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Effects of Transcranial Direct Current Stimulation in Post-stroke Aphasia

Not Applicable
Withdrawn
Conditions
Aphasia
Interventions
Device: Active tDCS plus Speech-Language Therapy
Device: Sham plus Speech-Language Therapy
Registration Number
NCT02622945
Lead Sponsor
Johns Hopkins University
Brief Summary

This study aims to determine whether transcranial direct current stimulation (tDCS) paired with speech-language therapy is more beneficial than speech-language therapy alone in acute and chronic post-stroke aphasia.

Detailed Description

This study aims to determine whether behavioral word-retrieval therapy coupled with anodal tDCS will improve the fluency and name retrieval performance of participants with post-stroke aphasia more efficiently and for greater duration than language therapy alone (i.e. in the sham condition).

tDCS neuronal targets will be selected in this order:

1. left posterior superior-middle temporal gyrus (an area critical for word retrieval and word comprehension),

2. left posterior frontal areas found to be responsible for lexical selection if the first area is infarcted, or

3. right cerebellum (important for learning, and consistently activated in naming task) if both of the other areas are infarcted.

The same areas will be stimulated during the first tDCS and sham periods. If the participant returns for a second period of tDCS and sham with language therapy, the right cerebellum will be stimulated (if it was the only uninfarcted target area investigators will stimulate this area again). For cerebellar stimulation, either anodal or cathodal will be used as studies show that anodal or cathodal stimulation has an effect on cognitive functions.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
  • Clinically diagnosed with with post-stroke aphasia and word-retrieval deficits
  • Premorbid speakers of English
  • Diagnosis will be based on neuropsychological testing, language testing (most commonly the Western Aphasia Battery), MRI and clinical assessment
  • Stroke size: any l
  • Location: Left hemisphere strokes only from any etiology.
  • Time since stroke onset: 1 day to 20 years.
Exclusion Criteria
  • uncorrected visual or hearing impairment by self report
  • other premorbid neurological disorder affecting the brain
  • any other language-based learning disorder or other neurodegenerative disorder such as Alzheimer's Disease or Primary Progressive Aphasia
  • premorbidly diagnosed with a developmental language disorder
  • Pregnant women will also be excluded

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Active tDCS plus Speech-Language TherapyActive tDCS plus Speech-Language TherapyActive tDCS will be applied at the beginning of 45min speech-language therapy session and will last for 20 min. Language therapy will be oral and written naming. This is a cross-over study so all participants will receive this arm but the order will be randomized.
Sham plus Speech-Language TherapySham plus Speech-Language TherapySham tDCS will be applied at the beginning of 45min speech-language therapy session. Language therapy will be oral and written naming. This is a cross-over study so all participants will receive this arm but the order will be randomized.
Primary Outcome Measures
NameTimeMethod
Change in picture naming scores in trained and untrained itemsBefore and after 15 sessions of intervention (3 weeks) and at 2 weeks and 2 months follow-ups
Secondary Outcome Measures
NameTimeMethod
Change in Philadelphia Naming Test: Picture naming of everyday objects, different from training setBefore and after 15 sessions of intervention (3 weeks) and at 2 weeks and 2 months follow-ups
Change in Written naming of objects and actionsBefore and after 15 sessions of intervention (3 weeks) and at 2 weeks and 2 months follow-ups

The investigators will evaluate the absolute number as well as the percent change of the list of objects and actions assigned for intervention as trained and untrained items.

Change in working memory (digit span)Before and after 15 sessions of intervention (3 weeks) and at 2 weeks and 2 months follow-ups
Change in verbal fluencyBefore and after 15 sessions of intervention (3 weeks) and at 2 weeks and 2 months follow-ups

The investigators will use letter (F, A, S) and semantic fluency measures (animals, fruits and vegetables) and the investigators will measure how many were added or omitted at follow-up intervals.

Trial Locations

Locations (1)

Johns Hopkins Medicine

🇺🇸

Baltimore, Maryland, United States

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