Stroke Clinical Trial
Official title:
Assessment of the Safety and Effectiveness of Targeted Sub-Threshold Epidural Cortical Stimulation Delivered Concurrent With Speech-Language Rehabilitation to Enhance Recovery in Patients Suffering From Broca's Aphasia, Following a Stroke.
The primary objective of this feasibility study is to evaluate the safety and effectiveness of targeted sub-threshold epidural cortical stimulation delivered concurrent with speech-language rehabilitation activities to enhance recovery in study subjects suffering from Broca's aphasia (the inability to speak or to organize the muscular movements for speech), following a stroke.
Stroke is the third leading cause of death and the most common cause of disability in the
United States. According to the American Stroke Association, the prevalence of stroke in the
U.S. is approximately 4.8 million with approximately 700,000 additional strokes occurring
annually. Approximately 150,000 to 250,000 stroke survivors becoming severely and
permanently disabled each year.
A common neurological deficit among these stroke survivors, and thus a substantial
contributor to post-stroke disability is Broca's aphasia, a condition in which the patient
is unable to speak normally, as they cannot effectively organize the muscular movements
required for speech. Broca's aphasia is often referred to as "non-fluent" or "motor" aphasia
as essentially the patient has impaired motor abilities for speech and thus, become
non-fluent in speech/language. The loss of speech for these patients is extremely
debilitating and has enormous social and economic impact to the quality of life for these
patients. Presently, the only treatment available for patients with Broca's aphasia is
speech-language rehabilitation. However, with rehabilitation only, many patients achieve a
less than satisfactory improvement in speech-language function and thus, are left with
significant disability.
Since Broca's aphasia is largely due to an impairment of language-related motor function,
researchers and clinicians believe it is very likely that cortical stimulation in
conjunction with speech rehabilitation may also enhance recovery of language motor function
for Broca's aphasia patients. This study proposes to evaluate the safety and effectiveness
of such cortical electrical stimulation in study subjects with Broca's aphasia after stroke,
delivered concurrent with speech-language rehabilitation.
In addition to evaluating changes from baseline level, safety and efficacy measures will be
compared to patients who undergo the same speech-language rehabilitation activities but
without cortical stimulation. The two study groups will be compared to determine the degree
to which the aphasia can be improved beyond rehabilitation alone by epidural stimulation of
a targeted cortical region.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind, Primary Purpose: Treatment
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