NCT00903266

Brief Summary

We are doing this clinical trial in order to evaluate two different treatments for non-fluent aphasia: Melodic Intonation Therapy (MIT) and Speech Repetition Therapy (SRT). MIT uses a simple form of singing, while SRT uses intensive repetition of a set of words and phrases. We want to see which intensive form of treatment is more effective in leading to an improvement in speech output compared to a no-therapy control period, and whether either treatment can cause changes in brain activity during speaking and changes in brain structure. We will use a technique known as functional Magnetic Resonance Imaging (fMRI) to measure blood flow changes in the brain and structural MRI that assess brain anatomy and connections between brain regions. We will use fMRI to assess brain activity while a patient speaks, sings, and hums. We will assess changes in brain activity and in brain structure by comparing scans done prior to treatment to scans obtained after treatment and we will also examine changes between treatment groups. We will correlate changes in brain activity and brain structure with changes in language test scores.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
30

participants targeted

Target at below P25 for phase_3

Timeline
Completed

Started Feb 2008

Longer than P75 for phase_3

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2008

Completed
1.3 years until next milestone

First Submitted

Initial submission to the registry

May 15, 2009

Completed
3 days until next milestone

First Posted

Study publicly available on registry

May 18, 2009

Completed
11 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2020

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2020

Completed
Last Updated

September 21, 2020

Status Verified

September 1, 2020

Enrollment Period

12.3 years

First QC Date

May 15, 2009

Last Update Submit

September 17, 2020

Conditions

Keywords

AphasiaSpeech ImpairmentStrokeCerebrovascular AccidentCerebral InfarctionBrain IschemiaBrain InfarctionCerebrovascular Disorder

Outcome Measures

Primary Outcomes (1)

  • Correct Information Units (CIU)/min and CIUs/phrase elicited during spontaneous speech

    Baseline (x2), midpoint of therapy, end of therapy, 4 weeks after end of therapy

Secondary Outcomes (1)

  • 1) Items named on a standard picture naming test; 2) timed automatic speech; 3) linguistically-based measures of phrase and sentence analysis; 4) functional and structural imaging measures

    baseline (x2), midpoint of therapy, end of therapy, 4 weeks after end of therapy

Study Arms (3)

MIT

EXPERIMENTAL

Melodic Intonation Therapy

Behavioral: Melodic Intonation Therapy

SRT

ACTIVE COMPARATOR

Speech-Repetition-Therapy

Behavioral: Speech-Repetition-Therapy

NTC

NO INTERVENTION

No-Therapy Control; Patients in this arm will be re-randomized to the two active arms at the end of the NTC period.

Interventions

MIT emphasizes the prosody of speech through the use of slow, pitched vocalization (singing).

MIT

Speech-Reception-Therapy is an equally intensive, alternative verbal treatment method developed for this study.

SRT

Eligibility Criteria

Age21 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • years of age
  • first-time ischemic left-hemispheric stroke or cerebrovascular accident
  • at least 12 months out from first ischemic stroke
  • right-handed (prior to stroke)
  • diagnosis of non-fluent or dysfluent aphasia

You may not qualify if:

  • older than 80 years of age
  • more than 1 stroke
  • presence of metal or metallic or electronic devices that cannot be exposed to the MRI environment
  • a terminal medical condition; history of major neurological or psychiatric diseases (e.g. epilepsy; meningitis, encephalitis)
  • use of psychoactive drugs/medications such as antidepressants, antipsychotic, stimulants
  • active participation in other stroke recovery trials testing experimental interventions

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Beth Israel Deaconess Medical Center / Harvard Medical School

Boston, Massachusetts, 02215, United States

Location

Related Publications (4)

  • Ozdemir E, Norton A, Schlaug G. Shared and distinct neural correlates of singing and speaking. Neuroimage. 2006 Nov 1;33(2):628-35. doi: 10.1016/j.neuroimage.2006.07.013. Epub 2006 Sep 7.

    PMID: 16956772BACKGROUND
  • Norton A, Zipse L, Marchina S, Schlaug G. Melodic intonation therapy: shared insights on how it is done and why it might help. Ann N Y Acad Sci. 2009 Jul;1169:431-6. doi: 10.1111/j.1749-6632.2009.04859.x.

    PMID: 19673819BACKGROUND
  • Schlaug G, Marchina S, Norton A. From Singing to Speaking: Why Singing May Lead to Recovery of Expressive Language Function in Patients with Broca's Aphasia. Music Percept. 2008 Apr 1;25(4):315-323. doi: 10.1525/MP.2008.25.4.315.

  • Schlaug G, Marchina S, Norton A. Evidence for plasticity in white-matter tracts of patients with chronic Broca's aphasia undergoing intense intonation-based speech therapy. Ann N Y Acad Sci. 2009 Jul;1169:385-94. doi: 10.1111/j.1749-6632.2009.04587.x.

Related Links

MeSH Terms

Conditions

AphasiaStrokeCerebral InfarctionSpeech DisordersBrain IschemiaBrain InfarctionCerebrovascular Disorders

Condition Hierarchy (Ancestors)

Language DisordersCommunication DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsBrain DiseasesCentral Nervous System DiseasesVascular DiseasesCardiovascular DiseasesInfarctionIschemiaPathologic ProcessesNecrosis

Study Officials

  • Gottfried Schlaug, MD, PhD

    Beth Israel Deaconess Medical Center / Harvard Medical School

    PRINCIPAL INVESTIGATOR
  • Andrea Norton, BM

    Beth Israel Deaconess Medical Center

    STUDY DIRECTOR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor of Neurology; Staff Neurologist

Study Record Dates

First Submitted

May 15, 2009

First Posted

May 18, 2009

Study Start

February 1, 2008

Primary Completion

May 1, 2020

Study Completion

June 1, 2020

Last Updated

September 21, 2020

Record last verified: 2020-09

Locations