Language Processing and TMS

Study Overview
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Brief Summary
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This study will examine the effect of TMS on people with stroke and aphasia as well as healthy individuals.

Detailed Description
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To examine the brain's structure and specific language function and interactive relationships, investigators will implement repetitive or rapid TMS protocols in an active (or sham)-controlled, within-subject, randomized studies. Aims will evaluate the effects of short-term changes on each of the semantic or phonological language process of interest in isolation and changes in the interaction between language sub-processes and their interaction with other cognitive domains that directly or indirectly affect language functions. The brain targets for TMS application will be informed by existing evidence on (correlational but not causal) associations between language regions and specific language processes from numerous prior neuroimaging (e.g., functional magnetic resonance imaging or fMRI) and neuropsychological studies. Healthy individuals and/or stroke survivors with aphasia will be recruited to address these aims.

Official Title
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Probing Language Processes Using Transcranial Magnetic Stimulation

Conditions
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Stroke, Aphasia, Language

Intervention / Treatment
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* Device: Transcranial Magnetic Stimulation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed with left hemisphere stroke Consent date >= 1 month after stroke onset Right-handed Fluent in English 18 years of age or older Exclusion Criteria: Severe cognitive, auditory or visual impairments that would preclude cognitive and language testing Non-decisional per decisionality questionnaire or other clinical assessment Presence of major untreated or unstable psychiatric disease (e.g. schizophrenia, bipolar disease) A chronic medical condition that is not treated or is unstable Presence of cardiac stimulators or pacemakers or intracardiac lines neurostimulators medication infusion device any other implants near the scalp (e.g., cochlear implants) or in the eye metal in the body Pregnancy History of skull fractures, or skin diseases History of ongoing or unmanaged seizures or a family history of epilepsy Presence of factors that potentially decrease seizure thresholds On pro-convulsant medications Untreated Sleep deprivation or insomnia Ongoing alcoholism or illegal drug abuse (e.g., cocaine or MDMA users) History of dyslexia or other developmental learning disabilities

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Multiple studies will be conducted in parallel. But within a study, the interventional assignment will be set to cross-over with 3-4 arms.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Active TMS<br>Deymed DuoMag XT-35 rTMS system (DM-XT35) connected to a 70-mm figure-of-eight coil with built-in cooling fans (also known as an air-cooled coil) will be used for delivering active repetitive or rapid TMS to the target site. | Device: Transcranial Magnetic Stimulation<br>* Deymed DuoMag XT-35 rTMS<br>* Other names: TMS;|
| Active Comparator: Control TMS<br>Deymed DuoMag XT-35 rTMS system (DM-XT35) connected to a 70-mm figure-of-eight coil with built-in cooling fans will be used for delivering active repetitive or rapid TMS to the control site. | Device: Transcranial Magnetic Stimulation<br>* Deymed DuoMag XT-35 rTMS<br>* Other names: TMS;|
| Sham Comparator: Sham TMS<br>Deymed DuoMag XT-35 rTMS system (DM-XT35) connected to a 70-mm figure-of-eight coil with built-in cooling fans will be used for delivering sham repetitive or rapid TMS to the control or target site. | Device: Transcranial Magnetic Stimulation<br>* Deymed DuoMag XT-35 rTMS<br>* Other names: TMS;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reaction time on language task performance | Improvement on language task performance as measured by decrease in reaction time. | Language tasks administered immediately before and/or after TMS administration (same day). | 
| Accuracy on language task performance | Improvement on language task performance as measured by increase in accuracy. | Language tasks administered immediately before and/or after TMS administration (same day). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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TMS, Transcranial Magnetic Stimulation, Aphasia, Semantic processing, Phonological processing