Using tDCS in Speech-based Stroke Rehabilitation

Study Overview
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Brief Summary
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The purpose of this study is to determine whether the effect of treatment for acquired speech impairment can be enhanced by combining effective behavioral treatment with non-invasive brain stimulation. Transcranial direct current stimulation (tDCS), which delivers low-intensity current to the scalp, and is a safe and well-tolerated approach that poses a non-significant risk to participants. tDCS provides low intensity neural stimulation which has been shown to facilitate motor learning in other domains of stroke rehabilitation such as arm motor learning but the potential to enhance speech motor learning has not been explored. This will be examined with a series of single-case experimental designs.

Official Title
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Using tDCS in Speech-based Stroke Rehabilitation

Conditions
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Apraxia of Speech

Intervention / Treatment
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* Device: Soterix 1x1 line tDCS low-intensity stimulator
* Device: Sham


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Right-handed Monolingual (English) Single left-hemisphere CVA A minimum of six months post-stroke Clinical diagnosis of apraxia of speech Normal speech perception Passing score on the hearing screening. Exclusion Criteria: Diagnosis of laryngeal voice disorder Dysarthria History of speech impairment prior to CVA Presence of potential tDCS risk factors: damaged skin at site of stimulation; Presence of electrically or magnetically activated implant (including pacemaker); metal in any part of their body; history of medication-resistant epilepsy in the family; past history of seizures or unexplained spells of loss of consciousness.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Active Stimulation<br>crossover design such that each participant receives behavioral treatment twice - once with active stimulation and once with sham stimulation - in order to evaluate differences in improvement based on treatment condition. | Device: Soterix 1x1 line tDCS low-intensity stimulator<br>* Introduction of the independent variable (treatment) across three different points in time. Participants will be randomly assigned to have each treatment phase begin after 3, 4, or 6 baseline sessions. This current stimulates the cortex, with anodal stimulation leading to a depolarized state in which neurons are more likely to fire.<br>* Other names: Soterix;Device: Sham<br>* Patients will have two electrodes applied (one anode, one cathode) administering no stimulation<br>|
| Sham Comparator: Sham Stimulation<br>crossover design such that each participant receives behavioral treatment twice - once with active stimulation and once with sham stimulation - in order to evaluate differences in improvement based on treatment condition. | Device: Soterix 1x1 line tDCS low-intensity stimulator<br>* Introduction of the independent variable (treatment) across three different points in time. Participants will be randomly assigned to have each treatment phase begin after 3, 4, or 6 baseline sessions. This current stimulates the cortex, with anodal stimulation leading to a depolarized state in which neurons are more likely to fire.<br>* Other names: Soterix;Device: Sham<br>* Patients will have two electrodes applied (one anode, one cathode) administering no stimulation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in accuracy in recordings from tasks from baseline to post treatment | Subjects will be given speech production tasks. Recordings of tasks will be scored for accuracy to measure speech motor learning | Baseline, 6 Months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke