The Effects of a Multimodal Approach for the Treatment of PPA

NCT ID: NCT04187391

Last Updated: 2024-10-03

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

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

47 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-15

Study Completion Date

2024-03-31

Brief Summary

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Primary Progressive Aphasia (PPA) is an untreatable neurodegenerative disorder that disrupts language functions. Available therapies are mainly symptomatic and recently attention has been gained by new techniques that allow for noninvasive brain stimulation such as transcranial direct current stimulation (tDCS). The primary objective of this study is to evaluate whether the application of Active tDCS (anode over the left dorsolateral prefrontal cortex- DLPFC with the cathode over the right supraorbital region) to the scalp during individualized language training, would improve naming abilities in the agrammatic variant of PPA (avPPA) more than use of one methodology alone. The effect of treatment on the clinical symptoms will be related to changes in brain activity (Magnetic Resonance Imaging, MRI and Functional near-infrared spectroscopy fNIRS) and in biological markers, using a multimodal approach. Finally, we will assess the long-term effects of this approach.

Detailed Description

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45 patients with avPPA, will be recruited from IRCCS Istituto Centro San Giovanni di Dio Brescia, Italy and ASST Spedali Civili Brescia, Italy .

Inclusion criteria will be a diagnosis avPPA according to the current clinical criteria (Gorno-Tempini et al., 2011) and a FTD Clinical Dementia Rating score \>0.5 and \<2. Exclusion criteria will be the presence of any medical or psychiatric illness that could interfere in completing assessments and the presence of any medical condition that represents a contraindication to tDCS. All the patients will undergo five consecutive days a week for two weeks of treatment sessions:

15 patients will receive Active tDCS over DLPFC while performing a language training; 15 patients will receive placebo tDCS during language training; 15 patients will receive Active tDCS over DLPFC during unstructured cognitive training.

Two trained neuropsychologists will administer the neuropsychological testing in two sessions. At baseline (T0), post-treatment (T1) and 3-months (T2) follow-up assessments were conducted by the same assessor. Blood sample withdrawal at baseline (T0) and after the DLPFC-tDCS intervention (T1) will be assessed.

To elucidate the mechanisms underlying tDCS effects, structural imaging, functional connectivity (fMRI) alterations and concentration changes of hemoglobin (fNIRS) will be collected off-line. Each avPPA patient will undergo an MRI scan at the ASST Spedali Civili Brescia, Italy at T0 and T1 and a fNIRS acquisition at the IRCCS Istituto Centro San Giovanni di Dio Brescia, Italy at T0, T1 and T2.

Conditions

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Primary Progressive Aphasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Active tDCS plus individual language training

Active tDCS plus individual language training

Group Type EXPERIMENTAL

Active tDCS

Intervention Type DEVICE

Active tDCS anode is applied over the left DLPFC with the cathode over the right supraorbital region.

Language training

Intervention Type BEHAVIORAL

patients receive language training

placebo tDCS plus individual language training

placebo tDCS plus individual language training

Group Type ACTIVE_COMPARATOR

Placebo tDCS

Intervention Type DEVICE

Placebo tDCS is applied but the current is turned off 10 seconds after the beginning and turned on for the last 10 seconds of the stimulation period.

Language training

Intervention Type BEHAVIORAL

patients receive language training

Active tDCS plus unstructured cognitive stimulation

Active tDCS plus unstructured cognitive stimulation

Group Type ACTIVE_COMPARATOR

Active tDCS

Intervention Type DEVICE

Active tDCS anode is applied over the left DLPFC with the cathode over the right supraorbital region.

Unstructured cognitive training

Intervention Type BEHAVIORAL

patients receive unstructured cognitive training.

Interventions

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Active tDCS

Active tDCS anode is applied over the left DLPFC with the cathode over the right supraorbital region.

Intervention Type DEVICE

Placebo tDCS

Placebo tDCS is applied but the current is turned off 10 seconds after the beginning and turned on for the last 10 seconds of the stimulation period.

Intervention Type DEVICE

Language training

patients receive language training

Intervention Type BEHAVIORAL

Unstructured cognitive training

patients receive unstructured cognitive training.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Diagnosis avPPA according to the current clinical criteria (Gorno-Tempini et al., 2011)
* FTD Clinical Dementia Rating (FTD-CDR) score \>0.5 and \<2

Exclusion Criteria

* Presence of any medical or psychiatric illness that could interfere in completing assessments
* Presence of any medical condition that represents a contraindication to tDCS.
Minimum Eligible Age

40 Years

Maximum Eligible Age

95 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Asst Degli Spedali Civili Di Brescia

OTHER

Sponsor Role collaborator

IRCCS Centro San Giovanni di Dio Fatebenefratelli

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rosa Manenti, PhD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Istituto Centro San Giovanni di Dio- Fatebenefratelli

Locations

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IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli

Brescia, BS, Italy

Site Status

Countries

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Italy

Other Identifiers

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GR 2018 12365105

Identifier Type: -

Identifier Source: org_study_id

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