_invitation=1&active_not_recruiting=1&not_yet_recruiting=0&completed=0&only_recruiting=0&only_eligible=0

Speech Entrainment Treatment for People With Aphasia The objective of the study is to (1) experimentally establish the direct effect of speech entrainment practice on independent speech production ...

3. centerwatch.com centerwatch.com/clinical-trials/listings/NCT05687994/speech-entrainment-treatment-for-people-with-aphasia

Speech Entrainment Treatment for People With Aphasia The objective of the study is to (1) experimentally establish the direct effect of speech entrainment practice on independent speech production ...

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

Speech Entrainment for Aphasia Recovery SpARc ... fluent aphasia, termed speech entrainment therapy (SET). SET is a form of speech therapy that uses an audio-visual system to guide (entrain) ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0021992421000137

Speech timing changes accompany speech entrainment in ... Prior speech entrainment studies, where individuals with non-fluent aphasia mimic an audio-visual model, suggest speech entrainment improves speech fluency, ...

6. trialx.com trialx.com/clinical-trials/listings/255782/speech-entrainment-treatment-for-people-with-aphasia/

Speech Entrainment Treatment for People With Aphasia With 24 participants, there is 80% power to detect the observed effect of 0.6 for speaking with audiovisual speech entrainment vs. auditory-only ...

7. withpower.com withpower.com/trial/phase-aphasia-2023-25608

Speech Entrainment for Aphasia Research shows that speech entrainment, where patients mimic an audiovisual speech model, significantly improves speech fluency in individuals with ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8982955/

Speech Entrainment Improves Connectivity Between ... Speech entrainment (SE), the online mimicking of an audiovisual speech model, has been shown to increase speech fluency in individuals with non-fluent aphasia.