Intention Treatment for Aphasia

Overseen By Laura Britan Lang, MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Severe apraxia, Dysarthria, Depression, others

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

Compensation: Varies

Number of Visits: 5

Duration: 3-12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores a new treatment for aphasia, a language impairment often following a stroke. The researchers aim to determine the best delivery method for the treatment and identify who benefits most. Participants will receive the Intention Treatment for Anomia, either over 12 weeks or concentrated in 3 weeks. Stroke survivors with language difficulties, particularly in word-finding, who had a stroke affecting the left side of the brain more than 6 months ago, might be suitable candidates. As an unphased study, this trial offers a unique opportunity to contribute to groundbreaking research that could enhance future aphasia treatments.

Will I have to stop taking my current medications?

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

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Intention Treatment for Anomia, which aids people with aphasia in finding words more easily, lacks specific safety data. However, studies have not reported harmful effects, suggesting the treatment is likely safe. In past research, participants did not experience negative side effects. While more information would be beneficial, the absence of negative reports is encouraging for those considering joining a clinical trial for this treatment. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Intention Treatment for Anomia because it explores innovative methods of delivering therapy for aphasia, a condition that impairs language skills. Unlike traditional speech therapy options, which often involve consistent, uniform sessions, this treatment investigates two distinct delivery methods: the Distributed Intention Treatment, which spreads 30 hours of therapy over 12 weeks, and the Massed Intention Treatment, which condenses the same amount of therapy into just 3 weeks. This approach allows researchers to determine the most effective way to structure therapy sessions for improved patient outcomes, potentially offering more personalized and flexible treatment plans for individuals with aphasia.

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

Studies have shown that the Intention Treatment for Anomia helps individuals with moderate to severe word-finding difficulties improve their ability to name pictures. Targeted speech therapy can significantly enhance naming abilities for some people with anomia, a condition characterized by difficulty finding words, often following a stroke. Research indicates that various treatment methods, including intention treatment, often result in immediate improvement on practiced words. In this trial, participants will receive either Distributed Intention Treatment (distributed-INT) over 12 weeks or Massed Intention Treatment (massed-INT) over 3 weeks. While individual results can vary, treatments for anomia have demonstrated both short- and long-term success in aiding word retrieval. These findings suggest that the Intention Treatment could be effective for those experiencing aphasia after a stroke. ^{1 2 6 7 8}

Who Is on the Research Team?

Amy D. Rodriguez, PhD

Principal Investigator

Atlanta VA Medical and Rehab Center, Decatur, GA

Are You a Good Fit for This Trial?

This trial is for Veterans who primarily speak English, have aphasia with difficulty finding words after a stroke in the left side of the brain, and can follow two-step commands. It's not for those with implanted medical devices or metal in their bodies, severe speech muscle control issues, or major depression.

Inclusion Criteria

I struggle to find the right words when speaking.

I can understand and follow two-step commands.

English as primary language

Exclusion Criteria

I don't have metal implants, devices, or severe fear of tight spaces.

I have severe difficulty speaking clearly.

I have been diagnosed with severe depression.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Standardized assessments and MRI scans are conducted to establish cognitive, language, and neural baselines

1 week

1 visit (in-person)

Treatment

Participants receive Intention Treatment (INT) with either massed or distributed practice

3-12 weeks

Multiple visits (in-person)

Follow-up

Participants are monitored for maintenance and generalization of treatment gains

6 months

4 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Intention Treatment for Anomia

Trial Overview The study tests a new word retrieval treatment for aphasia following a stroke. Researchers aim to find out how intense this therapy should be and what factors predict success in improving language skills among Veterans.

How Is the Trial Designed?

Group I: Distributed Intention Treatment (distributed-INT) Active Control 1 Intervention

Participants will receive 30 hours of Intention Treatment (INT) over 12 weeks.

Group II: Massed Intention Treatment (massed-INT) Active Control 1 Intervention

Participants will receive 30 hours of Intention Treatment (INT) over 3 weeks.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Published Research Related to This Trial

Intention gesture treatment (IGT) showed immediate benefits for verbal word retrieval in two participants with aphasia, but did not help with untrained words.

Pantomime gesture treatment (PGT) improved both verbal production for two participants and gesture production for three participants, with one participant showing carryover effects to untrained words.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparison of intention and pantomime gesture treatment for noun retrieval in people with aphasia. Ferguson, NF., Evans, K., Raymer, AM.[2022]

In a study of 57 individuals with aphasia, both Phonomotor Therapy (PMT) and Semantic Feature Analysis (SFA) showed initial improvements in discourse production, but only PMT led to significant long-term gains three months after treatment.

The results suggest that while both treatments can be effective, PMT may provide more lasting benefits for improving functional communication in daily situations compared to SFA.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Phonomotor Therapy and Semantic Feature Analysis on Discourse Production. Silkes, JP., Fergadiotis, G., Graue, K., et al.[2021]

A study found a significant gap between the treatment dosage used in research studies for aphasia interventions and what is typically provided in outpatient clinical settings, with research showing a median of 20 hours of treatment compared to only 7.5 hours in practice.

This dosage gap may reduce the effectiveness of aphasia treatments when applied in real-world settings, suggesting a need for future research to focus on aligning clinical practices with evidence-based dosages to improve patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is There a Research-Practice Dosage Gap in Aphasia Rehabilitation? Cavanaugh, R., Kravetz, C., Jarold, L., et al.[2022]

A study involving 10 adults with chronic post-stroke aphasia showed that phonological treatment for anomia led to significant improvements in naming accuracy for both treated and untreated words, with benefits observed at multiple follow-up points.

The research identified that early responsiveness to treatment cues and initial improvements in naming were strong predictors of overall treatment success, suggesting that strengthening lexical-phonological connections may facilitate generalization of treatment effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mechanisms underlying anomia treatment outcomes. Simic, T., Chambers, C., Bitan, T., et al.[2021]

In a study involving 23 chronic nonfluent aphasia patients, a novel picture-naming treatment focusing on intention (using complex left-hand movements) led to greater improvements in word-finding abilities compared to an attention-focused treatment.

Patients with moderate to severe impairments showed significant gains in picture naming, and nearly all who improved also generalized their skills to untrained items, indicating the effectiveness of the intention-based approach.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment of naming in nonfluent aphasia through manipulation of intention and attention: a phase 1 comparison of two novel treatments. Crosson, B., Fabrizio, KS., Singletary, F., et al.[2022]

In a study involving two patients with nonfluent aphasia after a stroke, an intention treatment successfully shifted language production mechanisms from the damaged left hemisphere to the right hemisphere in one patient, as shown by fMRI results.

The first patient improved only with the intention treatment, while the second patient improved with both intention and attention treatments, suggesting that the integrity of the basal ganglia may influence the ability to reorganize language functions after a stroke.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Role of the right and left hemispheres in recovery of function during treatment of intention in aphasia. Crosson, B., Moore, AB., Gopinath, K., et al.[2022]

In a study of 26 participants with aphasia undergoing a 6-week phonomotor treatment program, characteristics like aphasia severity and error profile were linked to improvements in confrontation naming and discourse abilities, but no single characteristic consistently predicted long-term benefits three months after treatment.

The variability in treatment responses suggests that factors beyond age, severity, and error profile may play a role in how individuals with aphasia respond to phonomotor therapy, indicating a need for further research into these influences.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Influence of Linguistic and Nonlinguistic Variables on Generalization and Maintenance Following Phonomotor Treatment for Aphasia. Pompon, RH., Bislick, L., Elliott, K., et al.[2022]

Citations

1. trialx.com trialx.com/clinical-trials/listings/233621/intention-treatment-for-anomia/

Intention Treatment for Anomia | Clinical Research Trial ... A variety of treatment approaches exist to improve word retrieval, and most of the treatments result in immediate improvement on trained words.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4703576/

Success of anomia treatment in aphasia is associated with ... Targeted speech therapy can lead to substantial naming improvement in some subjects with anomia following dominant-hemisphere stroke.

3. withpower.com withpower.com/trial/phase-aphasia-4-2021-c6ff9

Intention Treatment for Aphasia · Info for Participants Research shows that the Intention Treatment for Anomia can help people with moderate to severe word-finding difficulties improve their ability to name pictures.

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0021992420301167

Mechanisms underlying anomia treatment outcomes Treatments for anomia have demonstrated short- and long-term efficacy. However, individual outcomes can be variable, and evidence for treatment ...

5. sciencedirect.com sciencedirect.com/science/article/pii/S2589537024000622

Efficacy of a gamified digital therapy for speech production ... iTalkBetter significantly improved naming ability by 13% for trained items compared with no change for untrained items, an average increase of 29 words.

6. clinicaltrials.gov clinicaltrials.gov/study/NCT00764400?term=aphasia&spons=NIDCD&viewType=Table&rank=8

Treatment for Word Retrieval Impairments in Aphasia | ... In this study the investigators are examining the effectiveness of two different speech therapy protocols for word retrieval impairments experienced by ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC1486764/

Spaced retrieval treatment of anomia - PMC - PubMed Central Spaced Retrieval (SR) is a treatment approach developed to facilitate recall of information by individuals with dementia.

8. clinicaltrials.gov clinicaltrials.gov/study/NCT03326687

Pairing Word Retrieval and Physical Endurance Tasks to ... Participants will receive anomia treatment in isolation and will perform a physical endurance task in isolation during A phases. They will receive anomia ...