Speech Therapy + tDCS for Aphasia

Enrolling by invitation at 1 trial location

Overseen By Zoe Ezzes, M.S.

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Disqualifiers: Stroke, Epilepsy, Brain injury, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 3 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores new ways to assist individuals with primary progressive aphasia (PPA), a condition that gradually impairs speech and language. The study tests whether combining speech therapy with a non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS), can enhance communication skills. It examines two speech therapy methods: Lexical Retrieval Training (LRT) and Video Implemented Script Training in Aphasia (VISTA), to assess their effectiveness when paired with tDCS. This trial suits English-speaking individuals diagnosed with PPA who have high-speed internet access and a study partner to assist during the trial. As an unphased trial, it offers a unique opportunity to contribute to innovative research that could lead to new treatment options for PPA.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you have a history of seizures, migraines, or certain medical implants, you may not be eligible to participate.

What prior data suggests that these treatments are safe for individuals with PPA?

Research shows that both Lexical Retrieval Training (LRT) and Video Implemented Script Training in Aphasia (VISTA) are generally well-tolerated by people with primary progressive aphasia (PPA). These speech therapy methods can enhance communication skills without causing significant side effects.

LRT aids in recalling words. Studies suggest it is safe and effective for improving communication in people with PPA. Participants have managed this approach well, with no major safety concerns reported.

Similarly, VISTA uses video-based scripts to enhance speech fluency. Research indicates that VISTA is safe and beneficial, increasing speech fluency and being well-accepted by patients, with no significant safety issues found.

Overall, both treatments appear to be safe options for individuals with PPA seeking to improve their communication skills. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the combination of speech therapy and transcranial Direct Current Stimulation (tDCS) for treating aphasia because it brings a fresh approach to improving language recovery. Unlike conventional treatments that primarily focus on repetitive language practice, this method enhances brain plasticity by applying gentle electrical currents to the scalp, potentially boosting the brain's ability to reorganize and form new connections. This innovation could accelerate language improvement significantly more than traditional therapies alone, making it a promising option for those with aphasia.

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

Research shows that both treatments in this study may improve speech in people with primary progressive aphasia (PPA). Participants may receive Video Implemented Script Training in Aphasia (VISTA), which enhances speech production and fluency, making communication easier. One study showed it significantly improved the ability to name objects, crucial for everyday conversations. Alternatively, participants may receive Lexical Retrieval Training (LRT), which has also proven effective. Research indicates it helps with naming difficulties in different types of PPA, improving both speaking and writing. These findings suggest that either method could benefit those facing communication challenges due to PPA. ^{6 7 8 9 10}

Who Is on the Research Team?

Maya Henry, PhD

Principal Investigator

University of Texas at Austin

Are You a Good Fit for This Trial?

This trial is for adults with Primary Progressive Aphasia who can think clearly enough (score of 20+ on a mental state exam), see and hear well (with aids if needed), undergo an MRI, have internet access, and a partner to help them through the study. It's not for those with other neurological issues, history of stroke/epilepsy/severe brain injury, or contraindications for tDCS/MRI.

Inclusion Criteria

My mental state score is 20 or higher.

I have been diagnosed with primary progressive aphasia.

I have been diagnosed with a specific type of primary progressive aphasia.

Exclusion Criteria

I don't have a history of seizures, head injuries, severe migraines, metal implants in my head, chronic skin problems, or a pacemaker. I am not pregnant.

You do not have the specific type of PPA that the study is focusing on.

You have a score lower than 20 on a test that checks memory and thinking skills.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive home-based transcranial direct current stimulation (tDCS) combined with speech-language telerehabilitation methods

3 months

Remote supervision

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 months

What Are the Treatments Tested in This Trial?

Interventions

• Lexical Retrieval Training (LRT)
• Remotely supervised sham tDCS (RS-sham-tDCS)
• Remotely supervised Transcranial Direct Current Stimulation (RS-tDCS)
• Video Implemented Script Training in Aphasia (VISTA)

Trial Overview The trial tests whether home-based brain stimulation paired with speech-language therapy via video call helps people with different types of PPA. Participants will receive either real or sham brain stimulation while engaging in language exercises designed to improve communication.

How Is the Trial Designed?

Group I: RS-VISTA Experimental Treatment 3 Interventions

Group II: RS-LRT Experimental Treatment 3 Interventions

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

University of California, San Francisco

Collaborator

Trials

2,636

Recruited

19,080,000+

Published Research Related to This Trial

Transcranial direct current stimulation (tDCS) has shown promising results in enhancing language rehabilitation for patients with aphasia, a common language disorder following a stroke.

Traditional language therapies often leave patients with chronic deficits, highlighting the urgent need for innovative treatments like tDCS to improve recovery outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The potential effects of transcranial direct current stimulation (tDCS) on language functioning: Combining neuromodulation and behavioral intervention in aphasia. Marangolo, P.[2021]

A study involving eight individuals with chronic non-fluent aphasia demonstrated that using low-difficulty scripts significantly improved oral reading accuracy compared to high-difficulty scripts, regardless of the severity of aphasia.

The results support the effectiveness of using graded script templates tailored to individual abilities, which can enhance communication training for people with aphasia in both clinical and research settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Script Templates: A Practical Approach to Script Training in Aphasia. Kaye, RC., Cherney, LR.[2020]

The Video-Implemented Script Training for Aphasia (VISTA) significantly improved speech production, accuracy, and intelligibility in a Spanish-English bilingual speaker with aphasia, demonstrating its effectiveness as a treatment method.

Cross-linguistic transfer was observed, meaning improvements in one language also benefited the other; however, using scripts with many cognates reduced this transfer, suggesting that the design of training materials can impact outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Video-Implemented Script Training in a Bilingual Spanish-English Speaker With Aphasia. Grasso, SM., Cruz, DF., Benavidez, R., et al.[2020]

Script training was effective for individuals with apraxia of speech (AOS), as all three participants successfully acquired and retained their client-selected scripts for up to 6 months after treatment.

Participants reported increased confidence and ease in speaking, indicating that script training not only helped with retention but also improved their overall communication experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Script training treatment for adults with apraxia of speech. Youmans, G., Youmans, SR., Hancock, AB.[2016]

Transcranial direct current stimulation (tDCS) combined with language training showed improved verb production in a 43-year-old male with fluent-anomic aphasia after a stroke, suggesting enhanced language recovery.

The study indicates that using tDCS over Broca's area during language therapy may effectively support brain plasticity and improve language skills in individuals with aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Translational treatment of aphasia combining neuromodulation and behavioral intervention for lexical retrieval: implications from a single case study. Galletta, EE., Vogel-Eyny, A.[2020]

In a study involving 24 patients with non-fluent aphasia, both anodal transcranial direct current stimulation (A-tDCS) and sham stimulation (S-tDCS) combined with speech and language therapy (SLT) led to significant improvements in naming ability, indicating that therapy itself is beneficial.

While the A-tDCS group showed higher effect sizes in naming time post-treatment and at the 3-month follow-up, the overall evidence for A-tDCS providing additional language gains was weak, suggesting that more research is needed to confirm its effectiveness in early post-stroke rehabilitation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anodal transcranial direct current stimulation in early rehabilitation of patients with post-stroke non-fluent aphasia: a randomized, double-blind, sham-controlled pilot study. Polanowska, KE., Leśniak, MM., Seniów, JB., et al.[2016]

In a meta-analysis of single-case studies involving 142 patients, improvement in the production of treated verbs was linked to pre-treatment scores in verb comprehension and word repetition, as well as the frequency of treatment sessions, suggesting that these factors are crucial for recovery.

For the production of untreated verbs, which involved 166 patients, improvement was associated with the use of morphological cues and the presence of grammatical impairment, indicating that different mechanisms may underlie recovery for treated versus untreated language outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improving Production of Treated and Untreated Verbs in Aphasia: A Meta-Analysis. de Aguiar, V., Bastiaanse, R., Miceli, G.[2020]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC2942781/

Treatment for lexical retrieval in progressive aphasia - PMC Treatment for lexical retrieval impairment has been shown to yield positive outcomes in individuals with aphasia due to focal lesions, but there has been ...

2. frontiersin.org frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.583246/full

The Application of Lexical Retrieval Training in Tablet ... This pilot evaluation explored how six individuals with aphasia interacted with a tablet-based therapy application that targeted lexical retrieval.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7706007/

The Application of Lexical Retrieval Training in Tablet ... This pilot evaluation explored how six individuals with aphasia interacted with a tablet-based therapy application that targeted lexical ...

4. translationalneurodegeneration.biomedcentral.com translationalneurodegeneration.biomedcentral.com/articles/10.1186/s40035-021-00248-z

Language training for oral and written naming impairment in ... In conclusion, the lexical retrieval treatment, regardless of the type, is effective in treating naming difficulties in several subtypes of PPA.

5. tandfonline.com tandfonline.com/doi/abs/10.1080/02687038.2018.1491192

A review of lexical retrieval intervention in primary ... Conclusion: This review highlights that individuals with PPA and AD benefit from lexical retrieval intervention, irrespective of the mechanism ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12072502/

Safety and Efficacy of Different Therapeutic Interventions ... Background: Primary progressive aphasia (PPA) is a neurodegenerative disorder that worsens over time without appropriate treatment.

7. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40364094/

Safety and Efficacy of Different Therapeutic Interventions ... Data on study characteristics, patient demographics, PPA subtypes, therapeutic modalities, and treatment patterns were collected. Results: Fifty ...

8. clinicaltrials.gov clinicaltrials.gov/study/NCT05741853

Study Details | NCT05741853 | Cognitive Reserve and ... This stage 2 efficacy clinical trial seeks to establish the effects of culturally and linguistically tailored speech-language interventions administered to ...

9. clinicaltrials.gov clinicaltrials.gov/study/NCT07219680

Intervention for Communication Quality of Life in Primary ... The goal of this clinical trial is to determine whether individually tailored speech-language telerehabilitation helps improve communication in people with ...

10. pubs.asha.org pubs.asha.org/doi/10.1044/2021_PERSP-20-00296

Counseling and Care Partner Training in Primary ... Lexical Retrieval Cascade Treatment (Henry et al., 2013, 2019) was implemented with each participant with aphasia. This approach involves ...