scholarly journals Delayed Auditory Feedback and Transcranial Direct Current Stimulation Treatment for the Enhancement of Speech Fluency in Adults Who Stutter: Protocol for a Randomized Controlled Trial

10.2196/16646 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e16646
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Background Stuttering is a complex speech disorder that affects speech fluency. Recently, it has been shown that noninvasive brain stimulation may be useful to enhance the results of fluency interventions in adults who stutter. Delayed auditory feedback (DAF) is a method to enhance speech fluency in individuals who stutter. Adjunctive interventions are warranted to enhance the efficacy of this intervention. Objective Individuals who stutter have pathological activation patterns in the primary and secondary auditory areas. Consequently, in this study, we hypothesize that stimulation of these areas might be promising as an adjunctive method to fluency training via DAF to enhance speech therapy success in individuals with a stutter. We will systematically test this hypothesis in this study. Methods This study is designed as a randomized, double-blind, sham-controlled clinical trial. All participants will receive DAF. The intervention group will additionally receive real transcranial direct current stimulation, while the control group will be exposed to sham stimulation. The assignment of the participants to one of these groups will be randomized. Before starting the treatment program, 2 preintervention assessments will be conducted to determine the severity of stuttering. Once these assessments are completed, each subject will participate in 6 intervention sessions. Postintervention assessments will be carried out immediately and 1 week after the last intervention session. Subsequently, to explore the long-term stability of the treatment results, the outcome parameters will be obtained in follow-up assessments 6 weeks after the treatment. The primary outcome measurement—the percentage of stuttered syllables—will be calculated in pre-, post-, and follow-up assessments; the secondary outcomes will be the scores of the following questionnaires: the Stuttering Severity Instrument–Fourth Edition and the Overall Assessment of the Speaker’s Experience of Stuttering. Results This protocol was funded in 2019 and approved by the Research Ethics Committee of the Iran University of Medical Sciences in June 2019. Data collection started in October 2019. As of February 2020, we have enrolled 30 participants. We expect data analysis to be completed in April 2020, and results will be published in summer 2020. Conclusions We anticipate that this study will show an adjunctive effect of transcranial direct current stimulation, when combined with DAF, on stuttering. This should include not only a reduction in the percentage of stuttered syllables but also improved physical behavior and quality of life in adults who stutter. Trial Registration ClinicalTrial.gov NCT03990168; https://clinicaltrials.gov/ct2/show/NCT03990168 International Registered Report Identifier (IRRID) DERR1-10.2196/16646

scholarly journals Delayed Auditory Feedback and Transcranial Direct Current Stimulation Treatment for the Enhancement of Speech Fluency in Adults Who Stutter: Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

BACKGROUND Stuttering is a complex speech disorder that affects speech fluency. Recently, it has been shown that noninvasive brain stimulation may be useful to enhance the results of fluency interventions in adults who stutter. Delayed auditory feedback (DAF) is a method to enhance speech fluency in individuals who stutter. Adjunctive interventions are warranted to enhance the efficacy of this intervention. OBJECTIVE Individuals who stutter have pathological activation patterns in the primary and secondary auditory areas. Consequently, in this study, we hypothesize that stimulation of these areas might be promising as an adjunctive method to fluency training via DAF to enhance speech therapy success in individuals with a stutter. We will systematically test this hypothesis in this study. METHODS This study is designed as a randomized, double-blind, sham-controlled clinical trial. All participants will receive DAF. The intervention group will additionally receive real transcranial direct current stimulation, while the control group will be exposed to sham stimulation. The assignment of the participants to one of these groups will be randomized. Before starting the treatment program, 2 preintervention assessments will be conducted to determine the severity of stuttering. Once these assessments are completed, each subject will participate in 6 intervention sessions. Postintervention assessments will be carried out immediately and 1 week after the last intervention session. Subsequently, to explore the long-term stability of the treatment results, the outcome parameters will be obtained in follow-up assessments 6 weeks after the treatment. The primary outcome measurement—the percentage of stuttered syllables—will be calculated in pre-, post-, and follow-up assessments; the secondary outcomes will be the scores of the following questionnaires: the Stuttering Severity Instrument–Fourth Edition and the Overall Assessment of the Speaker’s Experience of Stuttering. RESULTS This protocol was funded in 2019 and approved by the Research Ethics Committee of the Iran University of Medical Sciences in June 2019. Data collection started in October 2019. As of February 2020, we have enrolled 30 participants. We expect data analysis to be completed in April 2020, and results will be published in summer 2020. CONCLUSIONS We anticipate that this study will show an adjunctive effect of transcranial direct current stimulation, when combined with DAF, on stuttering. This should include not only a reduction in the percentage of stuttered syllables but also improved physical behavior and quality of life in adults who stutter. CLINICALTRIAL ClinicalTrial.gov NCT03990168; https://clinicaltrials.gov/ct2/show/NCT03990168 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/16646

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that intervention caused improvements of speech fluency become more stable.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed before intervention as baseline, as well as immediately, one week and six weeks after intervention.Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two patient two groups after intervention.Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that the combined intervention cause improvements in speech fluency.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated to the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed as the baseline, before intervention as well as immediately, one week and six weeks after intervention. Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two groups after intervention. Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

scholarly journals Safety and Feasibility of Transcranial Direct Current Stimulation in Pediatric Hemiparesis: Randomized Controlled Preliminary Study

2015 ◽  
Vol 95 (3) ◽  
pp. 337-349 ◽  
Author(s):  
Bernadette T. Gillick ◽  
Tim Feyma ◽  
Jeremiah Menk ◽  
Michelle Usset ◽  
Amy Vaith ◽  
...  
Keyword(s):  
Adverse Events ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Hand Function ◽  
Behavioral Data ◽  
Control Group ◽  
Double Blind ◽  
Direct Current Stimulation ◽  
Preliminary Study

Background Transcranial direct current stimulation (tDCS) is a form of noninvasive brain stimulation that has shown improved adult stroke outcomes. Applying tDCS in children with congenital hemiparesis has not yet been explored. Objective The primary objective of this study was to explore the safety and feasibility of single-session tDCS through an adverse events profile and symptom assessment within a double-blind, randomized placebo-controlled preliminary study in children with congenital hemiparesis. A secondary objective was to assess the stability of hand and cognitive function. Design A double-blind, randomized placebo-controlled pretest/posttest/follow-up study was conducted. Setting The study was conducted in a university pediatric research laboratory. Participants Thirteen children, ages 7 to 18 years, with congenital hemiparesis participated. Measurements Adverse events/safety assessment and hand function were measured. Intervention Participants were randomly assigned to either an intervention group or a control group, with safety and functional assessments at pretest, at posttest on the same day, and at a 1-week follow-up session. An intervention of 10 minutes of 0.7 mA tDCS was applied to bilateral primary motor cortices. The tDCS intervention was considered safe if there was no individual decline of 25% or group decline of 2 standard deviations for motor evoked potentials (MEPs) and behavioral data and no report of adverse events. Results No major adverse events were found, including no seizures. Two participants did not complete the study due to lack of MEP and discomfort. For the 11 participants who completed the study, group differences in MEPs and behavioral data did not exceed 2 standard deviations in those who received the tDCS (n=5) and those in the control group (n=6). The study was completed without the need for stopping per medical monitor and biostatisticial analysis. Limitations A limitation of the study was the small sample size, with data available for 11 participants. Conclusions Based on the results of this study, tDCS appears to be safe, feasible, and well tolerated in most children with hemiparesis. Future investigations of serial sessions of tDCS in conjunction with rehabilitation in pediatric hemiparesis are indicated to explore the benefit of a synergistic approach to improving hand function.

scholarly journals A RANDOMIZED CONTROLLED TRIAL ON EFFECT OF TRANSCRANIAL DIRECT CURRENT STIMULATION AND COGNITIVE BEHAVIOURAL THERAPY ON HEADACHE RELATED DISABILITY AND IMPACT OF HEADACHE ON LIFE OF MIGRAINEURS

2017 ◽  
Vol 16 (4) ◽  
pp. 141-148
Author(s):  
Manoj Malik ◽  
◽  
Shailendra Kumar Singh ◽  
Narkeesh Arumugam ◽  
◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Public Health Problem ◽  
Control Group ◽  
Post Intervention ◽  
Pharmacological Management ◽  
Direct Current Stimulation

Introduction. Migraine is a public health problem of great impact on patients as well as society. Migraine prophylaxis requires daily administration of anti-migraine compounds whether or not migraine attack is occurring. All the drugs used for migraine prevention have potential and often relevant adverse effect or contraindications. The purpose of present study was to evaluate efficacy of non-pharmacological management techniques like Cognitive Behavioral Therapy (CBT) and Transcranial Direct Current Stimulation (TDCS) on headache related disability and impact of headaches on life of patients suffering from migraine. Methodology. Sixty six subjects fulfilling the selection criteria were recruited for the study. They were randomly allocated into three groups. Group one received TDCS, Group 2 received CBT, and Group 3 (Control group) did not receive any treatment. Participants were asked to fi ll HDI and HIT 6 prior to start of intervention, post intervention and at follow up. Collected data was analyzed for statistical significance. Results. We found a significant decrease in HDI and HIT 6 scores in TDCS and CBT Group as compared to Control Group. This improvement was maintained during follow up period. Conclusion. TDCS and CBT can be effective in decreasing headache related disability and impact of headache on daily life in patients suffering from Migraine.

scholarly journals Effects of Transcranial Direct Current Stimulation Combined with Rehabilitation for Upper Limb Function after Ischemic Stroke in Rehabilitation Center, Bach Mai Hospital

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Bui Thi Hoai Thu ◽  
Luong Tuan Khanh ◽  
Le Thi Luyen
Keyword(s):  
Ischemic Stroke ◽  
Upper Limb ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Barthel Index ◽  
Intervention Group ◽  
Control Group ◽  
Limb Function ◽  
Direct Current Stimulation ◽  
Upper Limb Function

Objective: evaluate effects of transcranial direct current stimulation (tdcs) combined with rehabilitation for upper limb function after ischemic. methods: the interventional study with the control group to evaluate effects of tdcs in upper limb function recovery programs in 20 ischemic stroke inpatients of the intervention group and 20 inpatients of the control group at the center rehabilitation of bach mai hospital from january 2020 to june 2020. results: the intervention group has the limb function on the arat scale increased 14,7%; and independence in daily activities according to barthel index improved 41 points and was higher than the control group, the barthel index change is statistically significant with p <0.05. there is no case recorded the side effects. conclusions: tdcs is safe and effective in recovering upper limb function and improving quality of life in ischemic patients. Keyword: Ischemic stroke, upper limb function, transcranial direct current stimulation. References  

scholarly journals Effect of Short Period Simultaneous Stimulation of Transcranial Direct Current Stimulation (tDCS) on Occupational Therapy to Motor Function of Upper Extremity in Stroke Subject

2020 ◽  
Vol 2 (2) ◽  
pp. 66
Author(s):  
Adrian Utomo ◽  
I Lukitra Wardhani ◽  
I Putu Alit Pawana
Keyword(s):  
Occupational Therapy ◽  
Ischaemic Stroke ◽  
Upper Extremity ◽  
Motor Function ◽  
Stroke Patient ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Intervention Group ◽  
Control Group ◽  
Direct Current Stimulation

ABSTRACTObjective: Stroke could cause upper extremity motor function disturbances that may affect to quality of life. The affected brain has an ability to get recovery by neuroplasticity process. Transcranial direct current stimulation (tDCS) is a non-invasive modality that could induce brain neuroplasticity Goal: To determine the effect of tDCS stimulation on recovery of upper extremity motor function in subacute ischaemic stroke patient. Methods: 22 stroke patients included in inclusion criteria, divided into 2 groups, control group and intervention group. Control group had occupational therapy for 5 days consecutively and intervention group had occupational therapy and tDCS stimulation simultaneously for 5 days consecutively. Upper extremity motor function was evaluated with Fugl-Meyer Assessment (FMA) before and after the treatment. Results: Significant improvement of FMA score on control group (p=0,018) and intervention group (p=0,000). Comparison of the result after the treatment revealed that the intervention group showed more significant improvement in FMA score than the control group (p=0,000). Conclusion: Application of tDCS stimulation on occupational therapy simultaneously showed improvement of upper extremity motor function in subacute ischaemic stroke patient better than only occupational therapy. Key Words: Transcranial direct current stimulation, occupational therapy, Fugl-Meyer Assessment, upper extremity motor function, subacute ischemic stroke.

scholarly journals Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter

2018 ◽  
Author(s):  
Jennifer Chesters ◽  
Riikka Möttönen ◽  
Kate E. Watkins
Keyword(s):  
Frontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Neurodevelopmental Disorder ◽  
Anodal Tdcs ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Fluency Intervention ◽  
Inferior Frontal Cortex ◽  
Adults Who Stutter

Stuttering is a neurodevelopmental disorder affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are required, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation (tDCS). Here, we report the results of the first trial investigating whether tDCS can improve speech fluency in adults who stutter. Thirty adult men who stutter completed a randomized, double-blind, controlled trial of anodal tDCS over left inferior frontal cortex. Fifteen men received 20 minutes of 1-mA tDCS on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 men received the same speech fluency intervention with sham stimulation. We predicted that applying anodal tDCS to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the five-day intervention, and at 1 and 6 weeks after the end of the intervention. TDCS combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument – version 4) also showed significant improvement in the group receiving tDCS compared with the sham group, in whom fluency was unchanged from baseline. We conclude that tDCS combined with behavioural fluency intervention has the capacity to improve fluency in adults who stutter. tDCS thereby offers a potentially useful adjunct to future speech therapy interventions for this population, for whom therapy outcomes are currently limited.

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