tDCS and Speech Therapy to Improve Aphasia
- Conditions
- Speech TherapyAphasia, GlobalStrokeTranscranial Direct Current Stimulation
- Interventions
- Procedure: tDCS + speech therapy
- Registration Number
- NCT02395874
- Lead Sponsor
- Medical Park AG
- Brief Summary
To study the effect of combined tDCS plus speech therapy compared to sham-tDCS plus speech therapy in subacute stroke patients suffering from moderate or severe aphasia. The patients will be randomized by a computer-generated lot. Assessment will be performed at study onset, after six weeks at the end of the specific intervention and 4 months after stroke onset for follow-up.
- Detailed Description
Approximately 25% of all patients after stroke suffer from aphasia. The aphasia could be so severe, that the patient cannot produce any words at all, and so the communication ability is rather poor. In that case speech therapy is the most common therapy, but the functional outcome for the patient is often not sufficiently. The transcranial direct current stimulation (tDCS) might improve the outcome of speech therapy in patients with severe aphasia. The patients will be randomized either to verum stimulation (group A) or sham stimulation (group B). In group A they will receive every workday for 6 weeks 20min of tDCS with 2 mA in combination with a 30 min speech therapy. In group B they will receive every workday for 6 weeks 20min of tDCS with 0 mA in combination with a 30 min speech therapy. The anodal electrode will be placed in case of a total anterior circulation stroke on the homologous speech area on the right hemisphere and in case of a partial anterior circulation stroke perilesional on the left hemisphere. The cathode will be positioned contralateral.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 96
- first time stroke (ischemic or hemorrhagic), either with a total or partial anterior circulation stroke according to the Bamford classification
- stroke interval 10-45 days
- moderate or severe aphasia, i.e. Goodglass-Kaplan-Communication-Scale (GKS, 0,1 or 2)
- native speaker - german
- age 18-90
- other neurological diseases affecting the CNS
- known history of epileptic fits, except for an immediate fit
- signs in the EEG of increased cortical excitability
- patients with hemicraniectomy
- fluent aphasia, i.e. GKS 3,4 or 5
- speech apraxia
- reduced sensibility of the scalp
- previously radiated scalp
- metallic parts or implants in the brain
- participation in other interventional studies
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description sham-tDCS tDCS + speech therapy sham-tDCS + speech therapy verum-tDCS tDCS + speech therapy verum-tDCS+ speech therapy
- Primary Outcome Measures
Name Time Method Goodglass-Kaplan communication scale (GKS, 0-5) 10-15 min the GKS is an ordinal scale, which assesses the communication ability of the patient from 0 to 5.
Aphasia Check-list (ACL, 0-148) 30-45 min a german tool to assess language (analogous to the Aachener Aphasie Test). it measures a) colour-figure test, b) word generation and c) single speech domains
- Secondary Outcome Measures
Name Time Method Aphasic depression rating scale (ADRS, 0-32) 5 min rates the depression in patients with aphasia
Barthel-Index (BI,0-100) 5min evaluates the activities of daily living in patients suffering from stroke
Alterskonzentrationstest (AKT, 0-35) 5 min assesses the concentration and vigilance of elderly people with stroke
Rivermead Motor Assessment - Arm (RMA, 0-15) 5-10 min assesses the motor control of the upper extremity in patients with stroke
Trial Locations
- Locations (1)
Medical Park Berlin Humboldtmuehle
🇩🇪Berlin, Germany