HD-tDCS + Speech Therapy for Aphasia
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Medical College of Wisconsin
Disqualifiers: Advanced neurodegenerative, Neurologic, Severe psychopathology, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
This study will investigate the effects of mild electrical stimulation in conjunction with speech therapy for people with post-stroke aphasia to enhance language recovery.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment HD-tDCS + Speech Therapy for Aphasia?
Research shows that combining transcranial direct current stimulation (tDCS) with speech therapy can help improve language skills in people with aphasia after a stroke. Studies have found that this combination can lead to better language comprehension and production, offering promising results for recovery.12345
Is the combination of transcranial direct current stimulation (tDCS) and speech therapy safe for humans?
How does the HD-tDCS + Speech Therapy treatment for aphasia differ from other treatments?
The HD-tDCS + Speech Therapy treatment is unique because it combines transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, with traditional speech therapy to enhance brain plasticity and improve language recovery in aphasia patients. This approach aims to boost the effectiveness of speech therapy by facilitating brain activity, offering a novel strategy compared to standard speech therapies alone.1391011
Research Team
Eligibility Criteria
This trial is for adults over 18 with aphasia from left-sided brain damage like a stroke, who can speak English and are MRI-eligible. It's not for those with advanced neurodegenerative diseases, unmanaged seizure disorders, severe mental health issues, major hearing or vision problems, developmental disabilities, or MRI contraindications such as metal implants.Inclusion Criteria
My eligibility is not affected by my race, ethnicity, or gender.
I am an adult who speaks and understands English fluently.
I am 18 years old or older.
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Exclusion Criteria
I have hearing, vision difficulties, or a learning disability that cannot be corrected.
I cannot have an MRI due to claustrophobia, implants, metal in my body, obesity, pregnancy, or inability to lie flat or see/hear well.
I have a neurological condition like epilepsy, Parkinson's, or ALS.
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Treatment Cycle A
Participants receive targeted anodal-tDCS or sham-tDCS along with speech therapy for 10 sessions
2 weeks
10 visits (in-person)
Assessment and Crossover
Participants undergo behavioral assessment and fMRI before crossing over to receive the alternate tDCS intervention
1-2 weeks
Treatment Cycle B
Participants receive the alternate tDCS intervention along with the same speech therapy arm for another 10 sessions
2 weeks
10 visits (in-person)
Follow-up
Participants are monitored for safety and effectiveness after treatment with behavioral assessments and fMRI at 3 and 6 months post Treatment Cycle B
6 months
Treatment Details
Interventions
- Speech Therapy (Behavioral Intervention)
- Targeted Transcranial Direct Current Stimulation (Device)
Trial OverviewThe study tests if mild electrical stimulation to the brain (HD-tDCS) combined with speech therapy helps language recovery in people who have speech difficulties after a stroke. Participants will receive this combination treatment and their progress will be monitored.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Speech TherapyExperimental Treatment1 Intervention
Participants will be randomized to receive either phonologic-focused speech therapy or semantic-focused speech therapy
Group II: HD-tDCSExperimental Treatment1 Intervention
Participants will be randomized to receive either anodal HD-tDCS or sham-tDCS.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Medical College of WisconsinMilwaukee, WI
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Who Is Running the Clinical Trial?
Medical College of Wisconsin
Lead Sponsor
Trials
645
Patients Recruited
1,180,000+
References
The Factors Associated with Good Responses to Speech Therapy Combined with Transcranial Direct Current Stimulation in Post-stroke Aphasic Patients. [2021]To determine factors associated with good responses to speech therapy combined with transcranial direct current stimulation (tDCS) in aphasic patients after stroke.
Effects of dual transcranial direct current stimulation for aphasia in chronic stroke patients. [2021]To investigate any additional effect of dual transcranial direct current stimulation (tDCS) compared with single tDCS in chronic stroke patients with aphasia.
The potential effects of transcranial direct current stimulation (tDCS) on language functioning: Combining neuromodulation and behavioral intervention in aphasia. [2021]Aphasia is a highly disabling language disorder usually caused by a left stroke brain damage. Even if traditional language therapies have been proved to induce an adequate clinical recovery, a large percentage of patients are left with chronic deficits at 6 months post-stroke. Therefore, new strategies to common speech therapies are urgently needed in order to maximize the recovery from aphasia. The recent application of transcranial direct current stimulation (tDCS) to language rehabilitation has already provided promising results. This brief review gives an overview of the most important results achieved using this approach and discusses how the application of this treatment might potentiate aphasia recovery.
Combined anodal transcranial direct current stimulation and behavioural naming treatment improves language performance in patients with post-stroke aphasia. [2022]During the last decade, studies using anodal transcranial Direct Current Stimulation (atDCS) have yielded promising results in patients with aphasia. The main aim of the present pilot study was to assess the effects of combined atDCS over the left posterior perisylvian region and behavioral naming training on the behavioral outcomes of language comprehension and production of patients with post-stroke aphasia.
A Systematic Review of Transcranial Direct Current Stimulation in Primary Progressive Aphasia: Methodological Considerations. [2022]A variety of tDCS approaches has been used to investigate the potential of tDCS to improve language outcomes, or slow down the decay of language competences caused by Primary Progressive Aphasia (PPA). The employed stimulation protocols and study designs in PPA are generally speaking similar to those deployed in post-stroke aphasic populations. These two etiologies of aphasia however differ substantially in their pathophysiology, and for both conditions the optimal stimulation paradigm still needs to be established. A systematic review was done and after applying inclusion and exclusion criteria, 15 articles were analyzed focusing on differences and similarities across studies especially focusing on PPA patient characteristics (age, PPA variant, language background), tDCS stimulation protocols (intensity, frequency, combined therapy, electrode configuration) and study design as recent reviews and group outcomes for individual studies suggest tDCS is an effective tool to improve language outcomes, while methodological approach and patient characteristics are mentioned as moderators that may influence treatment effects. We found that studies of tDCS in PPA have clinical and methodological and heterogeneity regarding patient populations, stimulation protocols and study design. While positive group results are usually found irrespective of these differences, the magnitude, duration and generalization of these outcomes differ when comparing stimulation locations, and when results are stratified according to the clinical variant of PPA. We interpret the results of included studies in light of patient characteristics and methodological decisions. Further, we highlight the role neuroimaging can play in study protocols and interpreting results and make recommendations for future work.
Clinical Feasibility of Combining Transcranial Direct Current Stimulation with Standard Aphasia Therapy. [2022]Transcranial direct current stimulation (tDCS) is a safe, portable, and inexpensive form of noninvasive brain stimulation that appears to augment the effects of concurrent therapy. However, several methodological issues in existing studies distance tDCS from current clinical practice. In this study, we offered (and administered) tDCS to individuals seeking typical behavioral aphasia therapy on an outpatient basis.
Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial. [2021]Transcranial direct current stimulation (tDCS) may enhance speech and language treatment (SLT) for stroke survivors with aphasia; however, to date, there is no standard protocol for the application of tDCS in post-stroke aphasia. We explored the safety and efficacy of fMRI-guided tDCS on functional language and cortical activity when delivered to the lesioned left hemisphere concurrently with SLT across an extended, six-week treatment period. Twelve persons with chronic, nonfluent aphasia following a single left-hemisphere stroke participated in the three-arm (anodal vs. cathodal vs. sham) single-blind, parallel, pilot trial. No serious adverse events occurred during 30 treatment sessions or in the following six weeks. All groups demonstrated functional language gains following intensive treatment; however, active tDCS resulted in greater gains in standardized, probe, and caregiver-reported measures of functional language than sham. Evidence declaring one polarity as superior for inducing language recovery was mixed. However, cathodal stimulation to the lesioned left hemisphere, expected to have a down-regulating effect, resulted in increased areas of cortical activation across both hemispheres, and specifically perilesionally. Generalization of these preliminary findings is limited; however, results are nevertheless compelling that tDCS combined with SLT can be safely applied across extended durations, with the potential to enhance functional language and cortical activation for persons with aphasia.
Transcranial direct current stimulation (tDCS) for improving aphasia after stroke: a systematic review with network meta-analysis of randomized controlled trials. [2020]Transcranial Direct Current Stimulation (tDCS) is an emerging approach for improving aphasia after stroke. However, it remains unclear what type of tDCS stimulation is most effective. Our aim was to give an overview of the evidence network regarding the efficacy and safety of tDCS and to estimate the effectiveness of the different stimulation types.
[Transcranial direct current stimulation and speech therapy intervention in people with aphasia: a systematic review of the literature]. [2021]The recovery of aphasia may require adjuvant therapies to speech therapy rehabilitation. Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique that can be used to improve cortical brain activity.
Translational treatment of aphasia combining neuromodulation and behavioral intervention for lexical retrieval: implications from a single case study. [2020]Transcranial direct current stimulation (tDCS), a non-invasive method of brain stimulation, is an adjunctive research-therapy for aphasia. The concept supporting translational application of tDCS is that brain plasticity, facilitated by language intervention, can be enhanced by non-invasive brain stimulation. This study combined tDCS with an ecologically focused behavioral approach that involved training nouns and verbs in sentences.
Effect of Anodic Transcranial Direct Current Stimulation Combined With Speech Language Therapy on Nonfluent Poststroke Aphasia. [2022]Transcranial direct current stimulation (tDCS) facilitates or inhibits spontaneous neuronal activity by low-intensity current. In this study, we evaluated the effects of tDCS and sham stimulation combined with speech language therapy (SLT) on nonfluent poststroke aphasia (PSA) patients.