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

40 Participants Needed

Trial Summary

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 data supports the effectiveness of the treatment Audiovisual Speech Entrainment Practice for aphasia?

Research shows that speech entrainment, where patients mimic an audiovisual speech model, significantly improves speech fluency in individuals with non-fluent aphasia, such as Broca's aphasia. Studies found that patients could produce a greater variety of words and improve speech output after using this treatment, suggesting it helps enhance speech production. ^{1 2 3 4 5}

Is speech entrainment therapy safe for humans?

The research does not report any safety concerns for speech entrainment therapy in humans, suggesting it is generally safe for use in individuals with aphasia. ^{1 2 4 5 6}

How is the treatment Speech Entrainment Therapy different from other treatments for aphasia?

Speech Entrainment Therapy is unique because it involves mimicking an audiovisual speech model, which helps improve speech fluency by synchronizing brain areas involved in language. This approach allows patients with non-fluent aphasia to produce more fluent speech compared to traditional methods, which often struggle to achieve such results. ^{1 2 3 5 7}

What is the purpose of this trial?

The objective of this research is to experimentally delineate the direct effect of speech entrainment practice on independent speech production and identify practice conditions that enhance treatment benefits. The primary outcome measure (Correct Information Units per minute) tallies informativeness and efficiency of independent speech in treated stories.

Research Team

Marja-Liisa Mailend, PhD

Principal Investigator

Albert Einstein Healthcare Network

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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, 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]

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]

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]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Speech Entrainment for Aphasia Recovery (SpARc) phase II trial design. [2023]

2. United States 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. [2022]

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

Speech timing changes accompany speech entrainment in aphasia. [2021]

4. Italy pubmed.ncbi.nlm.nih.gov

Speech entrainment compensates for Broca's area damage. [2018]

5. England pubmed.ncbi.nlm.nih.gov

Speech entrainment enables patients with Broca's aphasia to produce fluent speech. [2023]

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

Rhythm as a coordinating device: entrainment with disordered speech. [2021]

7. England pubmed.ncbi.nlm.nih.gov

Neural structures supporting spontaneous and assisted (entrained) speech fluency. [2020]