Brain Stimulation for Dyslexia
Recruiting in Palo Alto (17 mi)
Age: < 65
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Georgia State University
Must not be taking: Seizure threshold-lowering drugs
Disqualifiers: Autism, Hearing deficits, Seizure disorders, others
No Placebo Group
Approved in 3 Jurisdictions
Trial Summary
What is the purpose of this trial?The purpose of the proposed study is to use transcranial magnetic stimulation (TMS) to evaluate a neurobiological model of spoken word learning in older youth. Specifically, it is hypothesized that: (1) inhibition of the left dorsal stream will impact subsequent learning, processing, and retention of phonologically similar pseudowords; (2) the impact of dorsal stream inhibition on word learning will be associated with baseline levels of variability in neural activity, indicative of underlying differences in cortical excitability.
Will I have to stop taking my current medications?
The trial excludes individuals taking certain medications that lower the seizure threshold, so you may need to stop taking those specific medications. The protocol does not specify other medication restrictions.
What data supports the effectiveness of the treatment Transcranial Magnetic Stimulation for dyslexia?
Research shows that high frequency repetitive transcranial magnetic stimulation (hf-rTMS) can improve reading skills in adults with dyslexia by enhancing reading speed and accuracy. This treatment targets specific brain areas that are underactive in dyslexics, leading to better reading performance.
12345Is repetitive transcranial magnetic stimulation (rTMS) safe for humans?
Repetitive transcranial magnetic stimulation (rTMS) has been studied for safety, and while it is generally considered safe, it has been associated with some risks, such as seizures. Guidelines have been developed to ensure its safe use, and it is important to follow recommended limits and monitoring procedures during treatment.
16789How does the treatment Transcranial Magnetic Stimulation (rTMS) for dyslexia differ from other treatments?
Transcranial Magnetic Stimulation (rTMS) is unique because it uses magnetic fields to stimulate specific brain areas that are underactive in people with dyslexia, potentially improving reading skills by enhancing neural pathways. Unlike traditional methods, it directly targets brain function rather than focusing solely on behavioral interventions.
12101112Eligibility Criteria
This trial is for older youth with dyslexia. Participants should be able to undergo brain stimulation and are interested in how it might affect learning new spoken words. Specific eligibility details aren't provided, so generally healthy individuals who meet the age requirement for 'older youth' may apply.Inclusion Criteria
My vision is normal or corrected to normal with glasses or contacts.
Native English speaker (who is not fluent in any other language and does not identify as bilingual)
Exclusion Criteria
Individuals with MRI Screening and Contraindication Forms which do not pass MRI Tech review
Diagnosed with Autism Spectrum Disorder
Individuals with TMS Screening and Contraindication Forms which do not pass TMS Tech review
+3 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Baseline MRI
Participants complete a baseline MRI session to assess the reading and language network
1 week
1 visit (in-person)
Treatment
Participants receive cTBS or sham stimulation followed by pseudoword discrimination and word learning tasks
2 weeks
2 visits (in-person)
Follow-up
Participants are monitored for retention of learned items 24 hours after each treatment session
2 weeks
2 visits (in-person)
Participant Groups
The study tests if a type of brain stimulation called cTBS can influence learning, processing, and remembering made-up words that sound similar. Some participants will receive real cTBS while others get a sham (fake) treatment to compare results.
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Active cTBSExperimental Treatment1 Intervention
Active cTBS will be administered to the left supramarginal gyrus
Group II: Sham stimulationPlacebo Group1 Intervention
Sham stimulation will be administered to the left supramarginal gyrus
Transcranial Magnetic Stimulation is already approved in United States, Canada, European Union for the following indications:
🇺🇸 Approved in United States as Transcranial Magnetic Stimulation for:
- Major Depressive Disorder
- Obsessive Compulsive Disorder
🇨🇦 Approved in Canada as Transcranial Magnetic Stimulation for:
- Major Depressive Disorder
🇪🇺 Approved in European Union as Transcranial Magnetic Stimulation for:
- Major Depressive Disorder
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Georgia State University/Georgia Tech Center for Advanced Brain Imaging (CABI)Atlanta, GA
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Who Is Running the Clinical Trial?
Georgia State UniversityLead Sponsor
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)Collaborator
References
How to improve reading skills in dyslexics: the effect of high frequency rTMS. [2013]The latest progress in understanding remediation of dyslexia underlines how some changes in brain are a necessary mechanism of improvement. We wanted to determine whether high frequency repetitive transcranial magnetic stimulation (hf-rTMS) over areas that are underactive during reading in dyslexics, would improve reading of dyslexic adults. We applied 5Hz-TMS over both left and right inferior parietal lobule (IPL) and superior temporal gyrus (STG) prior to word, non-word and text reading aloud. Results show that hf-rTMS stimulation over the left IPL improves non-word reading accuracy and hf-rTMS stimulation over the left STG increases word reading speed and text reading accuracy. Moreover after right IPL stimulation, non-word reading accuracy also improves. These findings indicate that in dyslexics, L-STG and L-IPL have a differential role in word, non-word and text reading. Even if we would normally expect left-lateralized improvements only, the finding of a right IPL involvement suggests that there is additional compensatory recruitment of this region in dyslexics. In conclusion, we provide the first evidence that distinctive facilitation of neural pathways known to be underactive in dyslexics transitorily improves their reading performance. Such ameliorative effect may open new perspectives for the development of long-term specific treatments for dyslexia.
Reading with the right hemisphere: evidence from transcranial magnetic stimulation. [2015]Although many patients with dominant hemisphere damage retain some reading ability, the anatomic substrate of the preserved reading remains controversial. We tested the hypothesis that the right hemisphere mediates the reading of some patients with acquired dyslexia by using Transcranial Magnetic Stimulation (TMS) to assess the effect of transient cortical stimulation on reading. A patient with (partially recovered) pure alexia was asked to read aloud briefly presented words, half of which were shown in association with TMS of the right or left hemisphere. Consistent with the right hemisphere reading hypothesis, stimulation of the right but not the left hemisphere disrupted oral reading.
Therapeutic role of rTMS on recovery of dysphagia in patients with lateral medullary syndrome and brainstem infarction. [2017]There is some evidence for a therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) on dysphagia in hemispheric stroke.
Improved receptive and expressive language abilities in nonfluent aphasic stroke patients after application of rTMS: an open protocol case series. [2018]Repetitive transcranial magnetic stimulation (rTMS) has been identified as a potentially valuable tool for the rehabilitation of language impairment after left hemisphere (LH) stroke, in populations of persons with chronic aphasia. Applied to a homologue to Broca's area, rTMS is posited to modulate bilateral language networks, promoting measurable behavioral language change, in accordance with theories of transcallosal disinhibition arising from the damaged LH.
Therapeutic application of 6-Hz-primed low-frequency rTMS combined with intensive speech therapy for post-stroke aphasia. [2016]To clarify the safety, feasibility and efficacy of 6-Hz-primed low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive speech therapy (ST) for post-stroke aphasic patients.
Risk and safety of repetitive transcranial magnetic stimulation: report and suggested guidelines from the International Workshop on the Safety of Repetitive Transcranial Magnetic Stimulation, June 5-7, 1996. [2022]Single-pulse transcranial magnetic stimulation (TMS) is a safe and useful tool for investigating various aspects of human neurophysiology, particularly corticospinal function, in health and disease. Repetitive TMS (rTMS), however, is a more powerful and potentially dangerous modality, capable of regionally blocking or facilitating cortical processes. Although there is evidence that rTMS is useful for treating clinical depression, and possibly other brain disorders, it had caused 7 known seizures by 1996 and could have other undesirable effects. In June 1996 a workshop was organized to review the available data on the safety of rTMS and to develop guidelines for its safe use. This article summarizes the workshop's deliberations. In addition to issues of risk and safety, it also addresses the principles and applications of rTMS, nomenclature, and potential therapeutic effects of rTMS. The guidelines for the use of rTMS, which are summarized in an appendix, cover the ethical issues, recommended limits on stimulation parameters, monitoring of subjects (both physiologically and neuropsychologically), expertise and function of the rTMS team, medical and psychosocial management of induced seizures, and contra-indications to rTMS.
Effects of a 2- to 4-week course of repetitive transcranial magnetic stimulation (rTMS) on neuropsychologic functioning, electroencephalogram, and auditory threshold in depressed patients. [2019]The safety of repetitive transcranial magnetic stimulation (rTMS) has only previously been formally studied in volunteers receiving a single session of stimulation or in a small number of depressed subjects receiving a 2-week treatment course. This study examined safety issues in depressed subjects receiving up to 4 weeks of rTMS. Efficacy results from this study have been previously reported.
Side effects of repetitive transcranial magnetic stimulation. [2005]The side effects of repetitive transcranial magnetic stimulation are largely unexplored and the limits of safe exposure have not been determined except as regards the acute production of seizures. Although tissue damage is unlikely, however, cognitive and other adverse effects have been observed and the possibility of unintended long-term changes in brain function are theoretically possible.
Transcranial magnetic stimulation (TMS) safety: a practical guide for psychiatrists. [2019]Repetitive transcranial magnetic stimulation (rTMS) is increasingly being utilised as a treatment option for depression, and with this comes a need for a practical review of safety issues intended for clinicians. This article provides an overview of the current literature regarding safety issues with rTMS for depression, and provides recommendations for clinical practice.
Evidence for reading improvement following tDCS treatment in children and adolescents with Dyslexia. [2018]There is evidence that non-invasive brain stimulation transitorily modulates reading by facilitating the neural pathways underactive in individuals with dyslexia. The study aimed at investigating whether multiple sessions of transcranial direct current stimulation (tDCS) would enhance reading abilities of children and adolescents with dyslexia and whether the effect is long-lasting.
Adaptive short-term plasticity in the typical reading network. [2023]The left temporo-parietal cortex (TPC) is crucial for phonological decoding, i.e., for learning and retaining sound-letter mappings, and appears hypoactive in dyslexia. Here, we tested the causal contribution of this area for reading in typical readers with transcranial magnetic stimulation (TMS) and explored the reading network's response with fMRI. By investigating the underlying neural correlates of stimulation-induced modulations of the reading network, we can help improve targeted interventions for individuals with dyslexia. 28 typical adult readers overtly read simple and complex words and pseudowords during fMRI after effective and sham TMS over the left TPC. To explore differences in functional activation and effective connectivity within the reading network, we performed univariate and multivariate analyses, as well as dynamic causal modeling. While TMS-induced effects on reading performance and brain activation showed large individual variability, multivariate analyses revealed a shift in activation in the left inferior frontal cortex for pseudoword reading after effective TMS. Furthermore, TMS increased effective connectivity from the left ventral occipito-temporal cortex to the left TPC. In the absence of effects on reading performance, the observed changes in task-related activity and the increase in functional coupling between the two core reading nodes suggest successful short-term compensatory reorganization in the reading network following TMS-induced disruption. This study is the first to explore neurophysiological changes induced by TMS to a core reading node in typical readers while performing an overt reading task. We provide evidence for remote stimulation effects and emphasize the relevance of functional interactions in the reading network.
The use of noninvasive brain stimulation techniques to improve reading difficulties in dyslexia: A systematic review. [2023]Noninvasive brain stimulation (NIBS) allows to actively and noninvasively modulate brain function. Aside from inhibiting specific processes, NIBS may also enhance cognitive functions, which might be used for the prevention and intervention of learning disabilities such as dyslexia. However, despite the growing interest in modulating learning abilities, a comprehensive, up-to-date review synthesizing NIBS studies with dyslexics is missing. Here, we fill this gap and elucidate the potential of NIBS as treatment option in dyslexia. The findings of the 15 included studies suggest that repeated sessions of reading training combined with different NIBS protocols may induce long-lasting improvements of reading performance in child and adult dyslexics, opening promising avenues for future research. In particular, the "classical" reading areas seem to be most successfully modulated through NIBS, and facilitatory protocols can improve various reading-related subprocesses. Moreover, we emphasize the need to further explore the potential to modulate auditory cortex function as a preintervention and intervention approach for affected children, for example, to avoid the development of auditory and phonological difficulties at the core of dyslexia. Finally, we outline how future studies may increase our understanding of the neurobiological basis of NIBS-induced improvements in dyslexia.