Mirror Speech Entrainment for Aphasia

(MSE Trial)

Overseen By Gerald C Imaezue, Ph.D

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of South Florida

Disqualifiers: Dementia, Alzheimer's, Parkinsonism, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

20 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

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

What data supports the effectiveness of the treatment Mirror Speech Entrainment for aphasia?

Research shows that speech entrainment, which involves mimicking a speech model, helps people with Broca's aphasia speak more fluently. Studies found that patients could produce more words and improve speech fluency by using this method, especially when they had certain brain areas intact. ^{1 2 3 4 5}

Is Mirror Speech Entrainment safe for humans?

The research on speech entrainment, which involves mimicking an audiovisual speech model, does not report any safety concerns for humans. It has been used in studies with individuals who have aphasia, and no adverse effects have been noted. ^{1 2 3 4 5}

How does Mirror Speech Entrainment treatment differ from other treatments for aphasia?

Mirror Speech Entrainment is unique because it involves mimicking an audiovisual speech model, which helps synchronize brain regions involved in language, improving speech fluency in people with non-fluent aphasia. This approach provides an external guide for speech production, which is different from other therapies that may not use real-time audiovisual feedback. ^{1 2 3 4 5}

What is the purpose of this trial?

The goal of this clinical trial is to test the use of voice personalization through artificial intelligence (AI) voice cloning on speech entrainment tasks to improve language production of persons with aphasia (PWA). The main question the study aims to answer is: - What is the impact of personalized voice on speech entrainment in PWA compared to traditional speech entrainment? Speech entrainment is a technique used by speech-language pathologists to improve the speech production of PWA. Traditionally, speech therapists act as the model for participants to speak along with to improve their speech production. This study proposes the use of one's own voice (digitally altered) to improve speech production. The study uses a mobile health approach to administer speech entrainment treatment through a mobile app. * Smartphones with the mobile app pre-installed will be mailed to participants at no cost. * Participants will complete treatment in the comfort of their homes. * The experimental treatments involve: mirror speech entrainment (speaking along to one's own voice) and traditional speech entrainment (speaking along to someone else's voice).

Eligibility Criteria

This trial is for individuals who have had a stroke and are experiencing nonfluent aphasia, which includes difficulty with speech production. Participants should be comfortable using a smartphone app at home for the treatment. There's no mention of specific exclusion criteria provided.

Inclusion Criteria

I have difficulty speaking due to a stroke in the left side of my brain.

I primarily speak English.

Exclusion Criteria

Persons with significant difficulties with language comprehension

English is not my first language.

Persons with concomitant cognitive disability

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive speech entrainment treatment using a mobile app, involving mirror speech entrainment and traditional speech entrainment techniques

6 weeks

Remote participation via mobile app

Follow-up

Participants are monitored for language production improvements and safety after treatment

4 weeks

Treatment Details

Interventions

• Mirror Speech Entrainment

Trial Overview The study is testing mirror speech entrainment, where participants speak along to their own digitally altered voice, against traditional methods using someone else's voice (with or without visual aid). The aim is to see if personalized voices can better improve language production in people with aphasia.

Participant Groups

Group I: Experiment 3: Mirror SE versus Traditional SE (Auditory-visual) Experimental Treatment 2 Interventions

This arm will investigate the effect of mirror speech entrainment in the auditory-visual modality versus traditional speech entrainment in the auditory-visual modality.

Group II: Experiment 2: Mirror SE versus Traditional SE (Auditory-only) Experimental Treatment 2 Interventions

This arm investigates the use of mirror speech entrainment using auditory only feedback and traditional speech entrainment using auditory only feedback.

Group III: Experiment 1: Feasibility Study Experimental Treatment 1 Intervention

Participants will receive two treatments sequentially: mirror speech entrainment using the auditory-only modality followed by mirror speech entrainment using the auditory-visual modality.

Who Is Running the Clinical Trial?

University of South Florida

Lead Sponsor

Trials

433

Recruited

198,000+

Findings from Research

In a study of 44 chronic patients with left hemisphere stroke, those with Broca's aphasia showed a significant increase in speech fluency when using speech entrainment (SE) compared to spontaneous speech, indicating SE's effectiveness in enhancing speech production.

Voxel-wise lesion-symptom mapping revealed that damage to the inferior frontal gyrus is a predictor of positive response to SE, suggesting that specific patterns of cortical damage can help identify which patients may benefit from this treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech entrainment compensates for Broca's area damage. Fridriksson, J., Basilakos, A., Hickok, G., et al.[2018]

Speech entrainment (SE) helps individuals with non-fluent aphasia improve their speech fluency by normalizing functional connectivity between key language regions in the brain, making it more similar to that of neurotypical speakers.

In a study involving 24 individuals with aphasia and 20 controls, SE was found to enhance connectivity patterns during speech production, suggesting that SE may be an effective therapeutic approach for improving speech output in aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional Connectivity and Speech Entrainment Speech Entrainment Improves Connectivity Between Anterior and Posterior Cortical Speech Areas in Non-fluent Aphasia. Johnson, L., Yourganov, G., Basilakos, A., et al.[2022]

The SpARc trial is a multicenter phase II clinical trial involving 80 adults with chronic post-stroke non-fluent aphasia, aiming to evaluate the effectiveness of speech entrainment therapy (SET) over different durations (3, 4.5, or 6 weeks) compared to a control group.

Previous pilot studies indicated that SET can significantly improve speech production, as measured by verbs per minute (VPM), suggesting that this therapy may enhance fluent spontaneous speech in individuals with non-fluent aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech Entrainment for Aphasia Recovery (SpARc) phase II trial design. Cassarly, C., Doyle, A., Ly, T., et al.[2023]

Speech entrainment, where patients with Broca's aphasia mimic audio-visual speech stimuli, significantly increases their speech output, allowing them to produce a greater variety of words compared to spontaneous speech.

Neuroimaging studies reveal that speech entrainment activates specific brain regions associated with language processing, and a 6-week treatment using this method improved speech production in patients, suggesting it could be an effective therapy for this challenging condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Speech entrainment enables patients with Broca's aphasia to produce fluent speech. Fridriksson, J., Hubbard, HI., Hudspeth, SG., et al.[2023]

Individuals with non-fluent aphasia who preserved certain brain structures, like the posterior middle temporal gyrus and specific fasciculi, showed better speech fluency when using speech entrainment compared to spontaneous speech.

The study suggests that damage to the dorsal stream of the brain, while preserving ventral stream structures, may enhance the effectiveness of speech entrainment as a rehabilitation technique for improving speech output in non-fluent aphasia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Neural structures supporting spontaneous and assisted (entrained) speech fluency. Bonilha, L., Hillis, AE., Wilmskoetter, J., et al.[2020]

References

1. Italy pubmed.ncbi.nlm.nih.gov

Speech entrainment compensates for Broca's area damage. [2018]

2. United States pubmed.ncbi.nlm.nih.gov

Functional Connectivity and Speech Entrainment Speech Entrainment Improves Connectivity Between Anterior and Posterior Cortical Speech Areas in Non-fluent Aphasia. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Speech Entrainment for Aphasia Recovery (SpARc) phase II trial design. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Speech entrainment enables patients with Broca's aphasia to produce fluent speech. [2023]

5. England pubmed.ncbi.nlm.nih.gov

Neural structures supporting spontaneous and assisted (entrained) speech fluency. [2020]