- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04081207
Using Augmentative & Alternative Communication to Promote Language Recovery for People With Post-Stroke Aphasia (NAIL)
A Preliminary Study of the Neurobiology of AAC-Induced Language Recovery in Post-Stroke Aphasia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In aphasia rehabilitation, usual care is focused on helping people recuperate as much of their pre-stroke language capacity as possible.Typically, usual care is a non-standardized therapy that is tailored to the specific needs of the person with aphasia.Once a person reaches a plateau in language recovery, AAC is implemented with a focus on circumventing, or compensating for the communication challenges associated with aphasia.
The ability of people with aphasia to (1) recover language function well-into the chronic phase of stroke recovery and (2) self-cue to promote word retrieval during anomic events offer the solution for how AAC could be employed as a dual-purpose tool to augment language recovery and compensate for deficits. This approach, however, this requires a shift in how AAC is implemented. With the goal of language recovery, treatment needs to focus on instructing people with aphasia how to use AAC as a mechanism for self-cueing, rather than as a tool to replace speaking. Based on our pilot data, we hypothesize that this novel method to AAC implementation will promote language recovery by coupling the canonical language and visual processing neural networks.
This work will also contribute to our ability to identify, a priori, who will respond to this particular AAC intervention and who will not, by combining neuroimaging with behavioral and clinical data. This has the potential to reduce the cost of healthcare for stroke recovery by implementing the most effective treatment possible. Importantly, when we identify non-responders, this will allow us to construct a profile and identify features of the AAC treatment that require adjustment to meet their unique needs.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Aimee Dietz, PhD
- Phone Number: 513-558-8551
- Email: aimee.dietz@uc.edu
Study Contact Backup
- Name: Jennifer Vannest, PhD
- Phone Number: 513-558-8518
- Email: vannesjr@ucmail.uc.edu
Study Locations
-
-
Ohio
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Cincinnati, Ohio, United States, 45267
- Recruiting
- University of Cincinnati
-
Contact:
- Aimee Dietz, PhD
- Phone Number: 513-558-8551
- Email: aimee.dietz@uc.edu
-
Contact:
- Jennifer Vannest, BS
- Phone Number: Dietz 513-558-85418
- Email: aimee.dietz@uc.edu
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Principal Investigator:
- Aimee Dietz, PhD
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Sub-Investigator:
- Jennifer Vannest, PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- at least 18 years old
- native speaker of american English
- compatible for 3 Tesla MRI
- Ischemic, left middle cerebral artery stroke
- at least 12 months post stroke
- pass hearing screening
- pass vision screening
- diagnosis of aphasia on the Western Aphasia Bedside Screen
- ability to produce 5-10 intelligible words
- no more than a moderate apraxia of speech or dysarthria
- minimal or no AAC/iPad experience
- written consent by self or guardian
Exclusion Criteria:
- fails to meet the above
- Underlying degenerative or metabolic disorder or supervening medical illness
- Severe depression or other psychiatric disorder
- Report of pregnancy by women of childbearing age
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: AAC-LaRc
all participants receive the experimental treatment
|
iPads will be programmed with a personalized communication application (app) and a structured 4-step intervention will be employed to instruct patients how to cue themselves during anomic events via pictures, text, or speak buttons.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Western Aphasia Battery-Revised Aphasia Quotient
Time Frame: 3 years
|
a diagnostic tool used to determine aphasia type and severity
|
3 years
|
Visual Regions of Interest Activation intensity
Time Frame: 3 years
|
A functional magnetic resonance imaging (fMRI) measure to indicate change in brain involvement during resting state and language tasks.
|
3 years
|
Connectivity Indices
Time Frame: 3 years
|
Connectivity indices reflect the temporal correlation between canonical language and visual regions of interest during language and resting state fMRI tasks.
|
3 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Motor-Free Visual Perception Test-4
Time Frame: 3 years
|
The Motor-Free Visual Perception Test-4 assesses visual perceptual ability without requiring motor responses.
|
3 years
|
Discourse Analyses
Time Frame: 3years
|
We will calculate percentage of counted words, mazes, correct information units, t-units, during personal story retells with and without the AAC support.
|
3years
|
Communication analyses
Time Frame: 3 years
|
We will calculate percentage of communication conveyed via pictures, text boxes, and speak button during personal story retells with and without the iPad AAC support.
|
3 years
|
Stroke and Aphasia Quality of Life-39 (SAQOL-39)
Time Frame: 3 years
|
The SAQOL-39 is a valid and reliable measure of health related quality of life, post-stroke that uses an aphasia friendly 5 point Likert scale format.
|
3 years
|
Communication Effectiveness Index (CETI)
Time Frame: 3 years
|
The CETI measures functional communication scenarios that caregivers rate the ability of the patient to complete tasks, as compared to before their stroke, via a 10 cm visual analogue scale.
|
3 years
|
Fractional Anisotropy (FA)
Time Frame: 3 years
|
FA is a value of diffusion and reflects white matter density and myelination.
We will examine the following tracts: (1) superior, (2) inferior fronto-occipital, (3) middle longitudinal, (4) inferior longitudinal fasciculus, (5) arcuate, and (6) uncinate
|
3 years
|
Mean Diffusivity (MD)
Time Frame: 3 years
|
MD is used to map tracts and serves as a measure of health or disease in white matter.
We will determine the MD for the following pathways: (1) superior, (2) inferior fronto-occipital, (3) middle longitudinal, (4) inferior longitudinal fasciculus, (5) arcuate, and (6) uncinate
|
3 years
|
Language Lateralization Indices (LI)
Time Frame: 3 years
|
LI is a measure that reflects hemispheric dominance for language, while accounting for lesioned tissue.
|
3 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Aimee Dietz, PhD, University of Cincinnati
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 1R15DC017280-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- Study Protocol
- Informed Consent Form (ICF)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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