2 Participants Needed

Speech Sequencing Therapies for Stuttering

Recruiting at 2 trial locations
FH
BH
Overseen ByBarbara Holland
Age: Any Age
Sex: Any
Trial Phase: Academic
Sponsor: Boston University Charles River Campus
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to better understand how the brain plans and produces speech, focusing on individuals who stutter or have speech disorders like primary progressive aphasia. Researchers will use brain imaging and non-invasive techniques, such as Transcranial Direct Current Stimulation (tDCS), to compare speech effects in these groups with those having typical speech patterns. Participants will learn new word sounds and sequences to test how the brain processes speech. The trial seeks native English speakers with either persistent stuttering, typical speech, or primary progressive aphasia. As an unphased study, this trial offers a unique opportunity to contribute to groundbreaking research in speech disorders.

Do I need to stop my current medications to join the trial?

If you have primary progressive aphasia (PPA), you cannot participate if you are taking medications that affect speech or language. For others, the protocol does not specify if you need to stop taking your current medications.

What prior data suggests that these speech sequencing therapies are safe?

Research has shown that transcranial direct current stimulation (tDCS) is generally safe. Studies indicate that people tolerate tDCS well, with only minor side effects such as slight skin irritation or mild tingling at the electrode sites. Serious side effects are rare.

For learning new speech sounds and unfamiliar words, the emphasis is on practice and learning. No evidence suggests major safety concerns with these activities. Practicing new speech patterns is considered safe. Overall, researchers have used the treatments in this study in other research, demonstrating good safety records.12345

Why are researchers excited about this trial?

Researchers are excited about the Speech Sequencing Therapies for Stuttering trial because it explores innovative ways to improve speech fluency using combinations of novel sounds and advanced brain stimulation techniques. Unlike traditional speech therapy, which typically involves practicing speech patterns, this trial delves into learning non-native phoneme combinations and novel multisyllabic nonwords. It also uses transcranial direct current stimulation (tDCS) to potentially enhance learning by targeting specific brain areas involved in speech. Additionally, by employing functional magnetic resonance imaging (fMRI), the trial aims to understand the brain activity associated with these new learning methods. This approach could pave the way for more effective and tailored treatments for stuttering and related speech disorders.

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

Research shows that transcranial direct current stimulation (tDCS) combined with specific speech exercises can help adults who stutter speak more fluently. In this trial, some participants will receive anodal tDCS, while others will receive sham tDCS as a control. Studies have found that tDCS can noticeably reduce the frequency and severity of stuttering.

Research has shown that people can learn new sounds in a language with practice, even if they are initially difficult to distinguish. This trial includes arms where participants will engage in learning non-native phoneme combinations, which may improve speech organization in people who stutter.

For learning new, made-up words with many syllables, studies have found that people who stutter might struggle to repeat these words accurately. This trial will test multisyllabic learning in both children and adults, suggesting that focused practice might improve their ability to manage these speech patterns.16789

Who Is on the Research Team?

FH

Frank H Guenther, PhD

Principal Investigator

Boston University

SC

Soo-Eun Chang, PhD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for native American English speakers with limited second language exposure. It includes children who pass a hearing test, adults without neurological issues (except stuttering), and those diagnosed with primary progressive aphasia by MGH-FTD. Excluded are individuals with contraindications to MRI or tDCS, certain medication use in PPA patients, severe cognitive impairment, and outside the age range for child participants.

Inclusion Criteria

My hearing is good at specific test frequencies.
I am healthy with no history of brain, speech, or hearing problems, except for stuttering.
Only native speakers of American English with limited exposure to a second language will be recruited
See 8 more

Exclusion Criteria

I am not on medications that could affect my speech or language.
You cannot participate in MRI studies if you have had seizures, severe claustrophobia, metal implants in your body, or if you are pregnant.
You cannot participate if you have metal implants in your head, certain medical devices in your body, a history of seizures, significant scalp injuries, or if you are pregnant.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants undergo training sessions to learn novel speech sequences using various methods such as tDCS and fMRI

2-3 days
6-8 training sessions

Intervention

Functional MRI and other assessments are conducted to measure brain activity and speech performance

1 day
1 fMRI session

Follow-up

Participants are monitored for changes in speech performance and brain activity post-intervention

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Anodal tDCS
  • Learning of non-native phoneme combinations: 1 training session
  • Learning of non-native phoneme combinations: 6 training sessions
  • Learning of non-native phoneme combinations: 8 training sessions
  • Learning of novel multisyllabic nonwords
  • Sham tDCS
Trial Overview The study investigates brain mechanisms in speech motor planning through experiments involving speech production tasks, functional MRI scans, and non-invasive brain stimulation like sham and anodal tDCS. Participants will learn new phoneme combinations or multisyllabic nonwords across multiple sessions to help understand these processes in people with stuttering or neurodegenerative speech disorders.
How Is the Trial Designed?
7Treatment groups
Experimental Treatment
Placebo Group
Group I: Sub-syllabic learning in PPAExperimental Treatment1 Intervention
Group II: Sub-syllabic learning and fMRIExperimental Treatment1 Intervention
Group III: Sub-syllabic learning and anodal tDCS of inferior frontal sulcusExperimental Treatment2 Interventions
Group IV: Sub-syllabic learning and anodal tDCS of cerebellumExperimental Treatment2 Interventions
Group V: Multisyllabic learning in childrenExperimental Treatment1 Intervention
Group VI: Multisyllabic learning and fMRI in adultsExperimental Treatment1 Intervention
Group VII: Sub-syllabic learning and sham tDCSPlacebo Group2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Boston University Charles River Campus

Lead Sponsor

Trials
125
Recruited
14,100+

University of Michigan

Collaborator

Trials
1,891
Recruited
6,458,000+

Massachusetts General Hospital

Collaborator

Trials
3,066
Recruited
13,430,000+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials
377
Recruited
190,000+

Published Research Related to This Trial

The study demonstrated that practicing phoneme sequences with non-native consonant clusters improved utterance duration for new syllables containing those clusters, suggesting that our brains efficiently store these clusters as 'chunks' to enhance speech production.
However, practicing whole syllables led to greater reductions in error rates, indicating that while consonant clusters are important for phonological memory, syllables play a crucial role in the motor programming of speech.
Chunking of phonological units in speech sequencing.Segawa, J., Masapollo, M., Tong, M., et al.[2020]
The Therapeutic Stuttering Summer-camp, involving participants aged 9 to 19, successfully reduced stuttering frequency from 22.2% to 9.5%, demonstrating a significant effect size of 1.29, indicating effective therapy.
Follow-up assessments and various measurement tools, including questionnaires and Goal Attainment Scaling, showed clear improvements in participants' handling of stuttering and fluency, confirming the therapy's efficacy.
[Treatment outcome study of the stuttering therapy summer camp 2000 for children and adolescents].Baumeister, H., Caspar, F., Herziger, F.[2006]
Adults who stutter (AWS) demonstrated significantly lower accuracy in repeating nonwords as their length and complexity increased, indicating potential challenges in phonemic encoding and speech motor processes compared to control participants.
While both groups showed some practice effects, AWS did not retain improvements in speech kinematics across sessions, suggesting difficulties in skill acquisition and retention that may require further investigation.
Practice and retention of nonwords in adults who stutter.Sasisekaran, J., Weisberg, S.[2021]

Citations

The Effects of tDCS on Speech Fluency in People Who ...The studies reviewed in this study have reported a variable effectiveness of tDCS for enhancing speech fluency in PWS. As a result, it remains ...
The application of non-invasive neuromodulation in stutteringThe results revealed similar outcomes in terms of speech fluency between anodal and sham conditions. However, they reported that anodal stimulation modulated ...
Transcranial direct current stimulation over left inferior frontal ...We conclude that transcranial direct current stimulation combined with behavioural fluency intervention can improve fluency in adults who stutter.
Investigating the feasibility of using transcranial direct current ...We found a significant reduction in stuttering during sentence reading following the choral speech practice, in both the TDCS and sham sessions. The stuttering ...
Efficacy of Noninvasive Brain Stimulation Techniques in ...Meta-regression showed that transcranial direct current stimulation (tDCS) had the most significant effect in reducing stuttering severity and frequency among ...
Safety of transcranial Direct Current Stimulation: Evidence ...This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, ...
Effects of Anodal tDCS on Motor Sequence Practice in ...The findings of this study will contribute to understanding the feasibility of using anodal tDCS to observe nonspeech motor skill control in people who stutter.
Investigating Speech Sequencing in Neurotypical ...During the training, anodal transcranial direct current stimulation (tDCS) will be applied to the the subject's left inferior frontal sulcus. Intervention ...
Safety parameter considerations of anodal transcranial ...A commonly referenced transcranial Direct Current Stimulation (tDCS) safety threshold derives from tDCS lesion studies in the rat and relies on ...
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