Understanding two types of progressive speech disorders

The Neurobiology of Two Distinct Types of Progressive Apraxia of Speech

This study is trying to tell apart two types of speech disorders in people with progressive speech problems to better understand their causes and what they might mean for future health.

Quick facts

• Study type: Observational
• Enrollment: 47 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Mayo Clinic (Academic / other)
• Drugs / interventions: chemotherapy
• Locations: 1 site (Rochester, Minnesota)
• Trial ID: NCT03313011 on ClinicalTrials.gov

What this trial studies

This study aims to identify and differentiate between two distinct types of Progressive Apraxia of Speech (PAOS) using clinical imaging and testing. It focuses on patients with progressive speech impairment, examining their speech patterns to determine if they exhibit Phonetic PAOS or Prosodic PAOS. The research seeks to understand the neurobiological underpinnings of these speech disorders, which can be early indicators of neurodegenerative diseases. By analyzing the characteristics of these speech patterns, the study hopes to provide insights into their prognostic implications.

Who should consider this trial

Good fit: Ideal candidates are adults over 18 who speak English and have a documented progressive impairment of speech with evidence of Apraxia of Speech.

Not a fit: Patients whose speech is not intelligible enough for a confident diagnosis or those with other concurrent illnesses affecting speech will not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to better diagnosis and management strategies for patients with progressive speech disorders.

How similar studies have performed: Other studies have explored aspects of apraxia of speech, but this specific differentiation of PAOS types is a novel approach.

Eligibility criteria

Inclusion Criteria:

1. All enrolled patients must be over the age of 18, speak English as their primary language, and have an informant who can provide an independent evaluation of functioning.
2. Each new patient must present with a chief complaint of progressive impairment of speech and must have evidence of AOS documented by a speech-language pathologist during routine clinical evaluation.
3. At study entry, all patients must have speech sufficiently intelligible for a confident diagnosis of AOS, dysarthria, and/or aphasia, and for acoustic analysis.

Exclusion Criteria:

1. Any patient whose speech is not intelligible enough for confident speech-language diagnosis will be excluded from the study.
2. All patients with concurrent illnesses that could account for speech deficits (e.g., traumatic brain injury, strokes, developmental syndromes), and patients meeting criteria for another neurodegenerative disease (e.g., Alzheimer's type dementia57), will be excluded.
3. Patients with aphasia or dysarthria who do not have PAOS, or whose aphasia or dysarthria at study entry is more severe than PAOS, will be excluded.
4. All women who are pregnant, or post-partum and breast-feeding, will be excluded as they are unable to undergo the required imaging. All women who can become pregnant must have a pregnancy test no more than 48 hours before the DaTscan.
5. Patients will also be excluded if MRI is contraindicated (e.g., metal in head, cardiac pace maker), if there is severe claustrophobia, if there are conditions that may confound brain imaging studies (e.g. structural abnormalities, including subdural hematoma or intracranial neoplasm), or if they are medically unstable or are on medications that might affect brain structure or metabolism (e.g. chemotherapy).
6. Patients will be excluded if they do not have an informant, or do not consent to the research.

Where this trial is running

Rochester, Minnesota

• Mayo Clinic — Rochester, Minnesota, United States (Recruiting)

Study contacts

• Principal investigator: Keith Josephs, MD — Mayo Clinic
• Study coordinator: Sarah M Boland, CCRP

Conditions Apraxia of Speech; Non-fluent Aphasia; Primary Progressive Aphasia; Primary Progressive Nonfluent Aphasia; apraxia of speech