Up to 40% of stroke survivors suffer from aphasia, making recovery of language abilities a top priority in stroke rehabilitation. Conventional speech and language therapy may have limited effectiveness. Leveraging multimodal data (behavioral, neuroimaging, and genetics), this study aims to 1) evaluate the efficacy of combining tDCS with speech therapy, 2) examine neural changes associated with recovery, 3) identify factors influencing response to treatment.
Approximately one million people in the United States are living with aphasia, an acquired neurological disorder affecting the ability to use and/or understand language. This communication impairment affects up to 40% of stroke patients. Stroke victims usually prioritize speaking, writing, and walking as the three most important rehabilitation goals, two of these goals therefore involving communication. Conventional speech therapy strategies have nevertheless limited effectiveness in post-stroke aphasia. Indeed, approximately half of those affected will remain in this state despite intensive speech therapy. Effective novel treatment is therefore warranted to improve recovery in these patients. Recent evidence suggests that transcranial direct current stimulation (tDCS), a non-invasive, low-cost neuromodulation technique, applied in conjunction with speech therapy may be more effective in promoting language recovery than behavioral intervention alone. A double-blind quasi-randomized controlled study will be carried out in chronic post-stroke aphasics. Participants will be assigned to either the tDCS group or to the sham (placebo) group and will receive 20 minutes of concurrent speech and language therapy by a trained speech therapist over five consecutive days. Behavioral, EEG, and MRI data will be acquired within one week before and after intervention. Genetic samples will be collected once. Secondary behavioral outcome measures will be performed again 3 months following tDCS/sham intervention to assess long-term benefits.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
24
Anodal or sham tDCS will be applied to the scalp.
A trained speech pathologist will administer the speech and language therapy.
Casa Colina Hospital and Centers for Healthcare
Pomona, California, United States
Change in Western Aphasia Battery-Revised scores
WAB-R is an instrument for assessing the language function of adults with suspected neurological disorders as a result of a stroke.
Time frame: At baseline and at week 3
Change in Magnetic Resonance Imaging (MRI)
MRI scans will be acquired on a Siemens Magnetom Verio 3T Scanner at Casa Colina Imaging Center to assess structural changes.
Time frame: At baseline and at week 3
Change in resting state Electroencephalograph (EEG) signals
Using a B-Alert wireless EEG system, we will perform eyes-open resting-state EEG recordings to assess power spectral density changes.
Time frame: At baseline and at week 3
Change in Test of Nonverbal Intelligence (TONI-4)
TONI-4 is a language-free intelligence test for evaluating those with limited language ability.
Time frame: At baseline and at week 3
Change in Communication Outcomes after Stroke (COAST)
The COAST is used to assess self-perceived communication effectiveness for people with aphasia.
Time frame: At baseline, at week 3, and at week 17
Change in Patient-Reported Outcomes Measurement Information System (PROMIS)
PROMIS is used to assess physical, mental, and social health.
Time frame: At baseline, at week 3, and at week 17
Change in Stroke and Aphasia Quality of Life Scale-39 (SAQOL-39)
The SAQOL-39 is used to assess health-related quality of life in people with long-term aphasia.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: At baseline, at week 3, and at week 17