Electrical Field Guided Transcranial Magnetic Stimulation to Treat Subacute Post-stroke Aphasia
University of Pennsylvania
Summary
The goal of this clinical trial is to determine if Transcranial Magnetic Stimulation (TMS) combined with modified Constraint Induced Language Therapy (mCILT) is an effective treatment for aphasia when delivered in the subacute stage after stroke. The main questions this study aims to answer are: 1. Can TMS combined with mCILT improve overall speech? 2. Can we identify specific behavioral and biological characteristics that would benefit most from the TMS and mCILT treatment? Researchers will compare real TMS to sham (fake) TMS to see whether TMS can treat subacute aphasia. Importantly, this trial will use electric field guided TMS to identify optimal and individualized stimulation intensity and site targeting. Participants will: * Complete a screening and medical intake to determine eligibility * Undergo MRI scans * Participate in 10 consecutive sessions (Monday-Friday) of TMS and mCILT treatment * Complete follow-up assessments immediately and 4 months after treatment
Description
Aphasia is an acquired disorder of language that occurs in approximately 30% of individuals with stroke and impacts approximately 1 million Americans (see NINDS.NIH.gov). Current treatments for aphasia are only modestly beneficial, so there is a clear need for more efficacious therapy. Most studies of TMS as a therapy for aphasia have investigated treatment in the chronic phase after stroke (\>6 months post-stroke). Previous research has demonstrated that TMS improves language performance in persons with chronic aphasia and the benefit has been shown to be sustained. Several lines of evidence…
Eligibility
- Age range
- 18–85 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Left hemisphere stroke resulting in aphasia * The stroke must have occurred between 2 and 6 weeks prior to enrollment * Must be able to understand the nature of the study, and give informed consent * English proficiency * Right-handed Exclusion Criteria: * History of serious and/or ongoing issues with substance abuse * Previous head trauma with loss of consciousness for more than 5 minutes * History of major psychiatric illness * Dementia, or other neurological conditions * Epilepsy, or seizure after the stroke event * Pacemaker * Diagnosis of tinnitus * Pregnancy
Interventions
- DeviceTranscranial Magnetic Stimulation (TMS)
TMS, is a form of non-invasive brain stimulation, that uses magnetic pulses to stimulate specific areas of the brain. In this study we will utilize theta-burst stimulation which uses a higher frequency pulse of 50 Hz delivered for 40 seconds for a total of 600 pulses.
- BehavioralModified Constraint Induced Language Therapy (mCILT)
Constraint-induced language therapy (CILT) is a treatment approach for aphasia that focuses on forcing the patient to use their impaired language skills, while restricting the use of compensatory strategies like gestures or writing. All participants will receive mCILT.
Location
- University of PennsylvaniaPhiladelphia, Pennsylvania