Trial Outcomes & Findings for TMS in Aphasia Recovery (NCT NCT04777214)

NCT ID: NCT04777214

Last Updated: 2021-11-26

Results Overview

The Boston Naming Test is an assessment of confrontation naming, where a score ranges from 0 (no items named correctly) to 36 (all items named correctly)

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

24 participants

Primary outcome timeframe

Baseline, 2 months and 6-months after the last rTMS treatment session

Results posted on

2021-11-26

Participant Flow

Patients were assessed against the study inclusion and exclusion criteria. Eligible patients then underwent language tests before and after 6 ten minute sessions of rTMS to determine if there was a right hemisphere cortical region which, when suppressed with 1 Hz rTMS, resulted in significantly improved naming. If no benefit was observed from stimulation, the patient did not continue on to the treatment phase.

Participant milestones

Participant milestones
Measure
Active TMS
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold
Sham TMS
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz TMS are delivered, however, the coil will be rotated 90 degrees during stimulation. Sham TMS: Sham TMS will be administered at least 2 months later, patients then receive Active TMS if they so choose. There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold
Initial Randomization
STARTED
5
5
Initial Randomization
COMPLETED
5
5
Initial Randomization
NOT COMPLETED
0
0
Sham Crossover to Active TMS Arm
STARTED
0
5
Sham Crossover to Active TMS Arm
COMPLETED
0
5
Sham Crossover to Active TMS Arm
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

TMS in Aphasia Recovery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Active TMS
n=5 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold
Sham TMS
n=5 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz TMS are delivered, however, the coil will be rotated 90 degrees during stimulation. Sham TMS: Sham TMS will be administered
Total
n=10 Participants
Total of all reporting groups
Age, Continuous
60.6 years
STANDARD_DEVIATION 7.09 • n=5 Participants
62.6 years
STANDARD_DEVIATION 10.14 • n=7 Participants
61.6 years
STANDARD_DEVIATION 8.32 • n=5 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Sex: Female, Male
Male
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
5 participants
n=5 Participants
5 participants
n=7 Participants
10 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline, 2 months and 6-months after the last rTMS treatment session

Population: 9 participants completed the Active TMS arm and were available for follow-up at 2- and 6- months post treatment.

The Boston Naming Test is an assessment of confrontation naming, where a score ranges from 0 (no items named correctly) to 36 (all items named correctly)

Outcome measures

Outcome measures
Measure
Active TMS 2-month Follow-Up
n=9 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 2 months after TMS treatment sessions.
Active TMS 6-month Follow-Up
n=9 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 6 months after TMS treatment sessions.
Boston Naming Test
10.3 percent change from baseline
Standard Deviation 20.0
37.7 percent change from baseline
Standard Deviation 31.2

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 2 months after the last rTMS treatment session

Population: Comparison of total narrative word output change between baseline and 2-months between Active arm and Sham Arm. Active TMS arm includes both 5 participants initially randomized to Active TMS arm, plus 5 people who crossed over to Active arm after Sham arm.

The picture description of the Boston Diagnostic Aphasia Exam is a measurement of spontaneous speech, elicited by a picture description. It is not a scale. Quantitative Production Analysis (QPA) is used to analyze the production of words related to the picture stimulus. Total number of Narrative Words produced, defined as total words minus stereotyped utterances, task-related comments, or comments cued by administrator, was determined using QPA as a measure of discourse productivity.

Outcome measures

Outcome measures
Measure
Active TMS 2-month Follow-Up
n=10 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 2 months after TMS treatment sessions.
Active TMS 6-month Follow-Up
n=5 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 6 months after TMS treatment sessions.
Picture Description of the Boston Diagnostic Aphasia Exam
10.4 change in number of words from baseline
Standard Deviation 16.3
1.2 change in number of words from baseline
Standard Deviation 15.0

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 2 months after the last rTMS treatment session

Population: Comparison of percent change in outcome between baseline and 2-months between Active arm and Sham Arm. Active TMS arm includes both 5 participants initially randomized to Active TMS arm, plus 5 people who crossed over to Active arm after Sham arm.

The Boston Diagnostic Aphasia Exam - Word Discrimination Subtest is an assessment of auditory comprehension via word discrimination, where a score ranges from 0 (no items correct) to 72 (all items correct)

Outcome measures

Outcome measures
Measure
Active TMS 2-month Follow-Up
n=10 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 2 months after TMS treatment sessions.
Active TMS 6-month Follow-Up
n=5 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 6 months after TMS treatment sessions.
Boston Diagnostic Aphasia Exam - Word Discrimination Subtest
1.78 Percent change from baseline
Standard Deviation 6.83
0.32 Percent change from baseline
Standard Deviation 1.51

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline and 2 months after the last rTMS treatment

Population: Comparison of percent change in outcome between baseline and 2-months between Active arm and Sham Arm. Active TMS arm includes both 5 participants initially randomized to Active TMS arm, plus 5 people who crossed over to Active arm after Sham arm.

The Boston Diagnostic Aphasia Examination - Commands Subtest is an assessment of auditory comprehension via command following, where a score ranges from 0 (no items correctly performed) to 15 (all items correctly performed). Percent change was calculated by taking the mean performance at 2-months after rTMS treatment and subtracting mean performance at baseline, then dividing by the mean baseline performance and multiplying by 100.

Outcome measures

Outcome measures
Measure
Active TMS 2-month Follow-Up
n=10 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 2 months after TMS treatment sessions.
Active TMS 6-month Follow-Up
n=5 Participants
There are 10 TMS sessions over 2 consecutive weeks in which 20 minutes (1200 pulses) of 1 Hz active TMS are delivered to a previously determined optimal response site in right frontal lobe. Repetitive Transcranial Magnetic Stimulation: Active TMS will be at 90% motor threshold Outcome measures are then assessed 6 months after TMS treatment sessions.
Boston Diagnostic Aphasia Examination - Commands Subtest
2.22 percent change from baseline
Standard Deviation 12.08
8.00 percent change from baseline
Standard Deviation 10.26

Adverse Events

Active TMS

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Sham TMS

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Samuel Cason

University of Pennsylvania

Phone: 215-573-4336

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place