Combining tDCS and CILT in Non-fluent Aphasia

NCT05561400 | Completed Results FDA Device

• 1 other identifier: SLP-2022-29906
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

The long-term goal of this work is to determine if combining a highly intensive, task-specific behavioral language intervention with modulation of the efferent cerebellar-cortical pathway using transcranial direct current stimulation (tDCS) has a positive influence on discourse, verbal fluency and working memory in individuals with non-fluent aphasia after stroke. And if these changes can be related to neuroplastic change in the cerebellar cortical pathway indirectly measured through neurophysiologic changes using spectral electroencephalogram (EEG). The initial phase includes the proposed pilot study data from which will be used to inform a larger clinical trial. The primary aims of this pilot are to 1) determine the effect of combining cerebellar tDCS with constraint-induced language therapy (CILT) on language as measured by a verbal fluency task and discourse task in a small population and 2) identify the tolerance of the intervention and barriers to participation measured by the adverse events questionnaire that will inform the methodology of a larger study. The secondary aims include estimating the size of the treatment effect on 1) delta percentage in F3, F7 and Fp1 compared to F4, F8, and Fp2 using resting state EEG spectral analysis and coherence, 2) working memory as measured by the score on the n-back test and 3) quality of life as measured by the Stroke Aphasia Quality of Life survey tool. The secondary aims will be used to determine the utility of these measures in a larger clinical trial. This is a prospective, crossover study, sham-controlled intervention study with two intervention conditions delivered across 6 intervention sessions (3x/week for two weeks) with a 4-week washout in between. Conditions include: 1) sham cerebellar tDCS and 2) real cerebellar tDCS delivered at 2mA across 20 minutes. Each of these will be delivered during CILT intervention with a licensed, certified speech-language pathologist trained in CILT. Once tDCS stimulation has ended, CILT will continue to be delivered for an additional 25 minutes. Assessments of discourse, verbal fluency, working memory and EEG spectral analysis will be conducted at four timepoints, before and after each intervention phase.

Conditions

Aphasia; Non-fluent Aphasia; Stroke; Brain Injuries

Keywords

transcranial direct current stimulation (tDCS); non-invasive brain stimulation (NIBS); aphasia; constraint-induced language therapy (CILT)

Outcome Measures

Primary Outcomes (20)

• Discourse: Picture Description

  Picture Description using Main Concept Analysis (MCA), a reliable, valid method of discourse analysis. It captures a participant's ability to state the main points/highlights of a sequential story. Responses to the "Broken Window" picture sequence, a normed and standardized task are recorded as accurate and complete (3 points), accurate and incomplete (2 points), inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0points). The minimum score is 0 and the maximum score is 24. There are no subscales. The higher the score, the better the performance. Scores reported for individual participants are raw scores. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Baseline 1: occurred at Visit 2 (after consent)

• Discourse Analysis: Picture Description

  Picture Description using Main Concept Analysis (MCA), a reliable, valid method of discourse analysis. It captures a participant's ability to state the main points/highlights of a sequential story. Responses to the "Broken Window" picture sequence, a normed and standardized task are recorded as accurate and complete (3 points), accurate and incomplete (2 points), inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0points). The minimum score is 0 and the maximum score is 24. There are no subscales. The higher the score, the better the performance. Scores reported for individual participants are raw scores. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Follow up 1: Visit 9. 2 weeks after Baseline 1

• Discourse: Picture Description

  Picture Description using Main Concept Analysis (MCA), a reliable, valid method of discourse analysis. It captures a participant's ability to state the main points/highlights of a sequential story. Responses to the "Broken Window" picture sequence, a normed and standardized task are recorded as accurate and complete (3 points), accurate and incomplete (2 points), inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0points). The minimum score is 0 and the maximum score is 24. There are no subscales. The higher the score, the better the performance. Scores reported for individual participants are raw scores. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Baseline 2: Visit 10. 6 weeks after Baseline 1 and 4 weeks after Follow up 1

• Discourse Analysis: Picture Description

  Picture Description using Main Concept Analysis (MCA), a reliable, valid method of discourse analysis. It captures a participant's ability to state the main points/highlights of a sequential story. Responses to the "Broken Window" picture sequence, a normed and standardized task are recorded as accurate and complete (3 points), accurate and incomplete (2 points), inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0points). The minimum score is 0 and the maximum score is 24. There are no subscales. The higher the score, the better the performance. Scores reported for individual participants are raw scores. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Follow up 2: Visit 17. 8 weeks after Baseline 1, 6 weeks after Follow up 1 and 2 weeks after Baseline 2

• Discourse Analysis: Story Retell

  Story Retell using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful discourse. Responses to the "Cinderella" story retell task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 102. There are no subscales for this measure. Responses are scored using the following rubric: accurate and complete (3 points), accurate and incomplete (2 point), inaccurate and complete (2 point) inaccurate and incomplete (1 points) or absent (0 points). The higher the score, the better the performance. Participant scores are reported as raw scores. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Baseline 1: occurred at Visit 2

• Discourse Analysis: Story Retell

  Story Retell using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful discourse. Responses to the "Cinderella" story retell task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 102. There are no subscales for this measure. Responses are scored using the following rubric: accurate and complete (3 points), accurate and incomplete (2 point), inaccurate and complete (2 point) inaccurate and incomplete (1 points) or absent (0 points). The higher the score, the better the performance. Participant scores are reported as raw scores. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Follow up 1: Visit 9: 2 weeks after Baseline 1

• Discourse Analysis: Story Retell

  Story Retell using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful discourse. Responses to the "Cinderella" story retell task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 102. There are no subscales for this measure. Responses are scored using the following rubric: accurate and complete (3 points), accurate and incomplete (2 point), inaccurate and complete (2 point) inaccurate and incomplete (1 points) or absent (0 points). The higher the score, the better the performance. Participant scores are reported as raw scores. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Baseline 2: Visit 10. 6 weeks after Baseline 1 and 4 weeks after follow up 1

• Discourse Analysis: Story Retell

  Story Retell using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful discourse. Responses to the "Cinderella" story retell task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 102. There are no subscales for this measure. Responses are scored using the following rubric: accurate and complete (3 points), accurate and incomplete (2 point), inaccurate and complete (2 point) inaccurate and incomplete (1 points) or absent (0 points). The higher the score, the better the performance. Participant scores are reported as raw scores. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Follow up 2: Visit 17. 8 weeks after Baseline 1, 6 weeks after Follow up 1 and 2 weeks after Baseline 2

• Discourse Analysis: Procedural

  Procedural Discourse using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful procedural discourse. Responses "how to make a peanut butter sandwich" task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 30. There are no subscales. The higher the score, the better the performance. Participant responses are scored using a rubric: accurate and complete (3 points), accurate and incomplete (2 point)s, inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0 points). Participant scores are reported as raw scores. There are no subscales for this measure. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Baseline 1: Visit 2

• Discourse Analysis: Procedural

  Procedural Discourse using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful procedural discourse. Responses "how to make a peanut butter sandwich" task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 30. There are no subscales. The higher the score, the better the performance. Participant responses are scored using a rubric: accurate and complete (3 points), accurate and incomplete (2 point)s, inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0 points). Participant scores are reported as raw scores. There are no subscales for this measure. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Follow up 1: Visit 9: 2 weeks after Baseline 1

• Discourse Analysis: Procedural

  Procedural Discourse using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful procedural discourse. Responses "how to make a peanut butter sandwich" task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 30. There are no subscales. The higher the score, the better the performance. Participant responses are scored using a rubric: accurate and complete (3 points), accurate and incomplete (2 point)s, inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0 points). Participant scores are reported as raw scores. There are no subscales for this measure. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Baseline 2: Visit 10. 6 weeks after Baseline 1 and 4 weeks after follow up 1

• Discourse Analysis: Procedural

  Procedural Discourse using Main Concept Analysis (MCA), counts of the number of main ideas or propositions that are necessary for successful procedural discourse. Responses "how to make a peanut butter sandwich" task, a normed and standardized task will be recorded using the standardized "counts" or "raw score" main concept analysis scoring system. The minimum score is 0 and the maximum score is 30. There are no subscales. The higher the score, the better the performance. Participant responses are scored using a rubric: accurate and complete (3 points), accurate and incomplete (2 point)s, inaccurate and complete (2 points), inaccurate and incomplete (1 point) or absent (0 points). Participant scores are reported as raw scores. There are no subscales for this measure. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Follow up 2: Visit 17. 8 weeks after Baseline 1, 6 weeks after Follow up 1 and 2 weeks after Baseline 2

• Verbal Fluency: Semantic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many animals as they can in one minute. Norms for healthy adults is between 18-20 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17 items. The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Baseline 1: Visit 2

• Verbal Fluency: Semantic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many animals as they can in one minute. Norms for healthy adults is between 18-20 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17 items.The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Follow up 1: Visit 9: 2 weeks after Baseline 1

• Verbal Fluency: Semantic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many animals as they can in one minute. Norms for healthy adults is between 18-20 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17 items.The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Baseline 2: Visit 10. 6 weeks after Baseline 1 and 4 weeks after Follow up 1

• Verbal Fluency: Semantic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many animals as they can in one minute. Norms for healthy adults is between 18-20 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17 items.The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Follow up 2: Visit 17. 8 weeks after Baseline 1, 6 weeks after Follow up 1, 2 weeks after Baseline 2

• Verbal Fluency: Phonemic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many words they can that start with either /f/ in one minute. Norms for healthy adults is between 25-35 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17. The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Baseline 1: Visit 2

• Verbal Fluency: Phonemic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many words they can that start with either /f/ in one minute. Norms for healthy adults is between 25-35 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17. The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 1 and Follow up 1 refer to the first intervention condition in the cross over sequence.

  Follow up 1: Visit 9: 2 weeks after Baseline 1

• Verbal Fluency: Phonemic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many words they can that start with either /f/ in one minute. Norms for healthy adults is between 25-35 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17.The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Baseline 2: Visit 10. 6 weeks after Baseline 1 and 4 weeks after Follow up 1

• Verbal Fluency: Phonemic

  Verbal Fluency is a normed and standardized task of working memory and word recall. Participant will name as many words they can that start with either /f/ in one minute. Norms for healthy adults is between 25-35 items listed within the one minute timeframe. The number of items listed is the participants raw score. The higher the score, the better the performance. A score considered "no concerns" is \>17. The minimum score is 0. There is no maximum score as this is a timed measure. There is no subscales for this measure. Baseline 2 and Follow up 2 reflect the second intervention in the cross over sequence.

  Follow up 2: Visit 17. 8 weeks after Baseline 1, 6 weeks after Follow up 1 and 2 weeks after Baseline 2

Secondary Outcomes (8)

• Working Memory

  Baseline 1: Visit 2

• Working Memory

  Follow up 1: Visit 9: 2 weeks after Baseline 1

• Working Memory

  Baseline 2: Visit 10. 6 weeks after Baseline 1 and 4 weeks after Follow up 1

• Working Memory

  Follow up 2: Visit 17. 8 weeks after Baseline 1, 6 weeks after Follow up 1 and 2 weeks after Baseline 2

• Stroke Aphasia Quality of Life (SA-QOL)

  Baseline 1: Visit 2

Study Arms (2)

Real tDCS

ACTIVE COMPARATOR

the participant receives real tDCS to the right cerebellum during behavioral intervention (CILT)

Device: tDCS

Sham tDCS

PLACEBO COMPARATOR

the participant receives sham tDCS to the right cerebellum during behavioral intervention (CILT)

Other: Placebo

Interventions

tDCS DEVICE

5x5 saline-soaked sponge electrodes will be used with the cathode placed over the right cerebellar hemisphere; 1cm under and 4cm lateral of the inion targeting lobule VII and the anode will be placed on the right shoulder. The electrode placement will be the same across both conditions.

Real tDCS

Placebo OTHER

sham tDCS to the right cerebellum

Sham tDCS

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• over the age of 18 years
• history of stroke
• diagnosed with non-fluent aphasia.
• be able to independently understand simple directions,
• use some speech to communicate,
• have access to reliable transportation (including taxi and/or other transportation services),
• fluent in English.

You may not qualify if:

• Pregnancy,
• history of seizures,
• any metal implants in the body (excluding dental fillings),
• history of migraines,
• psoriasis or eczema affecting the scalp,
• history of a head injury such as a concussion
• diagnosis of a mental health or neurological condition/disease.

Sponsors & Collaborators

• University of Minnesota: lead

Study Sites (1)

University of Minnesota

Duluth, Minnesota, 55812, United States

Location

MeSH Terms

Conditions

Aphasia; Aphasia, Broca; Stroke; Brain Injuries

Interventions

Transcranial Direct Current Stimulation

Condition Hierarchy (Ancestors)

Speech Disorders; Language Disorders; Communication Disorders; Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Craniocerebral Trauma; Trauma, Nervous System; Wounds and Injuries

Intervention Hierarchy (Ancestors)

Electric Stimulation Therapy; Therapeutics; Convulsive Therapy; Psychiatric Somatic Therapies; Behavioral Disciplines and Activities; Electroshock; Psychological Techniques

Results Point of Contact

• Title: Sharyl Samargia-Grivette
• Organization: University of Minnesota

samargia@umn.edu

218-726-8347

Study Officials

• Sharyl A Samargia-Grivette, Ph.D.

  University of Minnesota

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Sham controlled blinded crossover design

Study Record Dates

• First Submitted: June 23, 2022
• First Posted: September 30, 2022
• Study Start: April 24, 2023
• Primary Completion: December 15, 2023
• Study Completion: December 15, 2023
• Last Updated: December 9, 2025
• Results First Posted: December 9, 2025

Record last verified: 2025-11

Locations

US (1)