NCT04041986

Brief Summary

This study proposes to use transcranial direct current stimulation (tDCS) in patients with chronic strokes and aphasia in order to characterize and enhance the mechanisms of language recovery following injury. Prior to enrollment subjects will undergo six "site-finding' sessions involving various placements of positively charged (anodal), negatively charged (cathodal), and sham stimulation over the damaged and intact hemispheres of the brain, along with standard tests of language. Subjects who are found to experience a transient improvement in language ability in this initial experiment will participate in an incomplete cross-over design study to determine if 10 sessions of tDCS stimulation lead to prolonged language benefit when delivered to the hemisphere and at the polarity shown previously to respond best to stimulation.

Trial Health

100
On Track

Trial Health Score

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

Enrollment
25

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Jul 2010

Longer than P75 for not_applicable

Status
completed

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2010

Completed
4.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2015

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2015

Completed
4.1 years until next milestone

First Submitted

Initial submission to the registry

July 11, 2019

Completed
21 days until next milestone

First Posted

Study publicly available on registry

August 1, 2019

Completed
Last Updated

August 1, 2019

Status Verified

July 1, 2019

Enrollment Period

4.9 years

First QC Date

July 11, 2019

Last Update Submit

July 30, 2019

Conditions

Keywords

strokenon-invasive brain stimulationtranscranial direct current stimulation (tDCS)

Outcome Measures

Primary Outcomes (2)

  • Change in naming ability after tDCS at different brain areas

    We will contrast naming ability before and after daily tDCS at 5 different brain regions. A change in naming ability as a function of tDCS to a specific brain region will be taken as evidence that stimulation of that brain region is relevant to the performance of the behavioral task in question.

    2 weeks

  • Change in overall aphasia severity after tDCS treatment

    We will contrast overall aphasia severity before and after tDCS comparing real vs. sham stimulation. A decrease in aphasia severity which is greater at real stimulation vs. sham stimulation suggests that tDCS may be a viable tool to improving language in post-stroke aphasia.

    Through study completion, about 2 months

Study Arms (3)

Site-Finding

EXPERIMENTAL

Each subject will receive anodal, cathodal, and sham stimulation to both the ipsilesional and contralesional hemispheres in a series of six sessions (one condition per session), each separated by at least two days. During anodal and cathodal tDCS sessions, subjects will receive stimulation for 20 minutes with a current of 2.0 mA using a 5x5 cm electrode. During sham tDCS, a 2.0 mA current will be delivered for approximately 30 seconds before being extinguished over a course of seconds. The participant will complete pre/post language testing at each session in order to determine if the subject is a tDCS responder and if so, which site produces the best transient language improvement in that individual. Subjects who do not respond to tDCS will not be invited to move forward to the treatment phase.

Device: Transcranial Direct Current Stimulation (tDCS)

Real tDCS

ACTIVE COMPARATOR

Half of our tDCS responders will be randomized to a group receiving 10 sessions (divided in to two five-day periods) of real tDCS. During real tDCS sessions, subjects will receive stimulation for 20 minutes at a current of 2.0 mA with a 5x5 cm electrode at their optimal responder site previously determined.

Device: Transcranial Direct Current Stimulation (tDCS)

Sham tDCS

SHAM COMPARATOR

Half of our tDCS responders will be randomized to a group receiving 10 sessions (divided in to two five-day periods) of sham tDCS. During sham tDCS, a 2.0 mA current will be delivered for approximately 30 seconds at the beginning of the sham condition before being extinguished over the course of seconds. Individuals randomized into the sham arm will be offered the option to crossover to real tDCS after their participation is complete.

Device: Transcranial Direct Current Stimulation (tDCS)

Interventions

Transcranial direct current stimulation (tDCS) is a form of non-invasive neuromodulation that uses constant, low (1-2mA), direct current delivered via electrodes on the head.

Real tDCSSham tDCSSite-Finding

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • \. Presence of aphasia attributable to one or more unilateral left hemispheric stroke(s)
  • \. Must speak English as a native language
  • \. Must be able to understand the nature of the study, and give informed consent

You may not qualify if:

  • \. Subjects with bilateral strokes.
  • \. History of neurologic illness(es) other than stroke
  • \. Current unstable medical illness(es)
  • \. Epilepsy or Seizure(s) within the last six months
  • \. Subjects with metallic objects in the face or head other than dental apparatus such as braces, fillings, and implants.
  • \. Subjects with Pacemakers or ICDs
  • \. Diagnosed psychiatric disorders
  • \. Pregnancy
  • \. Current alcohol or drug abuse

Contact the study team to confirm eligibility.

Sponsors & Collaborators

MeSH Terms

Conditions

AphasiaStroke

Interventions

Transcranial Direct Current Stimulation

Condition Hierarchy (Ancestors)

Speech DisordersLanguage DisordersCommunication DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and SymptomsCerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsConvulsive TherapyPsychiatric Somatic TherapiesBehavioral Disciplines and ActivitiesElectroshockPsychological Techniques

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Masking Details
Participants will be blinded to which tDCS group (real or sham) they are initially enrolled in; however, since only the sham group crosses over this will signal to subject that they are now getting real stimulation.
Purpose
TREATMENT
Intervention Model
CROSSOVER
Model Details: This is an incomplete crossover design where subjects randomized to the real tDCS group will end their participation but subjects randomized to the sham tDCS group will crossover into the real tDCS group.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

July 11, 2019

First Posted

August 1, 2019

Study Start

July 1, 2010

Primary Completion

June 1, 2015

Study Completion

June 1, 2015

Last Updated

August 1, 2019

Record last verified: 2019-07