CClinicalTrials.gg
CompletedNCT02606422Updated Jan 28, 2025Results posted

tDCS Intervention in Primary Progressive Aphasia

An interventional study of Active HD-tDCS plus Speech-Language Therapy and Sham plus Speech-Language Therapy in Primary Progressive Aphasia, MCI and FTD, sponsored by Johns Hopkins University. Completed at 1 site in United States. Open to participants aged 50 Years to 90 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2025-01-28.

Sponsored by Johns Hopkins University · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
61
Allocation
Randomized
Ages
50 Years to 90 Years
Sex
All
01

Study summary

Primary progressive aphasia (PPA) is a neurodegenerative disease that affects first and foremost language abilities. Mild cognitive impairment (MCI) is slowly progressive decline in a single domain of cognition (e.g. language) not attributable to motor or sensory loss, without impediment of social or occupational function. MCI can be an early sign of neurodegenerative disease, or can be due to normal aging. When language is the prominent affected domain in MCI, the person may later meet criteria for PPA or may progress to the clinical syndrome of Alzheimer's dementia. Spelling, naming, and working memory (e.g. repetition) are among the language abilities affected early in the course of PPA or language-centered MCI, and different variants have distinct deficits in these domains. This research project investigates the behavioral and neuromodulatory effects of high definition transcranial direct current stimulation (HD-tDCS) during language therapy in PPA participants over time. Anodal HD-tDCS targeting the left inferior frontal gyrus (IFG) administered in combination with language therapy is expected to be more beneficial when compared to language therapy alone. It will 1) improve language performance or decrease rate of decline, 2) have better-sustained effects at 2 weeks and 2 months post-treatment, and 3) produce generalization to untrained language items and some other cognitive functions. Resting-state fMRI, diffusion tensor imaging (DTI), and volumetric data are also collected to investigate changes in functional brain connectivity associated with HD-tDCS in individuals with PPA. A better understanding of the therapeutic and neuromodulatory mechanisms of HD-tDCS as an adjunct to language therapy in PPA may have a significant impact on the development of effective therapies for PPA and MCI, and may offer insight into ways of impeding neurodegeneration that may improve patients' quality of life, as well as extend their ability to work and manage their affairs.

Read the detailed description

A. Evaluation Tasks

Language Tasks:

Participants will be administered baseline language and cognitive tasks, including 1 or more of the following, depending on their residual language and cognitive skills:

a) writing to dictation b) oral spelling c) oral and written naming of pictures d) word-picture matching f) written and oral picture description g) digit span h) spatial span i) verbal learning j) grammatical sentence production k) oral word repetition l) sentence comprehension

Quality of Life questionnaires:

Participants will be administered standardized and non-standardized quality-of-life questionnaires before, after, and at follow-up intervals of each experimental period. The purpose of these questionnaires is to assess whether the proposed interventions have affected participants' well-being and the general quality of their life.

B. Spoken and Written Word Production Therapy Interventions

Individuals with PPA will receive spoken and written word production intervention tailored to their degree of deficit. Two interventions (basic and advanced) will be implemented, treating the main lexical retrieval deficits in PPA, in oral and written modalities. The goal of the combined interventions is to promote interaction between phonological and orthographic representations and processes in the remediation of lexical retrieval deficits that are prominent in all PPA subtypes.

C. Assessment of Language Therapy Tasks:

Follow-up assessment will probe all sets of trained phoneme-grapheme correspondences, words, or other stimuli (e.g. sentences) to identify whether or not the patient has retained knowledge of the trained items. Differences in baseline measures in pre- and post-therapy accuracy for phoneme-grapheme correspondences for each patient will be evaluated using the following: percentages of total number of points correct, arithmetic differences between percentage scores, and permutation tests (Pearson's chi-square test; Fisher's exact test).

C. HD-tDCS Methods:

Participants will take part in 10-15 consecutive training sessions (3-5 per week), separated by 2 months. Anodal HD-tDCS has typically been shown to up-regulate neuronal excitability and produce enhancement of behavioral performance. A Soterix-CT device will be delivering current at an intensity of 1-2 milliamps(mA) (estimated current density 0.04 mA/cm2; estimated total charge 0.048C/cm2) for a maximum of 20 minutes in the HD-tDCS groups and for a maximum of 30 seconds in the Sham group. For both interventions (HD-tDCS and Sham) the electrical current will be increased in a ramp-like fashion at the onset of the stimulation eliciting a transient tingling sensation on the scalp that usually disappears over seconds.

D. Imaging Methods:

Imaging will be performed at the beginning of enrollment, before and after each 12-to-15-day HD-tDCS treatment, and at follow-up intervals for up to 8 time points per individual on a 3T Philips system, and will consist of resting-state fMRI (rsfMRI), MPRAGE, and diffusion tensor imaging (DTI). Each scanning session will last approximately 1 hour.

E. Statistical Analyses:

In the within-subject crossover protocol, each participant will be administered three experimental conditions: Control (natural progression), IFG HD-tDCS+language (henceforth abbr. HD-tDCS treatment (word production) and sham HD-tDCS+language (henceforth abbr. sham treatment). To achieve an accurate estimate of degeneration and rate of decline in each participant at their particular stage of the disease progression, each participant will first be enrolled in the control condition (natural progression), such that for the first 12 weeks they will not receive any therapy. Then the participant will receive either the HD-tDCS treatment followed by sham, or vice versa. All analyses, behavioral and imaging, will be under the oversight of the study statisticians.

F. Study duration and number of study visits required of research participants.

Before any intervention, participants will be enrolled in a control condition for 12 weeks during which no therapy will be provided to enable us to assess their personal decline rate. After this period they will be randomly assigned to either sham or HD-tDCS experimental conditions. After 1-3 weeks of HD-tDCS application (3-5 sessions in a week, 10-15 sessions per stimulation site) there will be an interval of approximately 2 months and then we will implement the other two HD-tDCS conditions in a within-subject cross-over design. Participants will be followed up at 2-week and 2-month follow-up intervals.

G. Blinding, including justification for blinding or not blinding the trial, if applicable.

Participants will be blinded to the application of anodal or sham HD-tDCS. To achieve blinding, all participants will be fitted with the HD-tDCS electrodes placed over the left inferior frontal gyrus. The Soterix-CT device will be used for double-blinding purposes.

H. Justification of why participants will not receive routine care or will have current therapy stopped

Participation in this study will not disrupt any current care or therapy.

I. Justification for inclusion of a placebo or non-treatment group

All participants will undergo active and sham conditions, thus serving as their own control.

J. Definition of treatment failure or participant removal criteria

Participants will be removed from the study if they are unable to comply with task instructions or tolerate the HD-tDCS procedure.

K. Description of what happens to participants receiving therapy when the study ends or if a participant's participation in the study ends prematurely

When the study ends participants will continue to receive management with their neurologist as usual. If a patient's participation in the study ends prematurely s/he will still receive care as before. In sum, termination of the study or termination of participation in it will not affect the regular therapy he or she may be receiving.

L. Qualification of investigators:

The PI and co-investigators have extensive research and clinical experience with all study tasks: behavioral language therapy (including spelling, naming, and repetition therapy. The investigators have already published a tDCS study on the behavioral results for the improvement of spelling abilities.

02

Conditions studied

  • Primary Progressive Aphasia
  • MCI
  • FTD

Keywords

  • transcranial direct current stimulation (tDCS)
  • neurodegeneration
  • language therapy
  • Primary Progressive Aphasia (PPA)
03

In context

Aphasia

365 studies on the registry are indexed under Aphasia; 89 are open to participants now.

This study's enrollment of 61 is above the median of 30 across 316 interventional studies indexed under Aphasia.

Browse Aphasia studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,783 studies on the registry; 313 are open to participants now.

Of its 203 completed or terminated interventional studies of FDA-regulated products, 140 (69%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
50 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Eligibility criteria

Inclusion Criteria:

  • Must be clinically diagnosed with semantic variant PPA (svPPA), non-fluent variant PPA (nfvPPA), or logopenic variant PPA (lvPPA), unclassifiable PPA, or MCI. Diagnosis will be based on neuropsychological testing, language testing (most commonly the Western Aphasia Battery), MRI and clinical assessment.
  • Must be right-handed.
  • Must be speakers of English.
  • Must have at least 9th grade education.

Exclusion Criteria:

  • Uncorrected visual or hearing impairment by self report.
  • Stroke/other premorbid neurological disorder affecting the brain.
  • Any other language-based learning disorder other than PPA.
  • Inability to follow directions for baseline tasks.
  • Western Aphasia Battery Aphasia Quotient (AQ) \<30 (indicating severe language impairment).

Exclusion Criteria for MRI Participation:

  • Severe claustrophobia.
  • Cardiac pacemakers or ferromagnetic implants.
  • Pregnant women.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
61 participants (actual)

Study arms

  • Experimental
    Active HD-tDCS plus Speech-Language Therapy

    Active HD-tDCS will be applied at the beginning of 45min speech-language therapy session and will last for 20 min.

    Device: Active HD-tDCS plus Speech-Language Therapy

  • Sham comparator
    Sham plus Speech-Language Therapy

    Sham HD-tDCS will be applied at the beginning of 45min speech-language therapy session.

    Device: Sham plus Speech-Language Therapy

Interventions

  • DeviceActive HD-tDCS plus Speech-Language Therapy

    Stimulation will be delivered by a battery-driven constant current stimulator. The electrical current will be administered to a pre-specified region of the brain (inferior frontal gyrus). The stimulation will be delivered at an intensity of 2mA (estimated current density 0.04 mA/cm2; estimated total charge 0.048C/cm2) in a ramp-like fashion for a maximum of 20 minutes. Speech-language therapy will be oral and written naming.

  • DeviceSham plus Speech-Language Therapy

    Speech-language therapy will be administered during sham stimulation. Current will be administered in a ramp-line fashion but after the ramping the intensity will drop to 0 mA. Speech-language therapy will be oral and written naming.

06

What researchers measure

Primary outcomes

  1. Absolute Percent Change in Written Naming (Trained Items)

    The primary outcome measure was the absolute percentage change in the number of correct letters in the written response, compared to the target response in the trained word lists. This calculation reflects the change in accuracy between two timepoints. For letter accuracy scoring, a rule-based system was used where each letter was assigned one point if correct. Points were deducted for errors such as deletions, additions, substitutions, transpositions, or movements of letters. A second reviewer independently scored the responses and resolved any discrepancies through discussion to ensure consensus. Interrater reliability for letter accuracy scoring was 95%. Average letter accuracy per word was calculated for all trained items. Then the absolute percentage change was calculated by subtracting the earlier time point value (e.g., baseline) from the later one (e.g., immediately after treatment, 2 weeks post, and 2 months post), reflecting the change in accuracy.

    Time frame: Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention

  2. Absolute Percent Change in Written Naming (Untrained Items)

    The primary outcome measure was the absolute percentage change in the number of correct letters in the written response, compared to the target response in the untrained word lists.This calculation reflects the change in accuracy between two timepoints. For letter accuracy scoring, a rule-based system was used where each letter was assigned one point if correct. Points were deducted for errors such as deletions, additions, substitutions, transpositions, or movements of letters. A second reviewer independently scored the responses and resolved any discrepancies through discussion to ensure consensus. Interrater reliability for letter accuracy scoring was 95%. Average letter accuracy per word was calculated for all untrained items. Then the absolute percentage change was calculated by subtracting the earlier time point value (e.g., baseline) from the later one (e.g., immediately after treatment, 2 weeks post, and 2 months post), reflecting the change in accuracy.

    Time frame: Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention

  3. Absolute Percent Change in Oral Naming (Trained Items)

    The percent accuracy for each participant's trained oral naming list was calculated, with scores ranging from 0% to 100%. A score of 0% indicates no correct responses, while 100% represents perfect accuracy. Higher percentages reflect better performance. To assess changes in performance from pre- to post-treatment, the percent accuracy for untrained items was compared before and after the intervention. The absolute percentage change was then calculated by subtracting the accuracy at the baseline time point (e.g., baseline) from the accuracy at the later time points (e.g., immediately after treatment, 2 weeks post, and 2 months post). This reflects the change in the participant's ability to name trained items, expressed as absolute percent change. A positive difference indicates improvement in naming accuracy, with a larger change reflecting greater improvement. A negative difference indicates a decline, with a larger change reflecting greater deterioration in naming ability.

    Time frame: Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention

  4. Absolute Percent Change in Oral Naming (Untrained Items)

    The percent accuracy for each participant's untrained oral naming list was calculated, with scores ranging from 0% to 100%. A score of 0% indicates no correct responses, while 100% represents perfect accuracy. Higher percentages reflect better performance. To assess changes in performance from pre- to post-treatment, the percent accuracy for untrained items was compared before and after the intervention. The absolute percentage change was then calculated by subtracting the accuracy at the baseline time point (e.g., baseline) from the accuracy at the later time points (e.g., immediately after treatment, 2 weeks post, and 2 months post). This reflects the change in the participant's ability to name trained items, expressed as absolute percent change. A positive difference indicates improvement in naming accuracy, with a larger change reflecting greater improvement. A negative difference indicates a decline, with a larger change reflecting greater deterioration in naming ability.

    Time frame: Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention

Secondary outcomes

  1. Change in Sentence Comprehension as Measured by the Subject Object Active Passive (SOAP) Test

    The SOAP test is a test that has been shown to measure comprehension of simple and complex sentence structures. It contains sentences with different syntactic complexities: subject relatives, object relative, active and passive voice. The participant has to listen to a sentence and choose the correct picture that corresponds to its meaning amongst 3 alternatives. Scores range from 0-40 with higher scores indicating better comprehension. For each participant in each group absolute change from before to after treatment was calculated and the mean absolute change for the group was calculated.

    Time frame: Change from baseline to immediate follow-up (3 weeks).

  2. Change in Functional Connectivity

    Using resting-state functional magnetic resonance imaging (rsfMRI), investigators will investigate whether tDCS intervention will result in different changes in connectivity between the targeted area (left inferior frontal gyrus) and other nodes in the brain. Global connectivity is measured through the participation coefficient. The participation coefficient is scored on a scale from -1 to +1. Compared with healthy controls a score closer to +1 was associated with worse dementia severity.

    Time frame: Change from before treatment to immediate follow up (3 weeks)

07

Results

Posted Jan 28, 2025

Participant flow

61 patients were consented for eligibility between the study start date and end date at our lab located at Johns Hopkins Hospital.

Intervention Phase 1 (3 Weeks)
Participant flow — Intervention Phase 1 (3 Weeks)
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started2017
Completed2017
Not completed00
Phase 1: Immediate Follow up
Participant flow — Phase 1: Immediate Follow up
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started2017
Completed1817
Not completed20
Withdrew: Withdrawal by subject20
Phase 1, 2-Week Follow-up (Washout)
Participant flow — Phase 1, 2-Week Follow-up (Washout)
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started1817
Completed1617
Not completed20
Withdrew: Withdrawal by subject20
Phase 1 2-Month Follow-up (Washout)
Participant flow — Phase 1 2-Month Follow-up (Washout)
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started1617
Completed1516
Not completed11
Withdrew: Withdrawal by subject11
Intervention Phase 2 (3 Weeks)
Participant flow — Intervention Phase 2 (3 Weeks)
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started1516
Completed1516
Not completed00
Phase 2: Immediate Follow-up
Participant flow — Phase 2: Immediate Follow-up
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started1516
Completed1516
Not completed00
Phase 2, 2-Week Follow-up (Washout)
Participant flow — Phase 2, 2-Week Follow-up (Washout)
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started1516
Completed1515
Not completed01
Withdrew: Withdrawal by subject01
Phase 2: 2-Month Follow-up (Washout)
Participant flow — Phase 2: 2-Month Follow-up (Washout)
MilestoneActive HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language Therapy
Started1515
Completed1515
Not completed00

Outcome measures

PrimaryAbsolute Percent Change in Written Naming (Trained Items)

The primary outcome measure was the absolute percentage change in the number of correct letters in the written response, compared to the target response in the trained word lists. This calculation reflects the change in accuracy between two timepoints. For letter accuracy scoring, a rule-based system was used where each letter was assigned one point if correct. Points were deducted for errors such as deletions, additions, substitutions, transpositions, or movements of letters. A second reviewer independently scored the responses and resolved any discrepancies through discussion to ensure consensus. Interrater reliability for letter accuracy scoring was 95%. Average letter accuracy per word was calculated for all trained items. Then the absolute percentage change was calculated by subtracting the earlier time point value (e.g., baseline) from the later one (e.g., immediately after treatment, 2 weeks post, and 2 months post), reflecting the change in accuracy.

Time frame:
Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention
Reported as:
Mean · absolute percent change
Absolute Percent Change in Written Naming (Trained Items)
absolute percent changeActive tDCS Plus Speech-Language TherapySham Plus Speech-Language Therapy
Phase 1: Change from baseline to immediately after treatment39.4 ± 5.128.4 ± 5.2
Phase 1: change from baseline to 2-weeks post treatment33.1 ± 4.720.0 ± 5.1
Phase 1: change from baseline to 2-months post treatment. (Baseline for Phase 2)27.5 ± 5.511.7 ± 2.7
Phase 2: Change from baseline to immediate follow-up27.0 ± 5.425.5 ± 6.2
Phase 2:change from baseline to 2-weeks post treatment13.2 ± 4.913.2 ± 6.7
Phase 2: change from baseline to 2-months post treatment9.1 ± 4.18.9 ± 4.6
PrimaryAbsolute Percent Change in Written Naming (Untrained Items)

The primary outcome measure was the absolute percentage change in the number of correct letters in the written response, compared to the target response in the untrained word lists.This calculation reflects the change in accuracy between two timepoints. For letter accuracy scoring, a rule-based system was used where each letter was assigned one point if correct. Points were deducted for errors such as deletions, additions, substitutions, transpositions, or movements of letters. A second reviewer independently scored the responses and resolved any discrepancies through discussion to ensure consensus. Interrater reliability for letter accuracy scoring was 95%. Average letter accuracy per word was calculated for all untrained items. Then the absolute percentage change was calculated by subtracting the earlier time point value (e.g., baseline) from the later one (e.g., immediately after treatment, 2 weeks post, and 2 months post), reflecting the change in accuracy.

Time frame:
Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention
Reported as:
Mean · absolute percent change
Absolute Percent Change in Written Naming (Untrained Items)
absolute percent changeActive tDCS Plus Speech-Language TherapySham tDCS Plus Speech-Language Therapy
Phase 1: change from baseline immediately after treatment14.6 ± 2.79.6 ± 2.3
Phase 1: change from baseline 2-weeks post treatment15.6 ± 3.96.6 ± 3.4
Phase 1: change from baseline 2-months post treatment. (Baseline for Phase 2)17.3 ± 3.63.0 ± 3.0
Phase 2: change from baseline immediately after treatment9.9 ± 2.65.4 ± 2.5
Phase 2: change from baseline 2-weeks post treatment7.3 ± 3.90.7 ± 2.2
Phase 2: change from baseline 2-months post treatment9.9 ± 1.9-3.4 ± 2.7
PrimaryAbsolute Percent Change in Oral Naming (Trained Items)

The percent accuracy for each participant's trained oral naming list was calculated, with scores ranging from 0% to 100%. A score of 0% indicates no correct responses, while 100% represents perfect accuracy. Higher percentages reflect better performance. To assess changes in performance from pre- to post-treatment, the percent accuracy for untrained items was compared before and after the intervention. The absolute percentage change was then calculated by subtracting the accuracy at the baseline time point (e.g., baseline) from the accuracy at the later time points (e.g., immediately after treatment, 2 weeks post, and 2 months post). This reflects the change in the participant's ability to name trained items, expressed as absolute percent change. A positive difference indicates improvement in naming accuracy, with a larger change reflecting greater improvement. A negative difference indicates a decline, with a larger change reflecting greater deterioration in naming ability.

Time frame:
Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention
Reported as:
Mean · absolute percent change
Absolute Percent Change in Oral Naming (Trained Items)
absolute percent changeActive tDCS Plus Speech-Language TherapySham Plus Speech-Language Therapy
Phase 1: change from baseline immediately after treatment38.8 ± 7.326.9 ± 4.7
Phase 1: change from baseline 2-weeks post treatment30 ± 7.521.3 ± 4.9
Phase 1: change from baseline 2-months post treatment. (Baseline for Phase 2)24.9 ± 8.515.3 ± 4.8
Phase 2: change from baseline immediately after treatment23.5 ± 5.026.5 ± 10.9
Phase 2: change from baseline 2-weeks post treatment15.6 ± 4.122.6 ± 8.9
Phase 2: change from baseline 2-months post treatment6.5 ± 4.36.3 ± 6.3
PrimaryAbsolute Percent Change in Oral Naming (Untrained Items)

The percent accuracy for each participant's untrained oral naming list was calculated, with scores ranging from 0% to 100%. A score of 0% indicates no correct responses, while 100% represents perfect accuracy. Higher percentages reflect better performance. To assess changes in performance from pre- to post-treatment, the percent accuracy for untrained items was compared before and after the intervention. The absolute percentage change was then calculated by subtracting the accuracy at the baseline time point (e.g., baseline) from the accuracy at the later time points (e.g., immediately after treatment, 2 weeks post, and 2 months post). This reflects the change in the participant's ability to name trained items, expressed as absolute percent change. A positive difference indicates improvement in naming accuracy, with a larger change reflecting greater improvement. A negative difference indicates a decline, with a larger change reflecting greater deterioration in naming ability.

Time frame:
Change from Baseline to Immediately after treatment (3 weeks), 2 weeks post treatment (5 weeks), and 2 months post-treatment (11 weeks) for each period of intervention
Reported as:
Mean · absolute percent change
Absolute Percent Change in Oral Naming (Untrained Items)
absolute percent changeActive HD-tDCS Plus Speech-Language TherapySham Plus Speech-Language Therapy
Phase 1: change from baseline immediately after treatment8.1 ± 2.48.9 ± 4.6
Phase 1: change from baseline 2-weeks post treatment4.8 ± 2.57.9 ± 3.5
Phase 1: change from baseline 2-months post treatment. (Baseline for Phase 2)3.9 ± 4.02.6 ± 4.6
Phase 2: change from baseline immediately after treatment4.8 ± 2.6-1.8 ± 7.2
Phase 2: change from baseline 2-weeks post treatment1.8 ± 2.10.4 ± 2.9
Phase 2: change from baseline 2-months post treatment4.6 ± 2.7-6.7 ± 3.8
SecondaryChange in Sentence Comprehension as Measured by the Subject Object Active Passive (SOAP) Test

The SOAP test is a test that has been shown to measure comprehension of simple and complex sentence structures. It contains sentences with different syntactic complexities: subject relatives, object relative, active and passive voice. The participant has to listen to a sentence and choose the correct picture that corresponds to its meaning amongst 3 alternatives. Scores range from 0-40 with higher scores indicating better comprehension. For each participant in each group absolute change from before to after treatment was calculated and the mean absolute change for the group was calculated.

Time frame:
Change from baseline to immediate follow-up (3 weeks).
Reported as:
Mean · score on a scale
Change in Sentence Comprehension as Measured by the Subject Object Active Passive (SOAP) Test
score on a scaleActive HD-tDCS Plus Speech-Language TherapySham Plus Speech-Language Therapy
Change in Sentence Comprehension as Measured by the Subject Object Active Passive (SOAP) Test3.250 ± 3.911-0.412 ± 3.658
SecondaryChange in Functional Connectivity

Using resting-state functional magnetic resonance imaging (rsfMRI), investigators will investigate whether tDCS intervention will result in different changes in connectivity between the targeted area (left inferior frontal gyrus) and other nodes in the brain. Global connectivity is measured through the participation coefficient. The participation coefficient is scored on a scale from -1 to +1. Compared with healthy controls a score closer to +1 was associated with worse dementia severity.

Time frame:
Change from before treatment to immediate follow up (3 weeks)
Reported as:
Mean · score on a scale
Change in Functional Connectivity
score on a scaleActive HD-tDCS Plus Speech-Language TherapySham Plus Speech-Language Therapy
Change in Functional Connectivity-0.08 ± 0.020.02 ± 0.01
Statistical analysis
  • Active HD-tDCS Plus Speech-Language Therapy vs Sham Plus Speech-Language Therapy · t-test, 2 sided · p = <.05

Adverse events

Collected over Adverse events were not assessed during the 12-week control condition (natural progression period) preceding treatment. Adverse events were assessed from randomization to up to 2 months post treatment for each intervention.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Active HD-tDCS Plus Speech-Language Therapy0/36 (0%)0/36 (0%)0/36 (0%)
Sham Plus Speech-Language Therapy0/32 (0%)0/32 (0%)0/32 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Active HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language TherapyTotal
Mean66.45 ± 7.4068.82 ± 7.0567.45 ± 7.16
Sex: Female, Male
Sex: Female, Male(Participants)Active HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language TherapyTotal
Female9817
Male11920
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Active HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language TherapyTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(Participants)Active HD-tDCS Plus Speech-Language Therapy, Then Sham Plus Speech-Language TherapySham Plus Speech-Language Therapy, Then Active HD-tDCS Plus Speech-Language TherapyTotal
United States201737
08

Study locations

1 site
  • Johns Hopkins Hospital
    Baltimore, Maryland 21204, United States
09

References and documents

Publications

  • Tsapkini K, Frangakis C, Gomez Y, Davis C, Hillis AE. Augmentation of spelling therapy with transcranial direct current stimulation in primary progressive aphasia: Preliminary results and challenges. Aphasiology. 2014;28(8-9):1112-1130. doi: 10.1080/02687038.2014.930410. PubMed 26097278 ↗
  • Tippett DC, Hillis AE, Tsapkini K. Treatment of Primary Progressive Aphasia. Curr Treat Options Neurol. 2015 Aug;17(8):362. doi: 10.1007/s11940-015-0362-5. PubMed 26062526 ↗
  • Tsapkini K, Webster KT, Ficek BN, Desmond JE, Onyike CU, Rapp B, Frangakis CE, Hillis AE. Electrical brain stimulation in different variants of primary progressive aphasia: A randomized clinical trial. Alzheimers Dement (N Y). 2018 Sep 5;4:461-472. doi: 10.1016/j.trci.2018.08.002. eCollection 2018. PubMed 30258975 ↗
  • Herrmann O, Ficek B, Webster KT, Frangakis C, Spira AP, Tsapkini K. Sleep as a predictor of tDCS and language therapy outcomes. Sleep. 2022 Mar 14;45(3):zsab275. doi: 10.1093/sleep/zsab275. PubMed 34875098 ↗
  • Tao Y, Ficek B, Rapp B, Tsapkini K. Different patterns of functional network reorganization across the variants of primary progressive aphasia: a graph-theoretic analysis. Neurobiol Aging. 2020 Dec;96:184-196. doi: 10.1016/j.neurobiolaging.2020.09.007. Epub 2020 Sep 8. PubMed 33031971 ↗

Study documents

  • Protocol and statistical analysis plan · Mar 8, 2024
  • Informed consent form · Jan 21, 2022

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 28, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT02606422
Lead sponsor
Johns Hopkins University
Collaborators
National Institutes of Health (NIH), National Institute on Deafness and Other Communication Disorders (NIDCD)
Responsible party
Sponsor
First posted
Nov 17, 2015
Start date
Apr 2013
Primary completion
Jul 12, 2023
Completion
Aug 11, 2023
Results posted
Jan 28, 2025
Last update
Jan 28, 2025

Study contacts

Kyrana Tsapkini, PhD
principal investigator · Johns Hopkins University

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jan 2025. You cannot join it, but the record below documents what was studied.

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