Imaging Speech for Cerebellar Stroke

Overseen By Alexander Ocampo, B.A.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Must not be taking: Neuropsychiatric drugs

Disqualifiers: Neurological disease, Hearing loss, others

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

Compensation: Varies

Number of Visits: 7

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to explore how different parts of the brain work together to plan and control speech, especially after a cerebellar stroke. Researchers seek to understand which brain areas change their activity during speech and how they help catch and fix speech mistakes. Participants will undergo various speech tests, and their brain activity will be measured using non-invasive techniques like EEG and fMRI. Suitable candidates include right-handed, native English speakers who have either experienced a cerebellar stroke or are healthy adults without such a history. As an unphased trial, this study offers participants the opportunity to contribute to groundbreaking research on brain function and speech recovery.

What prior data suggests that this protocol is safe for participants?

Research has shown that non-invasive brain imaging techniques, such as EEG and fMRI, are generally safe for participants. These methods often study brain activity without causing harm. In cases of cerebellar stroke, studies have found that many people can recover their thinking and emotional abilities, although some may still face challenges.

The imaging and speech tests in this study observe brain activity related to speech. No evidence suggests that these activities pose any significant risk to participants. Standard safety measures minimize any potential discomfort or risk.

Overall, the treatments in this study, which include speech tasks and brain imaging, are well-tolerated and considered safe based on current evidence. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how speech behavior and functional imaging can reveal the brain's response to speaking after a cerebellar stroke. Unlike standard treatments, which might focus on physical rehabilitation or medication to manage symptoms, this approach uses neuroimaging to understand the neural pathways involved in speech recovery. By identifying how the brain modulates sensory input during speech, this method could lead to more personalized and effective therapies for stroke patients, potentially improving their communication skills in ways current treatments don't address.

What evidence suggests that this trial's methods could be effective for understanding cerebellar stroke?

Research has shown that the cerebellum plays a crucial role in speech and movement. Studies using brain scanning techniques like EEG and fMRI have demonstrated changes in brain areas involved in hearing and speech after a stroke in the cerebellum. This trial will assess the neural correlates of speaking-induced sensory modulation through behavior and neuroimaging tasks. While treatments like transcranial magnetic stimulation (TMS) have improved speech and movement in stroke patients, this trial will focus specifically on speech behaviors to provide valuable insights into the recovery process. Other research suggests that non-invasive brain stimulation can enhance the brain's ability to adapt and recover after a stroke. ^{2 6 7 8 9}

Who Is on the Research Team?

Jason W Bohland, Ph.D.

Principal Investigator

University of Pittsburgh

Are You a Good Fit for This Trial?

This trial is for adults who speak normally and those who have had a stroke affecting the cerebellum, which is part of the brain that helps coordinate movement. Participants should be willing to undergo various speech tests and non-invasive brain imaging like EEG and fMRI.

Inclusion Criteria

I am over 18, right-handed, speak English natively, and had a cerebellar stroke.

Exclusion Criteria

Cohort 3 (controls matched to Cohort 2): Presence of MRI risk factors, History of neurological disease, injury, or impairment, Hearing loss, Clinically diagnosed with or treated for a neuropsychiatric disorder, Clinically diagnosed with or treated for a speech, language, or hearing disorder, Head circumference greater than 60cm or weight greater than 300 pounds, History of claustrophobia, Currently pregnant

Cohort 1 (neurotypical adults): Presence of MRI risk factors, History of neurological disease, injury, or impairment, Hearing loss, Clinically diagnosed with or treated for a neuropsychiatric disorder, Clinically diagnosed with or treated for a speech, language, or hearing disorder, Head circumference greater than 60cm or weight greater than 300 pounds, History of claustrophobia, Currently pregnant

Cohort 2 (people with cerebellar lesions): Presence of MRI risk factors, Hearing loss, Clinically diagnosed with or treated for a neuropsychiatric disorder, Head circumference greater than 60cm or weight greater than 300 pounds, History of claustrophobia, Currently pregnant

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 session

1 visit (in-person)

Experimental Sessions

Participants complete up to 6 sessions involving behavioral speech tests and non-invasive brain imaging using EEG and fMRI

Up to 6 sessions

Up to 6 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after experimental sessions

4 weeks

What Are the Treatments Tested in This Trial?

Trial Overview The study investigates how different brain areas involved in planning, controlling movements, hearing, and perceiving speech work together. It involves auditory tests, monitoring neural responses during speech tasks, learning behaviors, silent articulation response tracking, and comparing self-generated versus external speech processing.

How Is the Trial Designed?

Group I: Speech behavior and functional imaging Experimental Treatment 9 Interventions

Assessing the neural correlates of speaking-induced sensory modulation in all three cohorts using behavior and neuroimaging tasks in up to 6 sessions.

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

Northwestern University

Collaborator

Trials

1,674

Recruited

989,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Citations

1. ahajournals.org ahajournals.org/doi/10.1161/STROKEAHA.124.049834

ESCAS Randomized Pilot Study | Stroke The primary outcome measure was the change in WAB-AQ score from baseline to each follow-up time point (30, 60, and 90 days). The secondary ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12550330/

Efficacy of cerebellar cathodal transcranial direct current ... Cerebellar cathodal tDCS combined with speech therapy improved language scores in post-stroke aphasia. fNIRS showed decreased right and ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC5812525/

Cerebellar Stroke Occupational Therapy and Physical ... The purpose of this case report is to describe the 14-month longitudinal rehabilitation management and outcomes from the intensive care unit, inpatient ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S0361923025001534

Effects of cerebellar repetitive transcranial magnetic ... Existing evidence suggests that cerebellar rTMS holds promise in mitigating post-stroke swallowing dysfunction and motor dysfunction.

5. mdpi.com mdpi.com/2227-9059/12/6/1348

Effects of Cerebellar Non-Invasive Stimulation on ... A systematic review was conducted to evaluate the effects of cerebellar NIBS on both motor and other symptoms in stroke rehabilitation.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10623651/

Clinical outcomes associated with speech, language and ... A retrospective study found individuals with aphasia post-stroke had higher mortality rates than those without aphasia (24.1% versus 10.7%, p = 0.004), which ...

7. frontiersin.org frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1203488/full

Neuropsychiatric outcomes following strokes involving the ... Our findings indicate that recovery of cognitive, emotional, and affective function is likely. However, a minority of individuals may suffer significant long- ...

8. pubs.asha.org pubs.asha.org/doi/10.1044/2022_AJSLP-21-00361

American Speech-Language-Hearing Association Clinical ... The panel found that cognitive rehabilitation was effective at reducing symptoms of cognitive dysfunction and was integral to meaningful, functional patient ...

9. bmj.com bmj.com/content/389/bmj-2024-083605

Right C7 neurotomy at the intervertebral foramen plus ... C7 neurotomy plus three weeks of intensive SLT was associated with a greater improvement in language function compared with three weeks of intensive SLT alone.