Using Transcranial Direct Current Stimulation to Reveal Mechanisms of Language Loss and to Treat Progressive Aphasia Associated with FTD and Related Dementias

Study Description:
This is a double-blind, sham-controlled, crossover study in which subjects with Primary Progressive Aphasia will undergo language testing and structural and functional brain imaging before and after receiving 10 semi-consecutive daily sessions of real or sham (fake) transcranial direct current stimulation (tDCS) paired with modified constraint-induced language therapy (mCILT). Language testing and brain imaging will be repeated immediately after completion of and up-to 24 weeks following completion of treatment. The investigators will examine changes in language performance induced by tDCS + mCILT compared to sham tDCS + mCILT. The investigators will also use network science to analyze brain imaging (fMRI) data to identify network properties associated with baseline PPA severity and tDCS-induced changes in performance. This study will combine knowledge gained from our behavioral, imaging, and network data in order to determine the relative degrees to which these properties predict whether persons with PPA will respond to intervention. After completion of one arm, participants will crossover into the second treatment arm, where all visits will be repeated. Participation will last about 12 months and takes place at the University of Pennsylvania.
Aphasia Friendly Study Description:
Primary Progressive Aphasia (PPA) is a disease that affects your brain and communication. There is currently no cure. Researchers want to know whether brain stimulation with language therapy can help improve language ability. Participants receive either real or placebo (fake) brain stimulation with language therapy, then complete language testing and brain imaging. After the first part of the study, participants get real or placebo (fake) brain stimulation again (whichever they did not get first) with language therapy. All testing sessions are repeated after the second treatment is completed. The study lasts about 12 months and takes place at the University of Pennsylvania.
Inclusion / Exclusion Criteria:
Inclusion: Presence of aphasia attributable to Primary Progressive Aphasia. Between the ages of 45 and 80. Must be an English speaker. Exclusion: Cognitive impairment of sufficient severity to preclude them from participating in testing / therapy (MMSE < 15). Subjects with Pacemakers or ICDs. Subjects with previous craniotomy or any breach in the skull. Subjects with a history of stroke. Subjects with history of TIA (at the PI’s discretion, a TIA which occurred at least 6 months ago is okay if no other events have been observed). Subjects with a history of small vessel disease. Use of sedation medication that may cause arousing the subject during testing difficult (must be free of meds that impair cognition for at least 3 months). Pregnancy.
Principal Investigator:
Roy Hamilton
Contact Email:
leslie.vnenchak@pennmedicine.upenn.edu
Condition
Primary Progressive Aphasia
Observational or Treatment:
Treatment
Type of Treatment:
Neurostimulation, Transcranial Direct Current Stimulation, Constraint Induced Language Therapy
Duration of Study:
The duration of the study is approximately 35 visits over 12 months.
Study Start Date:
December 1, 2020
Study End Date:
July 1, 2024
Costs or Reimbursement:
Subjects will be reimbursed for their time at a rate of $20 per hour and their transportation costs will be paid, up to $50 per visit.
IRB Approval #
843286
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