NCT05450341

Brief Summary

In a randomized controlled trial, efficacy of low-frequency, inhibitory rTMS will be examined in rehabilitation of acquired aphasia. Two cortical sites will be targeted: Right-hemispheric homologues of Broca's and Wernicke's areas. In addition to cognitive screening prior to onset of rTMS, language assessments will be conducted before, during and after the intervention. An eyetracking-while-listening experiment will also be conducted before and after the intervention to investigate morphosyntactic processing.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
20

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Jul 2022

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
unknown

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

First Submitted

Initial submission to the registry

June 30, 2022

Completed
8 days until next milestone

First Posted

Study publicly available on registry

July 8, 2022

Completed
10 days until next milestone

Study Start

First participant enrolled

July 18, 2022

Completed
8 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 1, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2023

Completed
Last Updated

August 30, 2022

Status Verified

August 1, 2022

Enrollment Period

8 months

First QC Date

June 30, 2022

Last Update Submit

August 27, 2022

Conditions

Keywords

Repetitive transcranial magnetic stimulationAphasia

Outcome Measures

Primary Outcomes (12)

  • Turkish Aphasia Language Assessment Test Scores Time 1 (pre-treatment)

    Baseline scores obtained from the Turkish Aphasia Language Assessment Test (ADD) Minimum score: 0 points Maximum score: 292 points Higher scores indicate a better outcome

    Immediately before the intervention (Day 0)

  • Turkish Aphasia Language Assessment Test Scores Time 2 (during treatment)

    Scores obtained from the Turkish Aphasia Language Assessment Test (ADD) at the end of the first week of treatment Minimum score: 0 points Maximum score: 292 points Higher scores indicate a better outcome

    At the end of the first week of intervention (Day 5)

  • Turkish Aphasia Language Assessment Test Scores Time 3 (post-treatment short-term)

    Post-treatment scores obtained from the Turkish Aphasia Language Assessment Test (ADD) at the end of the treatment Minimum score: 0 points Maximum score: 292 points Higher scores indicate a better outcome

    Immediately after the intervention (Day 10)

  • Turkish Aphasia Language Assessment Test Scores Time 4 (post-treatment medium-term)

    Post-treatment scores obtained from the Turkish Aphasia Language Assessment Test (ADD) one month after the end of the treatment Minimum score: 0 points Maximum score: 292 points Higher scores indicate a better outcome

    1 month after the intervention

  • Turkish Aphasia Language Assessment Test Scores Time 5 (post-treatment long-term)

    Post-treatment scores obtained from the Turkish Aphasia Language Assessment Test (ADD) six months after the end of the treatment Minimum score: 0 points Maximum score: 292 points Higher scores indicate a better outcome

    6 months after the intervention

  • Picture Naming Scores Time 1 (pre-treatment)

    Picture naming performance (number of accurately named pictures \& naming latency for correctly named pictures) There are 20 pictures in total, of which half are objects and half actions. Minimum score: 0 points Maximum score: 20 points Higher scores indicate a better outcome

    Immediately before the intervention (Day 0)

  • Picture Naming Scores Time 2 (during treatment)

    Picture naming performance (number of accurately named pictures \& naming latency for correctly named pictures) There are 20 pictures in total, of which half are objects and half actions. Minimum score: 0 points Maximum score: 20 points Higher scores indicate a better outcome

    At the end of the first week of intervention (Day 5)

  • Picture Naming Scores Time 3 (post-treatment short-term)

    Picture naming performance (number of accurately named pictures \& naming latency for correctly named pictures) There are 20 pictures in total, of which half are objects and half actions. Minimum score: 0 points Maximum score: 20 points Higher scores indicate a better outcome

    Immediately after the intervention (Day 10)

  • Picture Naming Scores Time 4 (post-treatment medium-term)

    Picture naming performance (number of accurately named pictures \& naming latency for correctly named pictures) There are 20 pictures in total, of which half are objects and half actions. Minimum score: 0 points Maximum score: 20 points Higher scores indicate a better outcome

    1 month after the intervention

  • Picture Naming Scores Time 5 (post-treatment long-term)

    Picture naming performance (number of accurately named pictures \& naming latency for correctly named pictures) There are 20 pictures in total, of which half are objects and half actions. Minimum score: 0 points Maximum score: 20 points Higher scores indicate a better outcome

    6 months after the intervention

  • Eye movements Time 1 (pre-treatment)

    An eyetracking-while-listening paradigm will be used to determine proportions of dwell time on the correct picture (out of two alternatives) corresponding to auditorily presented Turkish sentences varying in morphosyntactic complexity.

    Immediately before the intervention (Day 0)

  • Eye movements Time 2 (post-treatment)

    An eyetracking-while-listening paradigm will be used to determine proportions of dwell time on the correct picture (out of two alternatives) corresponding to auditorily presented Turkish sentences varying in morphosyntactic complexity.

    Immediately after the intervention (Day 10)

Study Arms (2)

Right frontal 1 Hz rTMS

EXPERIMENTAL

Low-frequency (1 Hz) inhibitory rTMS will be administered to right inferior frontal gyrus with the following parameters: Frequency: 1 Hz Stimulation site: Right IFG (as determined using EEG 10-20 system) Intensity: 100% of motor threshold Dosage: 20 minutes per day Duration: 10 days over 2 weeks (no stimulation during weekends)

Device: rTMS over right frontal target

Right temporal 1 Hz rTMS

ACTIVE COMPARATOR

Low-frequency (1 Hz) inhibitory rTMS will be administered to right posterior superior temporal gyrus with the following parameters: Frequency: 1 Hz Stimulation site: Right posterior superior temporal gyrus (as determined using EEG 10-20 system) Intensity: 100% of motor threshold Dosage: 20 minutes per day Duration: 10 days over 2 weeks (no stimulation during weekends)

Device: rTMS over right temporal target

Interventions

Low frequency (1 Hz) rTMS over right inferior frontal gyrus

Right frontal 1 Hz rTMS

Low frequency (1 Hz) rTMS over right posterior superior temporal gyrus

Right temporal 1 Hz rTMS

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Right-handedness,
  • Normal or corrected-to-normal vision and hearing,
  • Aphasia following cerebrovascular accident,
  • Cerebrovascular accident at least 6 months prior to enrolment in the study,
  • Satisfying current TMS safety guidelines (Rossi et al. 2009, 2021), which are:
  • No previous history of epilepsy,
  • No implant (e.g., cochlear implant) or stimulator (e.g., deep brain stimulation) in the head which may interact with the magnetic field,
  • No use of central nervous system active drugs that lower seizure threshold (as listed in the aforementioned guidelines)

You may not qualify if:

  • Left-handedness, ambidexterity,
  • Impaired and uncorrected vision or hearing,
  • No aphasia symptoms following cerebrovascular accident,
  • Time since cerebrovascular accident less than 6 months,
  • Violating current TMS safety guidelines (Rossi et al. 2009, 2021). In other words:
  • Having a previous history of epilepsy,
  • Having an implant (e.g., cochlear implant) or stimulator (e.g., deep brain stimulation) in the head which may interact with the magnetic field,
  • Taking central nervous system active drugs that lower seizure threshold (as listed in the aforementioned guidelines)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

İstanbul Medipol University, Speech, Language and Swallowing Therapy and Research Center (MEDKOM)

Istanbul, 34815, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Aphasia

Condition Hierarchy (Ancestors)

Speech DisordersLanguage DisordersCommunication DisordersNeurobehavioral ManifestationsNeurologic ManifestationsNervous System DiseasesSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Talat Bulut, Ph.D.

    Medipol University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Masking Details
The participant and the outcomes assessor (speech and language therapist conducting the assessment tests and the eyetracking experiment) will be blind as to which experiment group the participant belongs to. The investigator / clinician providing rTMS will not be blind to the experimental condition.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: The two groups receive one of the two treatments: right frontal versus right temporal stimulation.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assist. Prof. Dr.

Study Record Dates

First Submitted

June 30, 2022

First Posted

July 8, 2022

Study Start

July 18, 2022

Primary Completion

March 1, 2023

Study Completion

March 1, 2023

Last Updated

August 30, 2022

Record last verified: 2022-08

Data Sharing

IPD Sharing
Will share

Participants' anonymized data will be shared with the scientific community as part of open science practices. IPD refer to the data collected from the participants (language and cognitive test scores; i.e., ADD and naming performance, number/percentage of correct answers, raw and scaled scores, short-term memory scores (digit span), nonverbal intelligence scores (Raven's colored progressive matrices). IPD also include eye movements data obtained in the eyetracking experiment; i.e., proportions of dwell time on the target picture.

Shared Documents
STUDY PROTOCOL, SAP, ICF, ANALYTIC CODE
Time Frame
Upon publication of the results in a peer-reviewed journal. The data will be shared permanently.
Access Criteria
No access criteria required; a permanent link to the dataset will be made available so that the public can access the data (e.g., using https://osf.io/ or Mendeley Data)

Locations