Treatment for Aphasia

1
Effectiveness
1
Safety
Johns Hopkins University School of Medicine, Baltimore, MD
Aphasia+1 More
Eligibility
18+
All Sexes
Eligible conditions
Aphasia

Study Summary

This study is evaluating whether a combination of tDCS and computerized naming therapy may help improve language abilities for individuals with post-stroke aphasia.

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Eligible Conditions

  • Aphasia
  • Stroke

Treatment Effectiveness

Effectiveness Estimate

1 of 3

Study Objectives

This trial is evaluating whether Treatment will improve 1 primary outcome and 8 secondary outcomes in patients with Aphasia. Measurement will happen over the course of Pre- treatment and at 2 weeks post treatment (tDCS and sham).

Week 5
Change in accuracy of naming untrained pictures (Philadelphia Naming Test:PNT) pre- to post-treatment.
Before and after 15 sessions of treatment (tDCS and sham)
Change in functional communication skills pre- treatment to post treatment.
Change in lexical features of picture description pre- treatment to post treatment.
Month 2
Change in functional communication skills pre- treatment to 2 months post treatment.
Change in lexical features of picture description pre- treatment to 2 months post treatment.
Week 2
Change in functional communication skills pre- treatment to 2 weeks post-treatment.
Change in lexical features of picture description pre- treatment to pre- treatment to 2 weeks post-treatment.
Month 2
Change in accuracy of naming untrained pictures (PNT) pre- treatment to 2 months post treatment
Week 2
Change in accuracy of naming untrained pictures (PNT) pre- treatment to 2 weeks post treatment.

Trial Safety

Safety Estimate

1 of 3

Trial Design

2 Treatment Groups

Sham plus computerized naming therapy
Placebo group

This trial requires 50 total participants across 2 different treatment groups

This trial involves 2 different treatments. Treatment is the primary treatment being studied. Participants will all receive the same treatment. Some patients will receive a placebo treatment. The treatments being tested are not being studied for commercial purposes.

Sham plus computerized naming therapySham tDCS plus computerized naming treatment for 15 sessions (20 minutes per each 45 minute treatment session) over the course of 3-5 weeks. Current will be administered in the in a ramp like fashion for 15-30 seconds but then the current is gradually decreased and drop to 0 mA. Language therapy will be a computer delivered naming +picture matching task.
tDCS plus computerized naming therapyAnodal or cathodal tDCS, 2 milliamps (mA) plus computerized naming treatment for 15 sessions (20 minutes per each 45 minute treatment session) over the course of 3-5 weeks.The electrical current will be administered to the right cerebellum. The stimulation will be delivered at an intensity of 2 mA for a maximum of 20 minutes. Language therapy will be a computer delivered naming +picture matching task.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: pre- treatment and at 2 months post treatment (tdcs and sham)
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly pre- treatment and at 2 months post treatment (tdcs and sham) for reporting.

Closest Location

Johns Hopkins University School of Medicine - Baltimore, MD

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 8 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
Participants must have sustained a left hemisphere stroke.
Participants must be fluent speakers of English by self-report.
Participants must be capable of giving informed consent or indicating another to provide informed consent.
Participants must be age 18 or older.
Participants must be premorbidly right handed.
Participants must be at least 6 months post stroke.
Participants must have an aphasia diagnosis as confirmed by the Boston Diagnostic Aphasia Examination (BDAE) Short Form.
Participants must achieve at least 65% accuracy on screening task (comparable to treatment task) on 1 of 3 attempts

Patient Q&A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What are the signs of aphasia?

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There are many signs of aphasia. Signs include a weakened speech ability, which may be described as slurred, and abnormal speech mechanics such as a slurred speech rate.\n

Unverified Answer

What are common treatments for aphasia?

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The term aphasia is defined when a particular aphasia disorder is predominant, but other treatments may be needed. Many treatments for aphasia involve speech, reading, reading comprehension, and oral motor skills. These therapy techniques are designed to promote language production, language comprehension, and communication skills. Additionally, many patients with aphasia benefit from neuro-linguistic programming (NLP) training.

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What causes aphasia?

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In most cases, stroke and tumours cause damage to the brain and cause aphasia. The other types of aphasia are thought to be caused by loss of a part of the brain. The aphasia network is believed to be caused when lesions destroy a part of the brain that sends information via a pathway to the part of the brain responsible for producing speech. It is now believed that damage to this pathway, usually caused by stroke or tumour, can result in aphasia.

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What is aphasia?

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Aphasias are communication disorders that result from damage to the brain's language or speech processing centers. There are three distinct types of aphasias: expressive aphasia (lack of fluency and clarity of language); receptive aphasia (lack of understanding language); and conduction aphasia (lack of understanding language). Aphasias affect about 200 million people globally.\n

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Can aphasia be cured?

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Aphasia cannot be cured by any intervention because there is no single underlying cause that can be found to be responsible for the symptoms. Thus, it is necessary to determine if there are specific causes of the aphasia by diagnostic method.

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How many people get aphasia a year in the United States?

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Aphasia occurs in about 7.8 million patients a year in United States. Aphasia is much more common in men and there is a correlation between age of aphasic and aphasic. It seems aphasia occurs in all age groups and there is a gender bias.

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Does treatment improve quality of life for those with aphasia?

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There is a high rate of depression in people with aphasia, and the rate is independent of the presence of treatment. Despite this, treatment of depression leads to measurable improvements in mood and quality of life for people with aphasia.

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Does aphasia run in families?

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Despite the high frequency of apraxia in familial families as reported in the literature, only a small percentage of the sample was affected. Data from a recent study suggest that other genetic cause(s) are involved in inducing the aphasic syndrome.

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Has treatment proven to be more effective than a placebo?

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There is no evidence that treatment is more effective than a placebo in relieving aphasia. Patients and practitioners need to be aware that while treatment results in better patient recovery, it does not affect outcome in any other way.

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How serious can aphasia be?

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Aphasia severity can range from a very non-significant problem to needing full medical attention to prevent further problems associated with the disorder. In some cases patients' ability to cope with their difficulty with communication may be hindered by social attitudes towards the communication disorder. Most patients manage, however, since aphasis is usually a chronic problem. Some patients may be more likely to become involved with the medical profession due to their difficulties communicating and obtaining the help necessary in resolving problems. There is no one specific treatment which relieves all symptoms of aphasia, although many treatments that have positive results are being researched on. There are two main treatments: cognitive-behavioural therapy (CBT) and speech therapy.

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What is the primary cause of aphasia?

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Many different primary causes of aphasia exist and each can produce different signs and symptoms. The underlying etiology may be from stroke, a traumatic brain aneurysm or a tumor, or any neurological disease. The most common causes in our patient population were infarction or hemorrhage. A recent study also demonstrated a correlation between aphasia and Alzheimer's disease. The most important symptom is a difficulty in speaking, which can be either fluent or halting; and is most commonly seen in those older than 60 and in females. The severity of aphasia can differ throughout the severity of the disease, and is usually most apparent in those with early onset.

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What is treatment?

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The way speech therapy and/or other speech and language treatment can help with [aphasia is different if you have [apraxia of speech] (AOSP) or [apraxic dysphagia] (ADP)] is to provide repetition and learning for speech and language skills so the patient has the skills they need to carry out the functional communication that the patient needs. Also, these strategies have not found to be cost effective and time consuming for patients to learn to communicate, which is why it is not so often used to treat (AOSP)/ADP.  [Power] https://www.withpower.

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