Dextroamphetamine and tDCS to Improve the Fluency
Condition: Stroke
MeSH terms: Stroke
Intervention: Dexedrine; Active tDCS; Speech Therapy; Placebo; Sham tDCS
Intervention description: 10 mg immediate release of Dexedrine; 1.5 mA tDCS anodal tDCS; 60 min of speech therapy
Intervention MeSH terms: Adderall; Dextroamphetamine
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Outcomes Assessor)
Enrollment: 10.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No

Summary:

      The proposed study aims to evaluate safety and efficacy of combined dextroamphetamine
      (Dexedrine) and transcranial direct current stimulation (tDCS) with melodic intonation
      therapy (MIT) for treatment of aphasia after stroke. The target population is patients with
      chronic speech deficits due to a left hemisphere non-hemorrhagic stroke. Findings from this
      proposed project will help in the design of future larger studies.The safety phase will use
      cross-over, placebo controlled and single-blinded design. 10 participants with post stroke
      chronic non-fluent aphasia will undergo two experiments. To study the safety and effect of
      combined dextroamphetamine, tDCS and MIT therapy the study will use a parallel-groups,
      randomized, sham and placebo controlled, and double-blinded design in which 48 participants
      with post stroke chronic non-fluent aphasia will be randomly assigned to receive either 1)
      dextroamphetamine therapy with active stimulation, 2) placebo medication with active
      stimulation, 3) dextroamphetamine therapy with sham stimulation or 4) placebo medication with
      sham stimulation for the same duration.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Age above 18

          -  Native English proficiency;

          -  Nonfluent speech;

          -  Premorbid right handedness;

          -  Non-hemorrhagic left hemispheric stroke at least 6 months prior to the investigation.

          -  No contraindications for MRI (only subjects who will undergo MRI scan).

        Exclusion Criteria:

          -  Hypersensitivity or idiosyncrasy to dextroamphetamine or to other sympathomimetic
             agents;

          -  Pregnant or trying to become pregnant;

          -  Active alcohol abuse, illicit drug use or drug abuse or significant mental illness;

          -  Subjects receiving alpha adrenergic antagonists or agonists;

          -  Any history of epilepsy;

          -  Any condition that would prevent the subject from giving voluntary informed consent;

          -  An implanted brain stimulator;

          -  Aneurysm clip or other metal in the brain;

          -  Enrolled or plans to enroll in an interventional trial during this study;

          -  Scalp wounds or infections;

          -  Previous stroke with residual deficits (TIAs not a reason for exclusion);

          -  A concurrent progressive neurologic disorder, acute coronary syndrome, severe heart
             disease (NYHA Classification > 3), or other major medical condition;

          -  Advanced atherosclerosis, Unstable cardiac dysrhythmia or uncontrolled hypertension
             (>160/100 mm Hg), or untreated hyperthyroidism;

          -  Diagnosis of glaucoma

          -  During or within 14 days following the administration of monoamine oxidase inhibitors;

          -  Subjects requiring palliative care;

          -  Terminal medical condition such as AIDS or cancer;

          -  Subjects unable to comprehend or follow verbal commands;

          -  Based on PI's or local physician's assessment patient unable to tolerate the trial
             procedure due to medical condition;