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Speech Analysis in ALS Patients

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ClinicalTrials.gov Identifier: NCT03868345
Recruitment Status : Unknown
Verified March 2019 by Jeremy Shefner, Barrow Neurological Institute.
Recruitment status was:  Recruiting
First Posted : March 11, 2019
Last Update Posted : March 11, 2019
Arizona State University
Information provided by (Responsible Party):
Jeremy Shefner, Barrow Neurological Institute

Brief Summary:
The purpose of this study is to find out if changes in speech can signal changes in the ability to think or remember. ALS patients with and without cognitive dysfunction will be followed for one year. Every three months, patients will undergo a series of cognitive and basic clinical outcomes tests. In addition, participants will take home a study-provided tablet on which they will complete weekly speech recording activities.

Condition or disease
ALS Amyotrophic Lateral Sclerosis Lou Gehrig Disease

Detailed Description:
Cognitive dysfunction is increasingly recognized as a core feature of amyotrophic lateral sclerosis (ALS). With appropriate testing, up to 50% of ALS patients will show evidence of frontotemporal dysfunction. Approximately 15% of patients meet formal criteria for frontotemporal dementia (FTD). Certain genetic forms of ALS (e.g., mutations in C9orf72) have even higher incidences of FTD. The presence of cognitive abnormalities is an adverse risk factor for survival, and its presence influences the ability of patients to cooperate in clinical trials. However, screening for frontotemporal abnormalities is frequently not performed in ALS clinics, and tools for diagnosing cognitive dysfunction are either time consuming or insensitive. Additionally, the frequently co-existing dysarthria complicates the assessment and may mask more subtle cognitive deficits. Once identified, ways of following progressive decline are also lacking. In an ongoing study, it has been shown that a sophisticated suite of speech and language analytics, developed by two of the investigators, can identify abnormalities in cognitively normal ALS patients without speech symptoms, and predict important functional changes outside of the speech domain. In this study, investigators will evaluate both speech and language in 50 patients with ALS both with and without symptoms of cognitive decline. This evaluation will be paired with two cognitive screening tools frequently used in ALS clinics, the ALS Cognitive Behavioral Screen (ALS-CBS) and the Montreal Cognitive Assessment (MoCA). The investigators will evaluate the extent to which speech and language deficits precede abnormalities as measured by the above tools and determine whether cognitive change can be accurately followed over 12 months using speech and language measures. It is hypothesized that speech and language measures will accurately and sensitively predict cognitive changes. If so, such measures may be very useful in future studies of potential therapeutic agents for ALS-FTD and other dementias.

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Study Type : Observational
Estimated Enrollment : 50 participants
Observational Model: Case-Control
Time Perspective: Prospective
Official Title: Speech Analysis in ALS Patients With and Without Cognitive Abnormalities: Evaluation of Sensitivity and Disease Progression
Actual Study Start Date : February 18, 2019
Estimated Primary Completion Date : August 31, 2019
Estimated Study Completion Date : December 31, 2019

Primary Outcome Measures :
  1. Change in ability on Speech and Language Battery [ Time Frame: Weekly recordings for one year ]
    Speech recordings made at home via a tablet using the " SpeechAssess" app.

Secondary Outcome Measures :
  1. Change in Montreal Cognitive Assessment [ Time Frame: Administered every three months for a year ]
    Cognitive screening tool

  2. Change in ALS Cognitive Behavioral Screen [ Time Frame: Administered every three months for a year ]
    Cognitive screening tool

  3. Change in Vital Capacity [ Time Frame: Administered every three months for a year ]
    Measure of breathing function

  4. Change in Negative Inspiratory Force [ Time Frame: Administered every three months for a year ]
    Measure of nasal inhale capabilities

  5. Change in "ALS Functional Rating Scale- Revised" [ Time Frame: Administered every three months for a year ]
    Questionnaire regarding daily functioning. Scale is measured from 0 to 48 points, with 48 being normal function and 0 indicating no functional abilities.

Biospecimen Retention:   Samples With DNA
Blood serum and blood plasma to be collected at three timepoints and retained in a biorepository.

Information from the National Library of Medicine

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Ages Eligible for Study:   21 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Patients with ALS, diagnosed as definite, probable, or possible ALS according to the modified El Escorial Criteria.

Inclusion Criteria:

  1. male or female, age 21 or older,
  2. diagnosed with definite, probable, or possible ALS according to the modified El Escorial Criteria,
  3. a score of 2 or greater on the speech question of the ALSFRS-R (i.e. speech is intelligible with occasional repetition),
  4. continuous internet access at home,
  5. willingness and medical ability to comply with scheduled visits and study procedures,
  6. ability to understand the purpose and risks of the study and provide signed and dated informed consent and authorization to use protected health information (PHI) in accordance with national and local subject privacy regulations,
  7. geographic accessibility to study site,
  8. for the 25 participants in Group 1, NO noted symptoms of frontotemporal cognitive dysfunction, and
  9. for the 25 participants in Group 2, MUST have cognitive symptoms as noted either by themselves or a caregiver.

Exclusion Criteria:

  1. unwilling or unable to comply with the requirements of this protocol, including the presence of any condition (physical, mental, or social) that is likely to affect the participant's ability to comply with the protocol, and
  2. any other reasons that, in the opinion of the PI, cause the candidate to be deemed unsuitable for entry into the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03868345

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Contact: Kerisa Shelton, PhD 602-406-6598 kerisa.shelton@dignityhealth.org

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United States, Arizona
Barrow Neurological Institute Recruiting
Phoenix, Arizona, United States, 85013
Contact: Jessie Duncan       Jessie.Duncan@DignityHealth.org   
Principal Investigator: Jeremy Shefner, MD         
Principal Investigator: Shafeeq Ladha, MD         
Sponsors and Collaborators
Barrow Neurological Institute
Arizona State University
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Responsible Party: Jeremy Shefner, Senior Vice President and Chair of Neurology, Barrow Neurological Institute
ClinicalTrials.gov Identifier: NCT03868345    
Other Study ID Numbers: BNI-ALS-003
First Posted: March 11, 2019    Key Record Dates
Last Update Posted: March 11, 2019
Last Verified: March 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Jeremy Shefner, Barrow Neurological Institute:
Cognitive dysfunction
Additional relevant MeSH terms:
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Motor Neuron Disease
Amyotrophic Lateral Sclerosis
Neurodegenerative Diseases
Nervous System Diseases
Neuromuscular Diseases
Spinal Cord Diseases
Central Nervous System Diseases
TDP-43 Proteinopathies
Proteostasis Deficiencies
Metabolic Diseases