search
Back to results

Enhancing Language Function in Primary Progressive Aphasia (PPA)

Primary Purpose

Primary Progressive Aphasia

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
tDCS + language therapy
sham TDCS + language therapy
Sponsored by
University of Arizona
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Progressive Aphasia

Eligibility Criteria

45 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • diagnosed with PPA by neurologist or speech-language pathologist
  • speech-language deficit arising from PPA
  • native speaker of English Language or equivalent
  • adequate vision (normal or corrected to normal)
  • adequate hearing

Exclusion Criteria:

  • meeting (Diagnostic and Statistical Manual) DSM-IV criteria for Axis I mood, anxiety, psychotic or substance abuse disorders.
  • highly magnetizable metallic implants, including certain dental work
  • neurological disorders besides the ones of interest for the study (e.g., epilepsy)
  • Multiple Sclerosis
  • Parkinson's Disease
  • contraindications for MRI
  • pacemakers
  • metallic cardiac pumps
  • valves
  • magnetic materials such as surgical clips, implanted electronic perfusion pumps, or any other condition that would preclude proximity to a strong magnetic field.
  • clinically significant claustrophobia
  • severe systemic disease (e.g., renal failure)
  • poor health
  • pregnancy
  • epileptic activity in the past 12 months
  • family history of epilepsy or other seizure disorders
  • brain surgery in the past
  • metallic skull plates or implants
  • skin lesions or skull damage
  • excessive use of alcohol or drugs
  • premorbid psychiatric disease affecting communication
  • severe non-linguistic cognitive disturbances impeding language therapy

Sites / Locations

  • University of ArizonaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

active TDCS

sham TDCS

Arm Description

During intervention excitatory/anodal tDCS will be administered alongside speech-language therapy 5 days a week for 2 weeks. The exact location of the stimulation and electrode configuration will be targeted individually based on the optimal site identified in fMRI. TDCS will be administered with NeurConn1 Channel DC- Stimulator Plus (neuroCare Group, München, Germany) according to established guidelines and procedures. The active tDCS will be delivered for 20 minutes using sponge electrodes with a 30-s ramp-up and ramp-down period

The sham will be administered alongside speech-language therapy 5 days a week for 2 weeks. For sham, stimulation will be ramped up and then down to 0 milliamperes (mA) in the first minute of stimulation. The sham parameters were chosen based on previous reports that the perceived sensations on the skin, such as tingling, fade out in the first 30 s of tDCS

Outcomes

Primary Outcome Measures

Mean change from baseline scores on the Arizona Phonological Battery
Mean change from baseline scores on the Arizona Phonological Battery: Minimum score = 0; maximum = 100%; higher scores indicate better outcome
Mean change from baseline scores on the naming task
Mean change from baseline scores on the Boston Naming Test: Min score = 0; Max = 60; higher scores indicate better outcome
Mean change from baseline scores on the language probe task before and after each session
change on on the probe task from before the session; Min =0; Max = 100%; higher scores indicate better outcome

Secondary Outcome Measures

Full Information

First Posted
June 1, 2021
Last Updated
September 29, 2023
Sponsor
University of Arizona
search

1. Study Identification

Unique Protocol Identification Number
NCT04920318
Brief Title
Enhancing Language Function in Primary Progressive Aphasia
Acronym
PPA
Official Title
Enhancing Language Function in Primary Progressive Aphasia (PPA) With Transcranial Direct Current Stimulation (tDCS)
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 30, 2021 (Actual)
Primary Completion Date
December 30, 2025 (Anticipated)
Study Completion Date
June 15, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Arizona

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study's goal is to use non-invasive brain stimulation (NBS) techniques to treat language impairment associated with Primary Progressive Aphasia (PPA). The purpose of this study is to combine behavioral language intervention with individualized noninvasive brain stimulation techniques, called transcranial direct current stimulation (tDCS) to help the brain reorganize around damage and improve language functions.
Detailed Description
Primary Progressive Aphasia (PPA) is a neurodegenerative disorder that selectively affects language comprehension and/or production, with initial preservation of other cognitive domains. As tDCS has not been extensively studied in PPA, the investigators will measure both short- and long-term effects of stimulation in patients with this neurodegenerative disorder that affects specific language regions. Previous research suggests that neurostimulation with tDCS can safely induce changes in neural plasticity that can lead to long-term restoration of synaptic function. Thus, individually targeted stimulation to structurally preserved but dysfunctional regions may be able to produce behavioral improvements in primary progressive aphasia (PPA). TDCS is a method of stimulating the brain that does not require any sedation or surgery. TDCS is a technique that sends a weak electrical current through the scalp to stimulate the brain areas below. The information gained from this research study will aid in the development of therapies to improve language in people with neurological conditions that affect language use. TDCS will be applied over the activated area identified with the functional magnetic resonance imaging (fMRI) fMRI-localizer task. This approach will allow for individually optimized tDCS electrode placement. It will also account for potential inter-participant variability in the brain atrophy and language organization Summary of study sequence and procedures: Week 1: Baseline screening, language testing, one event-related brain potential (EEG-ERP) session Weeks 2: fMRI session to determine most effective treatment Weeks 3-4: tDCS with Language Treatment Part 1 Weeks 5 and 6: rest-period, post-treatment assessment Weeks 7 to 8: TDCS with Language Treatment Part 2 Weeks 9 and 10: rest period, post-treatment assessment 2-month follow-up, language assessment, one MRI scan, one EEG-ERP session

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Progressive Aphasia

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
individuals diagnosed with Alzheimer's Disease Primary Progressive Aphasia (AD-PPA) (~50-80 years old) will be randomized to receive active tDCS+language treatment or sham (fake tDCS)+language treatment in a cross-over design.
Masking
ParticipantCare ProviderInvestigator
Masking Description
The subject codes will be used for blinding of the participants, care-providers, and speech-language therapist administering the treatment.
Allocation
Randomized
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
active TDCS
Arm Type
Experimental
Arm Description
During intervention excitatory/anodal tDCS will be administered alongside speech-language therapy 5 days a week for 2 weeks. The exact location of the stimulation and electrode configuration will be targeted individually based on the optimal site identified in fMRI. TDCS will be administered with NeurConn1 Channel DC- Stimulator Plus (neuroCare Group, München, Germany) according to established guidelines and procedures. The active tDCS will be delivered for 20 minutes using sponge electrodes with a 30-s ramp-up and ramp-down period
Arm Title
sham TDCS
Arm Type
Sham Comparator
Arm Description
The sham will be administered alongside speech-language therapy 5 days a week for 2 weeks. For sham, stimulation will be ramped up and then down to 0 milliamperes (mA) in the first minute of stimulation. The sham parameters were chosen based on previous reports that the perceived sensations on the skin, such as tingling, fade out in the first 30 s of tDCS
Intervention Type
Combination Product
Intervention Name(s)
tDCS + language therapy
Other Intervention Name(s)
active tDCS, transcranial direct current simulation (tDCS)
Intervention Description
In this study fMRI-guided noninvasive neuromodulation will be applied, called Transcranial Direct Current Stimulation (tDCS) to the frontal and parietal brain regions that show reduced activation but still are structurally intact. TDCS will be paired with personalized speech-language therapy to enhance language functions.
Intervention Type
Combination Product
Intervention Name(s)
sham TDCS + language therapy
Other Intervention Name(s)
sham transcranial direct current simulation (tDCS)
Intervention Description
sham control will be applied with language therapy to the same regions as active TDCS.
Primary Outcome Measure Information:
Title
Mean change from baseline scores on the Arizona Phonological Battery
Description
Mean change from baseline scores on the Arizona Phonological Battery: Minimum score = 0; maximum = 100%; higher scores indicate better outcome
Time Frame
through study completion, an average of 1 year
Title
Mean change from baseline scores on the naming task
Description
Mean change from baseline scores on the Boston Naming Test: Min score = 0; Max = 60; higher scores indicate better outcome
Time Frame
through study completion, an average of 1 year
Title
Mean change from baseline scores on the language probe task before and after each session
Description
change on on the probe task from before the session; Min =0; Max = 100%; higher scores indicate better outcome
Time Frame
through study completion, an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: diagnosed with PPA by neurologist or speech-language pathologist speech-language deficit arising from PPA native speaker of English Language or equivalent adequate vision (normal or corrected to normal) adequate hearing Exclusion Criteria: meeting (Diagnostic and Statistical Manual) DSM-IV criteria for Axis I mood, anxiety, psychotic or substance abuse disorders. highly magnetizable metallic implants, including certain dental work neurological disorders besides the ones of interest for the study (e.g., epilepsy) Multiple Sclerosis Parkinson's Disease contraindications for MRI pacemakers metallic cardiac pumps valves magnetic materials such as surgical clips, implanted electronic perfusion pumps, or any other condition that would preclude proximity to a strong magnetic field. clinically significant claustrophobia severe systemic disease (e.g., renal failure) poor health pregnancy epileptic activity in the past 12 months family history of epilepsy or other seizure disorders brain surgery in the past metallic skull plates or implants skin lesions or skull damage excessive use of alcohol or drugs premorbid psychiatric disease affecting communication severe non-linguistic cognitive disturbances impeding language therapy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Aneta Kielar, PhD
Phone
15204883791
Email
akielar@email.arizona.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aneta Kielar, PhD
Organizational Affiliation
University of Arizona
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Arizona
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85721-0071
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aneta Kielar, PhD
Phone
520-488-3791
Email
akielar@email.arizona.edu

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Enhancing Language Function in Primary Progressive Aphasia

We'll reach out to this number within 24 hrs