Central Mechanisms in Speech Motor Control Studied With H215O PET

NCT ID: NCT00001308

Last Updated: 2019-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Total Enrollment

1163 participants

Study Classification

OBSERVATIONAL

Study Start Date

1992-04-28

Study Completion Date

2016-10-06

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Positron Emission Tomography (PET) is a technique used to investigate the functional activity of the brain. The PET technique allows doctors to study the normal biochemical and metabolic processes of the central nervous system of normal individuals and patients with neurologic illnesses without physical / structural damage to the brain. Radioactive water H215O in PET scans permits good visualization of areas of the brain related to speech.

Most of the PET scan studies conducted have concentrated on learning about how language is formed and decoded. Few studies have been conducted on speech production. This study aims to use radioactive water (H215O) and Positron Emission Tomography (PET scan) to measure blood flow to different areas of the brain in order to better understand the mechanisms involved in speech motor control.

When a region of the brain is active, it uses more fuel in the form of oxygen and sugar (glucose). As the brain uses more fuel it produces more waste products, carbon dioxide and water. Blood carries fuel to the brain and waste products away from the brain. As brain activity increases blood flow to and from the area of activity increases also. Knowing these facts, researchers can use radioactive chemicals (H215O) and PET scans to observe what areas of the brain are receiving more blood flow.

Researchers will ask patients to perform tasks that will affect speech, voice, and language. At the same time patients will undergo a PET scan. The tasks are designed to help researchers observe the blood flow to brain areas associated with voicebox (laryngeal) functions, movement of muscles in the jaw, tongue, and mouth, and other aspects of motor speech.

Special studies will be conducted to evaluate how certain therapies and tasks can draw out symptoms in illnesses in which speech and language are affected. Results of these tests will be used in other studies to evaluate the neurologic mechanisms of diseases like Tourette's syndrome and parkinson's disease.\<TAB\>

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Objective

The primary objective of this protocol is to use multimodal neuroimaging combining complementary electrophysiological and hemodynamic methods to characterize brain-language relationships in healthy subjects and those with neurological disorders that affect speech and language. A secondary objective is to utilize these findings to develop evaluation measures for future treatment studies.

Study Populations

We will focus on four neurological disorders that affect language processing post-stroke aphasia, traumatic brain injury, epilepsy and developmental stuttering. Each constitutes a significant clinical problem central to the NIDCD s mission. These disorders can impair language at several levels - from its elementary perceptual and motor features, the peripheral building blocks of language, to higher levels of language formulation, including word, sentence and narrative processing.

Design

We will utilize a set of tasks designed to evaluate language at the levels at which clinical pathology emerges. We will combine hemodynamic (functional MRI) and electrophysiological (EEG, MEG) modalities to capitalize on the superior spatial resolution of the former and temporal resolution of the latter methods. Whenever possible the same task paradigms are used with both techniques. We will conduct crosssectional sub-studies, addressing specific questions in each of the disorders of interest; we will also conduct longitudinal sub-studies of recovery and neuroplastic reorganization in post-stroke aphasia.

Outcome Measures

Outcome measures include speech-language and psychological tests, measures of behavioral performance during scanning and corresponding MRI, EEG and MEG data. Relationships between these datasets will be evaluated using statistical analytic packages.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Communication Disorder Healthy Stuttering Tourette Syndrome Voice Disorder

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Stuttering Tourette's Syndrome Spasmodic Dysphonia Dysarthria Parkinson's Disease Verbal Dyspraxia Aphasia Speech Motor Control

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Ages 18 to 85.

Ability to provide informed consent.

Must be a Native English speaker by age 2


Have had training and experience in creative writing

Have had training and experience in vocal or instrumental music

Have had training and experience in visual arts


Had sensorimotor and language deficits following ischemic infarcts.

Had stroke at least two weeks ago.


Diagnosis of TBI

At least one month post-injury


History of developmental stuttering with symptoms of dysfluency presenting before the age of 13

If recovered, history documented by school or medical records.


Ages 18 to 55 years.

Failure of seizures to respond to adequate therapy with at least two standard antiepileptic drugs.

Willingness to be considered for surgery

Fluency in English. Non-native speakers may be included if their fluency is equivalent to that of a native speaker.

Must have localization-related epilepsy

Must be currently enrolled in Protocol 08-N-0161 to participate in this study

Exclusion Criteria

Past or present major medical or psychiatric illnesses (DSM-IV criteria) except Post Traumatic Stress Disorder (PTSD) in TBI subjects an anxiety disorder in stuttering subjects

Significant abnormalities on the general physical examination unrelated to the stroke or TBI

Unable to undergo MRI studies due to pacemakers, aneurysm clips, cochlear implants, shrapnel fragments or a significant history of exposure to small metallic objects which might have become lodged in the tissues of the head or neck or who require hearing aids.

Subjects who are pregnant are excluded from the PET and MRI tests in this study.

Subjects who are lactating are excluded from the PET tests.

Subjects who have or are found to have significant visual agnosia.

Subjects who cannot provide informed consent.


More than two prior strokes

Concurrent diagnoses of neurodegenerative disorders or vascular dementia

Comprehension Aphasia Quotient (AQ) of less than 4 on the Western Aphasia Battery (WAB)


For military subjects: Positive screen for Acinetobacter baumannii-calcoaceticus complex (ABC) infection or colonization

Severe cognitive impairments as evidenced by scores of less than 7 on the Rancho Los Amigos Scale of Cognitive Functioning and/or less than 76 on the Galveston Orientation and Amnesia Test.

For all subjects: Comprehension AQ of less than 4 on the WAB

A diagnosis of PTSD, which is almost always found in TBI subjects recruited from the military, will not disquality TBI subjects from participation.


Structural abnormalities on standard clinical (MPRAGE, T2-weighted) MRI scans studies

A diagnosis of anxiety dirorder will not disqualify stuttering subjects from participation


Claustrophobia or anxiety disorders that could be exacerbated by the MRI Scanner

Subjects with neurological disorders, in addition to epilepsy such as, stroke, Parkinson s disease), or who have psychiatric diagnoses (, such as, obsessive-compulsive disorder)

Patients on Phenobarbital or chronic Benxodiazepines
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute on Deafness and Other Communication Disorders (NIDCD)

NIH

Sponsor Role lead

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Allen R Braun, M.D.

Role: PRINCIPAL_INVESTIGATOR

National Institute on Deafness and Other Communication Disorders (NIDCD)

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

National Institutes of Health Clinical Center, 9000 Rockville Pike

Bethesda, Maryland, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci. 1986;9:357-81. doi: 10.1146/annurev.ne.09.030186.002041. No abstract available.

Reference Type BACKGROUND
PMID: 3085570 (View on PubMed)

Andrews G, Quinn PT, Sorby WA. Stuttering: an investigation into cerebral dominance for speech. J Neurol Neurosurg Psychiatry. 1972 Jun;35(3):414-8. doi: 10.1136/jnnp.35.3.414.

Reference Type BACKGROUND
PMID: 5035315 (View on PubMed)

Bartlett EJ, Brown JW, Wolf AP, Brodie JD. Correlations between glucose metabolic rates in brain regions of healthy male adults at rest and during language stimulation. Brain Lang. 1987 Sep;32(1):1-18. doi: 10.1016/0093-934x(87)90115-5.

Reference Type BACKGROUND
PMID: 3498529 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

92-DC-0178

Identifier Type: -

Identifier Source: secondary_id

920178

Identifier Type: -

Identifier Source: org_study_id