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TerminatedNCT03437512Updated Apr 29, 2021Results posted

Non-invasive Brain Stimulation in Adults Who Stutter

An interventional study of Anodal tDCS and Fluency training in Stuttering, Developmental, sponsored by University of Michigan. Terminated at 1 site in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2021-04-29.

Sponsored by University of Michigan · Not applicable, Interventional, and Treatment

Why this study was terminated
Covid-19 paused human subjects research at study site, funding expired.
Phase
Not applicable
Study type
Interventional
Enrollment
29
Allocation
Randomized
Ages
18 Years to 65 Years
Sex
All
01

Study summary

Research studies in stuttering have shown that activity patterns in certain brain areas differ in people who stutter compared to people who do not stutter when speaking. The purpose of this study is to investigate how mild, non-invasive brain stimulation applied consecutively for five days affects speech relevant brain areas, which may in turn affect speech fluency and speaking-related brain activity in people who stutter.

02

Conditions studied

  • Stuttering, Developmental

Browse trials for

Keywords

  • transcranial direct current stimulation
  • MRI
  • Speech
  • fluency
  • tDCS
03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • history of persistent developmental stuttering
  • stuttering severity ranging from mild to very severe, specifically Stuttering Severity Instrument (SSI) total score of 20 (mild) or higher and stuttering rates of 3% or higher
  • scores within 1 standard deviation of the norm on the standardized tests for the study

Exclusion criteria

Exclusion Criteria:

  • received any treatment for stuttering within the past year
  • other neurological conditions such as Tourette's syndrome or post-traumatic stress disorder
  • taking any medications/drugs that affect brain function
  • history of past or current mental illness for example, schizophrenia that may affect brain development and function
  • history of serious medical or neurological illness such as epilepsy and Parkinson's disease
  • history of closed head injury (e.g., concussion)
  • history of reading disorders
  • hearing loss
  • taking any medication, prescription or non-prescription with any psychotropic effects at the time of the study
  • metal or electronic implants such as cochlear implants, and pacemakers
04

Study design

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

Study arms

  • Experimental
    Active tDCS and fluency training

    Participants will receive anodal tDCS at 2milliampere (mA) intensity for 20 minutes during speech fluency training (5 consecutive days).

    Device: Anodal tDCS · Behavioral: Fluency training

  • Sham comparator
    Sham tDCS and fluency training

    Participants will receive sham tDCS. Sham stimulation will involve 30 seconds of stimulation at the beginning of the 20 minutes of speech fluency training (5 consecutive days).

    Behavioral: Fluency training · Device: Sham tDCS

Interventions

  • DeviceAnodal tDCS

    20 minutes of 2mA anodal stimulation.

  • BehavioralFluency training

    Speaking along with a metronome and/or speaking along with another person (choral speech) for 20 minutes

  • DeviceSham tDCS

    For sham stimulation, current is ramped up and back down over 30 seconds.

05

What researchers measure

Primary outcomes

  1. Changes in Brain Activation as Assessed by fMRI Images

    Investigators will use the fMRI images taken from before and after tDCS to determine if the treatment intervention contributed to any changes within brain regions associated with speech production. This will be measured by Blood-Oxygen-Level-Dependent (BOLD) signal change (arbitrary units). Images from scans are preprocessed. Changes in BOLD signal are modeled for contrasts within a group for \[post-pre\] and \[follow up-pre\] (e.g., active group reading condition post visit MINUS active group reading pre visit). Results are reported for reading condition.

    Time frame: Baseline, 1 week (post), 4 weeks (follow up)

  2. Change in Percentage of Stuttered Syllables Produced During Speech Sample

    Investigators will calculate the percentage of stuttered syllables (out of total syllables) in a speech sample. Decreased stuttered syllables represents better outcomes (greater reduction in stuttering).

    Time frame: Baseline, 1 week (post), 4 weeks (follow up)

Secondary outcomes

  1. Changes From Baseline on the Overall Assessment of Speakers Experience of Stuttering (OASES)

    The OASES is a standardized assessment of the functional impact of stuttering on a person's life. There are 4 sub-tests: general information about speech, your reactions to stuttering, communication in daily situations, quality of life. Each one has a score from 1 to 5 with regard to impact (1 least, 5 most negative impact). These are combined to give a total impact score between 1 and 5, with 5 representing the highest negative impact on person's life. The change on the total impact score will be used. Changes are shown in the table below by comparison between the measurements at the three points in time.

    Time frame: Baseline, 1 week (post), 4 weeks (follow up)

Other outcomes

  1. Changes From Baseline on Rhythm Judgement Task

    Investigators will compare performance accuracy on a computerized rhythm judgement task from before and after tDCS to assess effects of tDCS. Improved accuracy reflects better performance.

    Time frame: Baseline, 1 week, 4 weeks

  2. Changes From Baseline on Tapping Tasks

    Investigators will compare performance on computerized tapping tasks from before and after tDCS to assess effects of tDCS.

    Time frame: Baseline, 1 week, 4 weeks

  3. Changes From Baseline on Self-rated Measure of Speech Fluency

    Investigators will compare participant scores on a self-rated measure of speech fluency (1 = NO STUTTERING; 9 = EXTREMELY SEVERE STUTTERING) from before and after tDCS to assess effects of tDCS. Lower scores indicate improvement.

    Time frame: Baseline, 1 week, 4 weeks

06

Results

Posted Apr 29, 2021
Limitations and caveats
Study was terminated early due to pandemic research pause, which resulted in fewer enrolled subjects than anticipated, which affected the number of subjects that could be analyzed.

Participant flow

Randomized
Participant flow — Randomized
MilestoneActive tDCS and Fluency TrainingSham tDCS and Fluency Training
Started1213
Completed1211
Not completed02
Withdrew: Withdrawal by subject02
Received First tDCS Session
Participant flow — Received First tDCS Session
MilestoneActive tDCS and Fluency TrainingSham tDCS and Fluency Training
Started1211
Completed1211
Not completed00
Received Final tDCS Session
Participant flow — Received Final tDCS Session
MilestoneActive tDCS and Fluency TrainingSham tDCS and Fluency Training
Started1211
Completed1211
Not completed00
Completed Study Follow up
Participant flow — Completed Study Follow up
MilestoneActive tDCS and Fluency TrainingSham tDCS and Fluency Training
Started1211
Completed1010
Not completed21
Withdrew: Could not complete study due to covid-19 research pause21

Outcome measures

PrimaryChanges in Brain Activation as Assessed by fMRI Images

Investigators will use the fMRI images taken from before and after tDCS to determine if the treatment intervention contributed to any changes within brain regions associated with speech production. This will be measured by Blood-Oxygen-Level-Dependent (BOLD) signal change (arbitrary units). Images from scans are preprocessed. Changes in BOLD signal are modeled for contrasts within a group for \[post-pre\] and \[follow up-pre\] (e.g., active group reading condition post visit MINUS active group reading pre visit). Results are reported for reading condition.

Time frame:
Baseline, 1 week (post), 4 weeks (follow up)
Reported as:
Mean · Percent signal change
Changes in Brain Activation as Assessed by fMRI Images
Percent signal changeActive tDCS and Fluency TrainingSham tDCS and Fluency Training
left supplementary motor area (SMA) (post-pre)1.39 ± 0.450.81 ± 0.47
left SMA (fol-pre)1.03 ± 0.490.9 ± 0.54
right SMA (post-pre)-0.45 ± 0.480.49 ± 0.52
right SMA (fol-pre)0.86 ± 0.540.09 ± 0.35
left superior temporal gyrus (STG) (post-pre)1.43 ± 0.740.79 ± 0.75
left STG (fol-pre)0.09 ± 0.530.57 ± 0.85
right STG (post-pre)-0.63 ± 0.971.56 ± 1.39
right STG (fol-pre)0.3 ± 1.070.83 ± 1.17
left putamen (post-pre)1.37 ± 0.66-0.31 ± 0.58
left putamen (fol-pre)2.42 ± 0.71-0.22 ± 0.59
right putamen (post-pre)-1.01 ± 0.65-0.74 ± 0.67
right putamen (fol-pre)0.89 ± 0.690.06 ± 0.86
left inferior frontal gyrus (IFG) (post-pre)1.6 ± 0.94-0.33 ± 0.97
left IFG (fol-pre)0.23 ± 0.960.14 ± 0.74
right IFG (post-pre)-0.48 ± 0.800.11 ± 0.65
right IFG (fol-pre)-0.2 ± 0.80-0.2 ± 0.80
left premotor cortex (PMC) (post-pre)1.33 ± 0.91-0.15 ± 1.67
left PMC (fol-pre)0.68 ± 0.960.62 ± 1.11
right PMC (post-pre)0.31 ± 0.721.2 ± 0.93
right PMC (fol-pre)1.32 ± 1.011.01 ± 1.17
Statistical analysis
  • Active tDCS and Fluency Training vs Sham tDCS and Fluency Training · t-test, 2 sided · p = <.001 (familywise error rate (FWE) corrected to .05 with cluster threshold of 80 voxels.)
PrimaryChange in Percentage of Stuttered Syllables Produced During Speech Sample

Investigators will calculate the percentage of stuttered syllables (out of total syllables) in a speech sample. Decreased stuttered syllables represents better outcomes (greater reduction in stuttering).

Time frame:
Baseline, 1 week (post), 4 weeks (follow up)
Reported as:
Mean · percent change in stuttered syllables
Change in Percentage of Stuttered Syllables Produced During Speech Sample
percent change in stuttered syllablesActive tDCS and Fluency TrainingSham tDCS and Fluency Training
% Change post-1.82 ± 2.221.06 ± 2.02
% Change follow up-1.03 ± 4.173.46 ± 5.47
Statistical analysis
  • Active tDCS and Fluency Training vs Sham tDCS and Fluency Training · ANOVA · p = .936 (Interaction between visit and group.)
SecondaryChanges From Baseline on the Overall Assessment of Speakers Experience of Stuttering (OASES)

The OASES is a standardized assessment of the functional impact of stuttering on a person's life. There are 4 sub-tests: general information about speech, your reactions to stuttering, communication in daily situations, quality of life. Each one has a score from 1 to 5 with regard to impact (1 least, 5 most negative impact). These are combined to give a total impact score between 1 and 5, with 5 representing the highest negative impact on person's life. The change on the total impact score will be used. Changes are shown in the table below by comparison between the measurements at the three points in time.

Time frame:
Baseline, 1 week (post), 4 weeks (follow up)
Reported as:
Mean · score on a scale
Changes From Baseline on the Overall Assessment of Speakers Experience of Stuttering (OASES)
score on a scaleActive tDCS and Fluency TrainingSham tDCS and Fluency Training
Pre2.48 ± .612.67 ± .75
Post2.34 ± .552.56 ± .78
Follow up2.35 ± .572.59 ± .88
Statistical analysis
  • Active tDCS and Fluency Training vs Sham tDCS and Fluency Training · ANOVA · p = .619 (Interaction between visit and group.)
Other pre-specifiedChanges From Baseline on Rhythm Judgement Task

Investigators will compare performance accuracy on a computerized rhythm judgement task from before and after tDCS to assess effects of tDCS. Improved accuracy reflects better performance.

Time frame:
Baseline, 1 week, 4 weeks

Results for this outcome have not been posted.

Other pre-specifiedChanges From Baseline on Tapping Tasks

Investigators will compare performance on computerized tapping tasks from before and after tDCS to assess effects of tDCS.

Time frame:
Baseline, 1 week, 4 weeks

Results for this outcome have not been posted.

Other pre-specifiedChanges From Baseline on Self-rated Measure of Speech Fluency

Investigators will compare participant scores on a self-rated measure of speech fluency (1 = NO STUTTERING; 9 = EXTREMELY SEVERE STUTTERING) from before and after tDCS to assess effects of tDCS. Lower scores indicate improvement.

Time frame:
Baseline, 1 week, 4 weeks

Results for this outcome have not been posted.

Adverse events

Collected over 6 weeks. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Active tDCS and Fluency Training0/12 (0%)0/12 (0%)12/12 (100%)
Sham tDCS and Fluency Training0/11 (0%)0/11 (0%)10/11 (90.9%)
Most frequent other events
Showing 10 of 11
Most frequent other events
EventActive tDCS and Fluency TrainingSham tDCS and Fluency Training
TinglingSkin and subcutaneous tissue disorders12/1210/11
Warm sensationSkin and subcutaneous tissue disorders10/128/11
SleepinessGeneral disorders9/128/11
Scalp painSkin and subcutaneous tissue disorders8/128/11
FatigueGeneral disorders6/124/11
Trouble concentratingGeneral disorders5/125/11
NervousnessGeneral disorders1/124/11
HeadacheGeneral disorders4/122/11
Neck painMusculoskeletal and connective tissue disorders1/123/11
Changes in visual sensationsGeneral disorders0/123/11

Baseline characteristics

Includes all participants who were assigned to an arm and received the first intervention

Age, Continuous
Age, Continuous(years)Active tDCS and Fluency TrainingSham tDCS and Fluency TrainingTotal
Mean27.43 ± 8.1423.31 ± 2.8725.46 ± 6.54
Sex: Female, Male
Sex: Female, Male(Participants)Active tDCS and Fluency TrainingSham tDCS and Fluency TrainingTotal
Female213
Male101020
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Active tDCS and Fluency TrainingSham tDCS and Fluency TrainingTotal
Hispanic or Latino101
Not Hispanic or Latino111122
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Active tDCS and Fluency TrainingSham tDCS and Fluency TrainingTotal
American Indian or Alaska Native112
Asian213
Native Hawaiian or Other Pacific Islander000
Black or African American213
White7815
More than one race000
Unknown or Not Reported000
Stuttering Severity
Stuttering Severity(percent)Active tDCS and Fluency TrainingSham tDCS and Fluency TrainingTotal
Mean5.66 ± 3.239.72 ± 8.887.69 ± 6.06
Overall Assessment of Speaker's Experience of Stuttering
Overall Assessment of Speaker's Experience of Stuttering(score on a scale)Active tDCS and Fluency TrainingSham tDCS and Fluency TrainingTotal
Mean2.48 ± 0.582.67 ± 0.682.57 ± 0.64
07

Study locations

1 site
  • University of Michigan
    Ann Arbor, Michigan 48105, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Feb 25, 2021

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

09

Registry details

Key details

Study ID
NCT03437512
Lead sponsor
University of Michigan
Responsible party
Emily O'Dell Garnett (Research Investigator, University of Michigan) — Principal investigator
First posted
Feb 19, 2018
Start date
Jun 25, 2018
Primary completion
Apr 1, 2020
Completion
Apr 1, 2020
Results posted
Apr 29, 2021
Last update
Apr 29, 2021

Study contacts

Emily O Garnett, PhD
principal investigator · University of Michigan

Oversight

FDA-regulated drug
No
FDA-regulated device
Yes
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