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Auditory Masking Effects on Speech Fluency in Aphasia and Apraxia of Speech

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ClinicalTrials.gov Identifier: NCT02094014
Recruitment Status : Completed
First Posted : March 21, 2014
Last Update Posted : May 12, 2016
Sponsor:
Collaborator:
National Institute on Deafness and Other Communication Disorders (NIDCD)
Information provided by (Responsible Party):
University of North Carolina, Chapel Hill

Tracking Information
First Submitted Date March 13, 2014
First Posted Date March 21, 2014
Last Update Posted Date May 12, 2016
Study Start Date March 2014
Actual Primary Completion Date December 2015   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures
 (submitted: March 20, 2014)
Disfluency duration change with masking noise [ Time Frame: 1 day of the study ]
Measured disfluency duration in sentences produced while listening to masking noise compared to speaking in quiet without noise.
Original Primary Outcome Measures Same as current
Change History
Current Secondary Outcome Measures
 (submitted: March 20, 2014)
  • Speech rate change with masking noise [ Time Frame: 1 day of the study ]
    Measured syllables per second in sentences produced while listening to masking noise compared to speaking in quiet without noise.
  • Speech sound accuracy change with masking noise [ Time Frame: 1 day of the study ]
    Measured speech sound accuracy in sentences produced while listening to masking noise compared to speaking in quiet without noise.
Original Secondary Outcome Measures Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title Auditory Masking Effects on Speech Fluency in Aphasia and Apraxia of Speech
Official Title Auditory Masking Effects on Speech Fluency in Aphasia and Apraxia of Speech
Brief Summary Impaired speech production is a major obstacle to full participation in life roles by stroke survivors with aphasia and apraxia of speech. The proposed study will demonstrate the short-term effects of auditory masking on speech disfluencies and identify individual factors that predict a positive response, enabling future work to develop auditory masking as a treatment adjuvant targeting long-term improvement in speech. Providing an additional treatment option for adults with aphasia and apraxia of speech will have the clear benefit of improving quality of life and allowing individuals to participate more actively in their health care decisions through improved communication.
Detailed Description The objective of this research is to test the short-term effects of listening to noise (i.e. auditory feedback masking) on speech fluency in stroke survivors with aphasia and apraxia of speech. People with nonfluent types of aphasia frequently have apraxia of speech, which affects the motor programming of speech movements, causing distortions, slow rate, and speech disfluencies that impede the forward flow of communication. Speaking while listening to noise (e.g. auditory masking) is known to reduce disfluencies and increase speech rate in people who stutter. This method has been tested in people with aphasia, resulting in positive effects on speech production for a subset of those tested. The investigators contend that individuals who have apraxia of speech in addition to aphasia are most likely to benefit from auditory masking, but most previous studies did not test participants for apraxia of speech. In addition, though masking is most likely to affect speech disfluencies, previous studies did not measures disfluencies. The proposed work has two specific aims. Aim 1 will determine the short-term effect of auditory masking, provided on a single day, on speech fluency in stroke survivors with aphasia and apraxia of speech. Aim 2 will identify individual factors that predict a positive response, including presence of apraxia of speech, lesion characteristics, and type of aphasia (e.g. Broca's, Wernicke's). Voxel-based lesion analysis techniques will be used to determine sites of lesion associated with positive and negative response to auditory masking. Completion of this study will remove barriers to studying auditory masking as a technique for clinical intervention, but also as a research tool for behavioral neuroscientists probing the speech motor control system in speakers with aphasia and apraxia of speech.
Study Type Observational
Study Design Observational Model: Case-Control
Time Perspective: Cross-Sectional
Target Follow-Up Duration Not Provided
Biospecimen Not Provided
Sampling Method Non-Probability Sample
Study Population Participants with aphasia (PWA) will be referred from existing referral sources (e.g. UNC Stroke registry, Triangle Aphasia Project), clinicians in the community, and the Carolina Data Warehouse for Health.
Condition
  • Apraxia of Speech
  • Aphasia
  • Cerebrovascular Accident
Intervention
  • Behavioral: Normal Auditory Feedback
    Participants will produce sentences under normal speaking conditions, able to hear their own speech.
  • Behavioral: Masked Auditory Feedback
    Participants will produce sentences while listening to speech-shaped noise at 85 decibels (sound pressure level) to mask ability to hear their own speech.
    Other Name: Masking Noise
  • Behavioral: Altered Auditory Feedback
    Participants will produce sentences while listening to their speech shifted up one octave and delayed.
    Other Name: Delayed and pitch-shifted feedback
Study Groups/Cohorts
  • Aphasic/Apraxic Participants

    The aphasic/apraxic participant group will include 30 adults who have had strokes affecting their ability to communicate verbally, broadly classified as aphasic and including individuals with and without apraxia of speech (AOS).

    Participants will speak under Masked Auditory Feedback, Altered Auditory Feedback, and Normal Auditory Feedback.

    Interventions:
    • Behavioral: Normal Auditory Feedback
    • Behavioral: Masked Auditory Feedback
    • Behavioral: Altered Auditory Feedback
  • Neurologically Healthy Participants

    The neurologically healthy participant group will include 15 adults with no history of stroke or developmental speech or language disorder.

    Participants will speak under Masked Auditory Feedback, Altered Auditory Feedback, and Normal Auditory Feedback.

    Interventions:
    • Behavioral: Normal Auditory Feedback
    • Behavioral: Masked Auditory Feedback
    • Behavioral: Altered Auditory Feedback
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status Completed
Actual Enrollment
 (submitted: May 10, 2016)
46
Original Estimated Enrollment
 (submitted: March 20, 2014)
45
Actual Study Completion Date December 2015
Actual Primary Completion Date December 2015   (Final data collection date for primary outcome measure)
Eligibility Criteria

Inclusion Criteria for Aphasic/Apraxic Participants:

  • Single left-hemisphere cerebrovascular accident
  • Speech errors are present, but participant is able to produce approximations of words or sentences by reading or repetition; < 90% and > 10% on Chapel Hill Multilingual Intelligibility Test (Haley, 2011)
  • Right-handed prior to stroke by report
  • Normal visual attention, acuity, and color vision
  • Pure-tone threshold <= 40 decibels in at least one ear

Exclusion Criteria for Aphasic/Apraxic Participants:

  • Predominating disorders of cognition or hearing (e.g. dementia, hearing impairment).
  • Presence of degenerative neurological illness (e.g. Parkinson's disease, amyotrophic lateral sclerosis, primary progressive aphasia).

Inclusion Criteria for Neurologically Healthy Participants:

  • Matched in age and sex to a participant with aphasia
  • score of 90% or higher on the single-word intelligibility test
  • Right-handed prior to stroke by report
  • Normal visual attention, acuity, and color vision
  • Pure-tone threshold <= 40 decibels in at least one ear

Exclusion Criteria for Neurologically Healthy Participants:

  • History of stroke
  • History of developmental speech or language disorder
Sex/Gender
Sexes Eligible for Study: All
Ages 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers Yes
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries United States
Removed Location Countries  
 
Administrative Information
NCT Number NCT02094014
Other Study ID Numbers 10-0503
R03DC011881 ( U.S. NIH Grant/Contract )
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement Not Provided
Responsible Party University of North Carolina, Chapel Hill
Study Sponsor University of North Carolina, Chapel Hill
Collaborators National Institute on Deafness and Other Communication Disorders (NIDCD)
Investigators
Principal Investigator: Adam Jacks, Ph.D. University of North Carolina, Chapel Hill
PRS Account University of North Carolina, Chapel Hill
Verification Date May 2016