Skip to main content
OpenTrials
Enrolling by Invitation

NCT Number: NCT05901233

Speech-Language Treatment With Remotely Supervised Transcranial Direct Current Stimulation in Primary Progressive Aphasia

Primary progressive aphasia (PPA) is a disorder characterized by gradual decline in speech-language ability caused by underlying neurodegenerative disease. PPA is a devastating condition that can affect adults as young as their 50's, depriving them of the ability to communicate and function in society. Along with Alzheimer's Disease and other Alzheimer's Disease Related Dementias (AD/ADRD), PPA is now identified earlier and with greater precision. Increasingly, patients and families seek options for behavioral and neuromodulatory treatments to address PPA's devastating effects on communication, prolong speech-language skills, and maximize quality of life. Studies have documented the robust benefits of speech-language telerehabilitation methods for persons with PPA, with in-home treatment resulting in immediate and long-term benefits. This investigation aims to further enhance the potency of these treatment approaches by pairing them with tailored neuromodulatory intervention that targets critical brain networks supporting treatment in each clinical subtype of PPA. The study will evaluate the feasibility and preliminary benefit of home-based transcranial direct current stimulation (tDCS) combined with evidence-based speech-language telerehabilitation methods. tDCS will be delivered to patients in their own homes and site of stimulation will be tailored for each clinical subtype of PPA. This project has the potential to enhance clinical management and rehabilitation for individuals with PPA by establishing the benefit of behavioral and neuromodulatory treatment that is neurobiologically-motivated and accessible for patients and families.

Enrolling by Invitation

Interested in participating?

Request Info

Key information

Conditions

Primary Progressive Aphasia Alzheimer Disease Aphasia Aphasia, Primary Progressive Brain Diseases Central Nervous System Diseases Communication Disorders Dementia Frontotemporal Dementia Frontotemporal Lobar Degeneration Language Disorders Mental Disorders Metabolic Diseases Nervous System Diseases Neurobehavioral Manifestations Neurocognitive Disorders Neurodegenerative Diseases Neurologic Manifestations Nutritional and Metabolic Diseases Pathological Conditions, Signs and Symptoms Proteostasis Deficiencies Signs and Symptoms Speech Disorders TDP-43 Proteinopathies Tauopathies

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Memory and Aging Center, University of California, San Francisco, San Francisco, California, United States

Loading trial locations.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Because PPA is a rare disease, the study aims to recruit all eligible participants with PPA who are referred to the Aphasia Research and Treatment Lab at the University of Texas (UT) Austin, the UT/Dell Medical School Department of Neurology, and the University of California at San Francisco (UCSF) Memory and Aging Center, as well as individuals with PPA from other clinical and research sites. The study will aim to include males, females, and transgender or non-binary individuals. Great efforts will be made to recruit participants from minority populations, subject to the limitation that participants need to be fluent speakers of English.

Inclusion criteria

  • Meets diagnostic criteria for PPA
  • Meets diagnostic criteria for a specific variant of PPA
  • Score of 20 or higher on the Mini-Mental State Examination
  • Adequate hearing and vision (with hearing or vision aids, if needed)
  • Has a study partner that can co-enroll in the study and attend pre-treatment training as well as continue to be present for weekly teleconference meetings
  • Able and willing to undergo MRI brain scan
  • Access to high speed internet

Exclusion criteria

  • Speech and language deficits better accounted for by another neurological disorder
  • Does not meet diagnostic criteria for a specific variant of PPA
  • Score of less than 20 on the Mini-Mental State Examination
  • Does not have a study partner who can co-enroll in the study
  • Contraindications for tDCS or MRI scan (History of seizures, head injury, craniotomy, skull surgery or fracture; History of severe or frequent migraines; Metallic implant in head or any metal in head; Pacemaker or cardioverter-defibrillator or any other stimulator; Chronic skin problems; Pregnancy)
  • History of stroke, epilepsy, or significant brain injury

Treatment and study plan

Remotely supervised Transcranial Direct Current Stimulation (RS-tDCS)

Device

tDCS is a type of non-invasive brain stimulation. 1.5 milliamp (mA) of current will be delivered via electrodes in saline-soaked sponges placed on the left side of the head and right upper arm. The stimulation will be delivered for 20 minutes, 5 times weekly, in the participant's home setting while the participant engages in computer-delivered speech-language training. Sessions are monitored by study personnel.

Remotely supervised sham tDCS (RS-sham-tDCS)

Device

tDCS is a type of non-invasive brain stimulation. During sham stimulation 1.5 milliamp (mA) of current will be delivered for a brief period and then turned off. Current will be delivered via electrodes in saline-soaked sponges placed on the left side of the head and right upper arm. Sham will be delivered for 20 minutes, 5 times weekly, in the participant's home setting while the participant engages in computer-delivered speech-language training. Sessions are monitored by study personnel.

Lexical Retrieval Training (LRT)

Behavioral

Participants work on producing spoken and written names of personally relevant target items using a self-cueing hierarchy. Treatment focuses on the use of strategies that capitalize on spared cognitive-linguistic abilities to support word retrieval. The participant completes two (one hour each) teletherapy sessions per week with a clinician plus 30 minutes of additional independent, computer-based practice exercises 3 times per week.

Video Implemented Script Training in Aphasia (VISTA)

Behavioral

Participants work on producing personally relevant scripts of 4-6 sentences in length. Length and complexity of scripts are individually tailored. The participant completes two (one hour each) teletherapy sessions per week with a clinician targeting clear and accurate script production, script memorization, and conversational usage of scripts. The participant completes 30 minutes of independent, computer-based practice 3 times per week, during which they speak in unison with a video/audio model of a healthy speaker clearly articulating the scripts.

Primary outcomes

  1. RS-LRT arm: Change in spoken naming

    Time frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)

    Change in percent correctly named trained/untrained pictures

  2. RS-VISTA arm: Change in script production accuracy

    Time frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)

    Change in percent correct, intelligible, scripted words produced for trained/untrained scripts

Secondary outcomes

  1. Change on Communication Confidence Rating Scale for Aphasia

    Time frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)

    Change on 10-item Likert-type self-rating scale evaluating communication confidence in different settings for persons with aphasia. A higher score indicates greater confidence.

  2. Change on Aphasia Impact Questionnaire

    Time frame: change from pre-treatment to one month and three months after onset of treatment in each phase (stimulation and sham)

    Change on Patient Reported Outcome Measure for persons with aphasia; characterizes activities, participation and emotional state/wellbeing using a 5-point pictorial rating scale. A higher score indicates greater impact of aphasia.

  3. Client Satisfaction Questionnaire

    Time frame: four months after treatment onset

    Likert-type scale measuring patient/client satisfaction with intervention. A higher score indicates greater satisfaction.

  4. Remotely-supervised Transcranial Direct Current Stimulation (RS-tDCS) Survey

    Time frame: four months after onset of treatment

    Likert type scale used to capture participants' perceptions regarding the acceptability and potential demand for remotely-supervised tDCS.

  5. Care Partner Survey

    Time frame: four months after onset of treatment

    Likert-type scale used to characterize care partners' perceptions of the benefits of speech-language treatment.

Sponsors and collaborators

Lead sponsor

University of Texas at Austin

Other

Collaborators

  • University of California, San Francisco

Registry information

Official study title

Telerehabilitation With Remotely-Supervised tDCS in Progressive Aphasia

Important dates

Study start
2023
Primary completion
2026
Study completion
2026
First posted
Jun 13, 2023
Registry last updated
Oct 8, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.