Speech-Language Treatment With Remotely Supervised Transcranial Direct Current Stimulation in Primary Progressive Aphasia
Telerehabilitation With Remotely-Supervised tDCS in Progressive Aphasia
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Lisa Wauters, M.A.
- Phone Number: 512-471-3420
- Email: lisa.wauters@austin.utexas.edu
Study Contact Backup
- Name: Zoe Ezzes, M.S.
- Phone Number: 415-580-0294
- Email: zoe.ezzes@ucsf.edu
Study Locations
-
-
California
-
San Francisco, California, United States, 94158
- Memory and Aging Center, University of California, San Francisco
-
-
Texas
-
Austin, Texas, United States, 78712
- University of Texas
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Because PPA is a rare disease, the study aims to recruit all eligible participants with PPA who are referred to the Aphasia Research and Treatment Lab at the University of Texas (UT) Austin, the UT/Dell Medical School Department of Neurology, and the University of California at San Francisco (UCSF) Memory and Aging Center, as well as individuals with PPA from other clinical and research sites. The study will aim to include males, females, and transgender or non-binary individuals. Great efforts will be made to recruit participants from minority populations, subject to the limitation that participants need to be fluent speakers of English.
Inclusion Criteria:
- Meets diagnostic criteria for PPA
- Meets diagnostic criteria for a specific variant of PPA
- Score of 20 or higher on the Mini-Mental State Examination
- Adequate hearing and vision (with hearing or vision aids, if needed)
- Has a study partner that can co-enroll in the study and attend pre-treatment training as well as continue to be present for weekly teleconference meetings
- Able and willing to undergo MRI brain scan
- Access to high speed internet
Exclusion Criteria:
- Speech and language deficits better accounted for by another neurological disorder
- Does not meet diagnostic criteria for a specific variant of PPA
- Score of less than 20 on the Mini-Mental State Examination
- Does not have a study partner who can co-enroll in the study
- Contraindications for tDCS or MRI scan (History of seizures, head injury, craniotomy, skull surgery or fracture; History of severe or frequent migraines; Metallic implant in head or any metal in head; Pacemaker or cardioverter-defibrillator or any other stimulator; Chronic skin problems; Pregnancy)
- History of stroke, epilepsy, or significant brain injury
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: RS-LRT
|
tDCS is a type of non-invasive brain stimulation.
1.5 milliamp (mA) of current will be delivered via electrodes in saline-soaked sponges placed on the left side of the head and right upper arm.
The stimulation will be delivered for 20 minutes, 5 times weekly, in the participant's home setting while the participant engages in computer-delivered speech-language training.
Sessions are monitored by study personnel.
tDCS is a type of non-invasive brain stimulation.
During sham stimulation 1.5 milliamp (mA) of current will be delivered for a brief period and then turned off.
Current will be delivered via electrodes in saline-soaked sponges placed on the left side of the head and right upper arm.
Sham will be delivered for 20 minutes, 5 times weekly, in the participant's home setting while the participant engages in computer-delivered speech-language training.
Sessions are monitored by study personnel.
Participants work on producing spoken and written names of personally relevant target items using a self-cueing hierarchy.
Treatment focuses on the use of strategies that capitalize on spared cognitive-linguistic abilities to support word retrieval.
The participant completes two (one hour each) teletherapy sessions per week with a clinician plus 30 minutes of additional independent, computer-based practice exercises 3 times per week.
|
|
Experimental: RS-VISTA
|
tDCS is a type of non-invasive brain stimulation.
1.5 milliamp (mA) of current will be delivered via electrodes in saline-soaked sponges placed on the left side of the head and right upper arm.
The stimulation will be delivered for 20 minutes, 5 times weekly, in the participant's home setting while the participant engages in computer-delivered speech-language training.
Sessions are monitored by study personnel.
tDCS is a type of non-invasive brain stimulation.
During sham stimulation 1.5 milliamp (mA) of current will be delivered for a brief period and then turned off.
Current will be delivered via electrodes in saline-soaked sponges placed on the left side of the head and right upper arm.
Sham will be delivered for 20 minutes, 5 times weekly, in the participant's home setting while the participant engages in computer-delivered speech-language training.
Sessions are monitored by study personnel.
Participants work on producing personally relevant scripts of 4-6 sentences in length.
Length and complexity of scripts are individually tailored.
The participant completes two (one hour each) teletherapy sessions per week with a clinician targeting clear and accurate script production, script memorization, and conversational usage of scripts.
The participant completes 30 minutes of independent, computer-based practice 3 times per week, during which they speak in unison with a video/audio model of a healthy speaker clearly articulating the scripts.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
RS-LRT arm: Change in spoken naming
Time Frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
Change in percent correctly named trained/untrained pictures
|
change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
|
RS-VISTA arm: Change in script production accuracy
Time Frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
Change in percent correct, intelligible, scripted words produced for trained/untrained scripts
|
change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change on Communication Confidence Rating Scale for Aphasia
Time Frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
Change on 10-item Likert-type self-rating scale evaluating communication confidence in different settings for persons with aphasia.
A higher score indicates greater confidence.
|
change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
|
Change on Aphasia Impact Questionnaire
Time Frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
Change on Patient Reported Outcome Measure for persons with aphasia; characterizes activities, participation and emotional state/wellbeing using a 5-point pictorial rating scale.
A higher score indicates greater impact of aphasia.
|
change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)
|
|
Client Satisfaction Questionnaire
Time Frame: four months after treatment onset
|
Likert-type scale measuring patient/client satisfaction with intervention.
A higher score indicates greater satisfaction.
|
four months after treatment onset
|
|
Remotely-supervised Transcranial Direct Current Stimulation (RS-tDCS) Survey
Time Frame: four months after onset of treatment
|
Likert type scale used to capture participants' perceptions regarding the acceptability and potential demand for remotely-supervised tDCS.
|
four months after onset of treatment
|
|
Care Partner Survey
Time Frame: four months after onset of treatment
|
Likert-type scale used to characterize care partners' perceptions of the benefits of speech-language treatment.
|
four months after onset of treatment
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Maya Henry, PhD, University of Texas at Austin
Publications and helpful links
General Publications
- Henry ML, Hubbard HI, Grasso SM, Dial HR, Beeson PM, Miller BL, Gorno-Tempini ML. Treatment for Word Retrieval in Semantic and Logopenic Variants of Primary Progressive Aphasia: Immediate and Long-Term Outcomes. J Speech Lang Hear Res. 2019 Aug 15;62(8):2723-2749. doi: 10.1044/2018_JSLHR-L-18-0144. Epub 2019 Aug 7.
- Dial HR, Hinshelwood HA, Grasso SM, Hubbard HI, Gorno-Tempini ML, Henry ML. Investigating the utility of teletherapy in individuals with primary progressive aphasia. Clin Interv Aging. 2019 Feb 25;14:453-471. doi: 10.2147/CIA.S178878. eCollection 2019.
- Henry ML, Hubbard HI, Grasso SM, Mandelli ML, Wilson SM, Sathishkumar MT, Fridriksson J, Daigle W, Boxer AL, Miller BL, Gorno-Tempini ML. Retraining speech production and fluency in non-fluent/agrammatic primary progressive aphasia. Brain. 2018 Jun 1;141(6):1799-1814. doi: 10.1093/brain/awy101.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- Alzheimer's Disease
- Transcranial Direct Current Stimulation
- Neurodegenerative Disease
- Telehealth
- Teletherapy
- Primary Progressive Aphasia
- Noninvasive Brain Stimulation
- Logopenic Variant Primary Progressive Aphasia
- Fronto-Temporal Dementia
- Semantic Dementia
- Logopenic
- Nonfluent Variant Primary Progressive Aphasia
- Speech-Language Pathology
- Semantic
- Nonfluent
- Semantic Variant Primary Progressive Aphasia
- Speech Entrainment
- Script Training
- Remotely-Supervised Transcranial Direct Current Stimulation
- Lexical Retrieval
Additional Relevant MeSH Terms
- Neurologic Manifestations
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Mental Disorders
- Metabolic Diseases
- Neurobehavioral Manifestations
- Neurocognitive Disorders
- Dementia
- Tauopathies
- TDP-43 Proteinopathies
- Proteostasis Deficiencies
- Communication Disorders
- Language Disorders
- Aphasia
- Speech Disorders
- Frontotemporal Lobar Degeneration
- Pathological Conditions, Signs and Symptoms
- Nutritional and Metabolic Diseases
- Signs and Symptoms
- Alzheimer Disease
- Neurodegenerative Diseases
- Frontotemporal Dementia
- Aphasia, Primary Progressive
Other Study ID Numbers
Other Study ID Numbers
- STUDY00002453
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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