The Effect of Non-invasive Brain Stimulation on Language Production in Post-stroke Aphasia
- Conditions
- AphasiaStrokeLanguage Disorders
- Interventions
- Behavioral: Language treatment for improving discourse productionDevice: Transcranial direct-current stimulation (tDCS)
- Registration Number
- NCT04204356
- Lead Sponsor
- King's College London
- Brief Summary
Aphasia is a language impairment caused by brain injury such as stroke that affects the ability to understand and express language, read and write due to damage in the language regions of the brain. Non-invasive brain stimulation (NIBS) techniques like transcranial direct-current stimulation (tDCS) have been found to improve aphasia treatment effects in post stroke patient populations such as improved naming abilities.
However, the effect of tDCS on more functional, higher level language skills such as discourse production (i.e. story telling, giving instructions) has yet to be understood.Therefore the aim of this study is to determine the potential effectiveness of tDCS as an adjunct to speech and language therapy (SLT) to improve discourse speech production in people with post-stroke aphasia. It is hypothesised that SLT combined with tDCS will result in greater improvements in discourse language production compared to SLT on its own.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 6
- aphasia caused by a single stroke
- at least 6 months post stroke
- at least 18 years old
- competent English speaker prior to stroke
- right handed prior to stroke
- normal aided or unaided visual acuity
- willing to participate and to comply with the proposed block of intervention and testing regime.
Persons with
- neurological symptoms or history of a neurological event other than their stroke
- contraindications to tDCS including history of epilepsy or seizures and pacemakers
- global/severe aphasia
- cognitive impairment identified by a score less than 20/30 in the Montreal Cognitive Assessment
- left-handed dominance prior to stroke
- visual problems which interfere with persons' ability to access visual materials (i.e. pictures)
- inability to attend sessions
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description tDCS group Transcranial direct-current stimulation (tDCS) Participants randomly allocated to this group using a random number generator will receive a once weekly, 6-week block of language treatment with active tDCS. Sham group Language treatment for improving discourse production Participants randomly allocated to this group using a random number generator will receive a once weekly, 6-week block of language treatment without active tDCS (sham) tDCS group Language treatment for improving discourse production Participants randomly allocated to this group using a random number generator will receive a once weekly, 6-week block of language treatment with active tDCS.
- Primary Outcome Measures
Name Time Method Verb token total 30 minutes The number of all verb occurrences in a language sample
Verb type total 30 minutes The number of distinct verbs in a sample
- Secondary Outcome Measures
Name Time Method Total number of utterances 30 minutes The total number of utterances in a language sample
Communicative Effectiveness Index (CETI) 10 minutes CETI is a valid and reliable measure of change in functional communication ability in adults with aphasia. This assessment includes 16 everyday situations such as having a one to one conversation and giving yes or no answers appropriately. Participants are asked to rate their ability in each particular communication situation using a rating scale with one end labelled as 'not at all able and the other 'as able as before
Total number of words 30 minutes The total number of words in a language sample
Hospital Anxiety and Depression Scale (HADS) 10 minutes HADS is a 14-item scale which assesses non-somatic anxiety and depression symptoms. Scores range from 0 to 21 for each sub-scale with a score ≥8 proposed for the identification of caseness, for both depression and anxiety.
Montreal Cognitive Assessment (MoCA) 15 minutes The MoCA is a brief and easy to administer cognitive assessment. Different aspects of cognition such as memory, executive function, language, visual-spatial ability and orientation are assessed. Scores range from 0-30, where the recommended cut-off score for identifying multi-domain cognitive impairment in persons with chronic stroke is 20/30.
Aphasia Impact Questionnaire-21 (AIQ) 15 minutes AIQ is a self-report questionnaire which utilises pictures to enable people with aphasia to communicate their experiences of aphasia. There are 8 questionnaires to select from with scales that vary in relation to gender and race. Pictorial responses can be translated into numerical scores, and then documented on a summary score sheet. The questionnaire has three sections; communication, participation and well-being/emotional state. The first section looks at activities which are commonly difficult for people with aphasia such as talking and understanding. The participation section looks at how communication difficulties arising from aphasia impact the person's ability to complete tasks in everyday life such as shopping and work. The last section looks at the emotional effect of aphasia.
Predicate argument structure (PAS) 30 minutes The main verbs and their arguments will be identified in each sentence within a language sample. A PAS complexity score will be calculated using the formula: number of arguments/number of main verbs
Trial Locations
- Locations (1)
King's College London
🇬🇧London, United Kingdom