Effects of Transcranial Direct Current Stimulation (tDCS) on Language

NCT ID: NCT04166513

Last Updated: 2025-10-03

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-13

Study Completion Date

2024-07-01

Brief Summary

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This study will investigate the effects of mild electrical stimulation in conjunction with speech therapy for people with post-stroke aphasia to enhance language recovery.

Detailed Description

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Aphasia is a disturbance of language, primarily caused by brain injury to the left cerebral hemisphere. Aphasia treatments include speech and language therapy and pharmacologic therapy, but several studies have found that these treatments are not completely effective for patients with aphasia, leaving them with residual deficits that significantly add to the cost of stroke-related care. Additionally, the amount and frequency of speech and language therapy delivered may have a critical effect on recovery. Therefore, there is a need for new treatments or adjuncts to existing treatments, such as brain stimulation interventions, that have the potential to show greater improvements in patients with aphasia. One such new approach for non-invasive brain stimulation is transcranial direct current stimulation (tDCS).

This study will examine the effects of tDCS during speech therapy to further examine which method or methods is best for patient recovery. Patients enrolled in the study will undergo language testing that covers a broad range of language functions. Functional Magnetic Resonance Imaging (fMRI) will be completed before and after speech therapy intervention arms to investigate the neural processes affected by tDCS and speech therapy.

Study design:

Patients will be randomly assigned to one of 2 speech therapy groups in a double-blind, partial crossover design. Patients will receive one of two different speech therapy treatment interventions to focus on specific processing deficits. Participants will undergo neuropsychological evaluation and fMRI assessment before receiving targeted or active-control anodal-tDCS for 10 therapy sessions. Participants will then be re-tested using the behavioral assessment measure and fMRI before crossing over to either receive the tDCS intervention they did not already receive, within the same speech therapy arm. They will complete a behavioral assessment and fMRI at 3 months post Treatment 2 and a final behavioral assessment at 6 months post Treatment 2.

Conditions

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Stroke Aphasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Partial crossover design. Participants will maintain one of two speech therapy modalities throughout the study, but will crossover from targeted to active control stimulation (or vice versa).
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
Care provider, participant, and outcome assessor are masked for tDCS status.

Study Groups

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Targeted tDCS with Phonologic-Focused Speech Therapy

Participants will receive phonologic-focused speech therapy with targeted anodal-tDCS for 10 therapy sessions before.

Group Type EXPERIMENTAL

Targeted Transcranial Direct Current Stimulation

Intervention Type DEVICE

High-Definition-tDCS will be delivered via a battery-driven constant direct current stimulator (Soterix) using a 4x1 montage (1 central anodal electrode and 4 cathodal electrodes) arranged in a HD-cap. The current is turned on and increased in a ramplike fashion over approximately 30 seconds until reaching a strength of no more than 2mA, with a current density equal to 0.08mA/cm2. Stimulation will be maintained no longer than 20 minutes, and stimulation will be applied to the targeted region.

Phonologic-Focused Speech Therapy

Intervention Type BEHAVIORAL

Participants are asked to generate or choose from a list phonologic information about a target picture.

Active Control tDCS with Phonologic-Focused Speech Therapy

Participants will receive phonologic-focused speech therapy with active control tDCS for 10 therapy sessions.

Group Type ACTIVE_COMPARATOR

Active Control Transcranial Direct Current Stimulation

Intervention Type DEVICE

High-Definition-tDCS will be delivered via a battery-driven constant direct current stimulator (Soterix) using a 4x1 montage (1 central anodal electrode and 4 cathodal electrodes) arranged in a HD-cap. The current is turned on and increased in a ramplike fashion over approximately 30 seconds until reaching a strength of no more than 2mA, with a current density equal to 0.08mA/cm2. Stimulation will be maintained no longer than 20 minutes, and stimulation will be applied to the active control region.

Phonologic-Focused Speech Therapy

Intervention Type BEHAVIORAL

Participants are asked to generate or choose from a list phonologic information about a target picture.

Targeted tDCS with Semantic-Focused Speech Therapy

Participants will receive semantic-focused speech therapy with targeted anodal-tDCS for 10 therapy sessions.

Group Type EXPERIMENTAL

Targeted Transcranial Direct Current Stimulation

Intervention Type DEVICE

High-Definition-tDCS will be delivered via a battery-driven constant direct current stimulator (Soterix) using a 4x1 montage (1 central anodal electrode and 4 cathodal electrodes) arranged in a HD-cap. The current is turned on and increased in a ramplike fashion over approximately 30 seconds until reaching a strength of no more than 2mA, with a current density equal to 0.08mA/cm2. Stimulation will be maintained no longer than 20 minutes, and stimulation will be applied to the targeted region.

Semantic-Focused Speech Therapy

Intervention Type BEHAVIORAL

Participants who have difficulty retrieving an object name are given hierarchical clues or asked questions about the objects function as a way of activating the semantic network for that object, leading to eventual retrieval of the target word.

Active Control tDCS with Semantic-Focused Speech Therapy

Participants will receive semantic-focused speech therapy with active control tDCS for 10 therapy sessions.

Group Type ACTIVE_COMPARATOR

Active Control Transcranial Direct Current Stimulation

Intervention Type DEVICE

High-Definition-tDCS will be delivered via a battery-driven constant direct current stimulator (Soterix) using a 4x1 montage (1 central anodal electrode and 4 cathodal electrodes) arranged in a HD-cap. The current is turned on and increased in a ramplike fashion over approximately 30 seconds until reaching a strength of no more than 2mA, with a current density equal to 0.08mA/cm2. Stimulation will be maintained no longer than 20 minutes, and stimulation will be applied to the active control region.

Semantic-Focused Speech Therapy

Intervention Type BEHAVIORAL

Participants who have difficulty retrieving an object name are given hierarchical clues or asked questions about the objects function as a way of activating the semantic network for that object, leading to eventual retrieval of the target word.

Interventions

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Targeted Transcranial Direct Current Stimulation

High-Definition-tDCS will be delivered via a battery-driven constant direct current stimulator (Soterix) using a 4x1 montage (1 central anodal electrode and 4 cathodal electrodes) arranged in a HD-cap. The current is turned on and increased in a ramplike fashion over approximately 30 seconds until reaching a strength of no more than 2mA, with a current density equal to 0.08mA/cm2. Stimulation will be maintained no longer than 20 minutes, and stimulation will be applied to the targeted region.

Intervention Type DEVICE

Active Control Transcranial Direct Current Stimulation

High-Definition-tDCS will be delivered via a battery-driven constant direct current stimulator (Soterix) using a 4x1 montage (1 central anodal electrode and 4 cathodal electrodes) arranged in a HD-cap. The current is turned on and increased in a ramplike fashion over approximately 30 seconds until reaching a strength of no more than 2mA, with a current density equal to 0.08mA/cm2. Stimulation will be maintained no longer than 20 minutes, and stimulation will be applied to the active control region.

Intervention Type DEVICE

Phonologic-Focused Speech Therapy

Participants are asked to generate or choose from a list phonologic information about a target picture.

Intervention Type BEHAVIORAL

Semantic-Focused Speech Therapy

Participants who have difficulty retrieving an object name are given hierarchical clues or asked questions about the objects function as a way of activating the semantic network for that object, leading to eventual retrieval of the target word.

Intervention Type BEHAVIORAL

Other Intervention Names

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HD-tDCS tDCS Active Control tDCS Active Control HD-tDCS Phonologic Component Analysis Semantic Feature Analysis

Eligibility Criteria

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Inclusion Criteria

* Patients with a language deficit from focal neurologic damage (e.g. stroke, tumor).
* Patients must be adults and have English-language fluency.
* Patients must be eligible to undergo MRI.

Exclusion Criteria

* Advanced neurodegenerative disease (i.e. Stage 3 Alzheimer's disease) or neurologic disorder (e.g. idiopathic epilepsy, Parkinson's disease, ALS)
* Severe psychopathology (e.g. schizophrenia, bipolar disorder, acute major depressive episode)
* No suspected or diagnosed uncorrectable hearing or vision difficulties, or developmental disabilities (i.e. intellectual disability or learning disability).
* Contraindications to MRI such as claustrophobia, implanted electronic devices, MRI-incompatible metal in the body, extreme obesity, pregnancy, inability to lie flat, and inability to see or hear stimulus materials
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical College of Wisconsin

OTHER

Sponsor Role lead

Responsible Party

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Sara Pillay

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sara Pillay, PhD

Role: PRINCIPAL_INVESTIGATOR

Medical College of Wisconsin

Locations

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Medical College of Wisconsin

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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33162

Identifier Type: -

Identifier Source: org_study_id

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