Targeted TDCS to Enhance Speech-Language Treatment Outcome in Persons With Chronic Post-Stroke Aphasia.

University of New Mexico50 enrolled

Overview

62 patients who are one year post stroke and have Aphasia as a result of that stroke will be recruited. Participants will have 4 assessment sessions and 15 treatment sessions. The TDCS will be to right Inferior Frontal Gyrus (IFG) (25 active, 25 sham) for 15 days. A combined semantic feature analysis/phonological components analysis treatment will be paired with the stimulation. Two assessment sessions will be pretreatment, 1 session immediately post-treatment, and 1 session at 3 months follow-up.

Our long-term goal is to develop safe and effective treatments for the communication problems of Aphasia due to stroke that restore patients to higher levels of functioning, decrease disability, and promote higher quality of life. While language therapy for aphasia is effective, improvements are typically slow, and gains may be small. Noninvasive brain stimulation has been suggested as a method to enhance outcomes from language therapy. This study will examine whether outcomes for language therapy with brain stimulation are different from outcomes for language therapy without brain stimulation in people with aphasia. Our central hypotheses are (1) targeted right hemisphere HDtDCS (RH-HD-tDCS) administered in combination with language treatment will result in greater changes in naming accuracy than language treatment with the sham RH-HD-tDCS (2) RH-HD-tDCS plus language treatment will result in greater increases in communication within the affected hemisphere compared to language treatment plus sham RH-HD-tDCS (3) RH-HD-tDCS plus language treatment will result in greater increases in perilesional areas working together immediately post-treatment compared to language treatment plus sham RH-HD-tDCS

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Interventions

Active Comparator: Experimental: Active cathodal tDCS + language trainingDEVICE

Cathodal tDCS raises neuronal membrane potentials, leading to decreased probability of depolarization from incoming stimuli. Speech and Language training involves a combined semantic feature analysis and phonological components analysis treatment.

Sham Comparator: Placebo cathodal tDCS + Speech and languageBEHAVIORAL

Speech and Language training involves a combined semantic feature analysis and phonological components analysis treatment. .

Eligibility

Sex: ALLMin age: 25 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. aged 25-85 2. must be greater than 6 months post-stroke 3. must have a diagnosis of aphasia based on impaired performance on the Western Aphasia Battery-Revised, Boston Naming Test, or during discourse production 4. must be left-hemisphere dominant as demonstrated by aphasia onset subsequent to left hemisphere damage 5. must be stimulable for naming Exclusion Criteria: 1. comorbid neurological disease. 2. damage to the anterior right hemisphere. 3. significant mood disorder. 4. substance/alcohol dependence or abuse within the past year 5. presence of any implanted electrical device or contraindications to tDCS or MRI 6. recent medical instability (within 4 weeks) 7. pregnancy

Outcomes

Primary Outcomes

Picture Naming of trained items

Change in naming of pictures of trained items; 60 pictured items; higher score indicates improvement

Time frame: 3 months

Naming Response Time of trained items Scales - IV (WAIS-IV; Wechsler, Coalson, & Railford, 2008)

Change in response time of naming of pictures of trained items; 0-20 seconds, decreased response time indicates improvement Scales - IV (WAIS-IV; Wechsler, Coalson, \& Railford, 2008)

Time frame: 3 months

Naming Efficiency of trained items

Change in efficiency of naming of pictures of trained items; median response time divided by proportion correct naming; smaller numbers indicate greater efficiency

Time frame: 3 months

Secondary Outcomes

Discourse informativeness - Main Concept Production

Change in discourse informativeness as measured by main concept scores; increased values indicate improvement

Time frame: 3 months

Efficiency of discourse informativeness - Main Concept Production

Change in efficiency of discourse informativeness; accurate and complete main concepts produced over the time of discourse elicitation (ACs/min); larger numbers indicate greater efficiency

Time frame: 3 months

Picture Naming of untrained items - Boston Naming Test

Change in naming of pictures of untrained items; 60 pictured items; higher score indicates improvement

Time frame: 3 months

Naming Response Time of untrained items - Boston Naming Test

Change in response time of naming of pictures of untrained items; 0-20 seconds, decreased response time indicates improvement

Time frame: 3 months

Naming Efficiency of untrained items - Boston Naming Test

Change in efficiency of naming of pictures of untrained items; median response time divided by proportion correct naming; smaller numbers indicate greater efficiency

Time frame: 3 months

Targeted TDCS to Enhance Speech-Language Treatment Outcome in Persons With Chronic Post-Stroke Aphasia.

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts