Trial Outcomes & Findings for Bihemispheric Transcranial Direct Current Stimulation* on Speech Fluency (NCT NCT06278233)

NCT ID: NCT06278233

Last Updated: 2026-03-20

Results Overview

Percentage of syllables stuttered (%SS) was calculated as the number of stuttered syllables divided by the total number of syllables produced, multiplied by 100. Repetitions, prolongations, syllable repetitions, tense pauses and pre-speech sound blocking were defined as moments of disfluency. Whole-word and whole-phrase repetitions were included in the total syllable count but were not counted as stuttered syllables.Video recordings have been used in assessment procedures and pre-speech sound blocking identified by postural fixations. For both reading and speaking measures, the first 300 syllables were used for analysis (syllable count ranged from 139-490 syllables).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

36 participants

Primary outcome timeframe

immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

Results posted on

2026-03-20

Participant Flow

Participants were recruited between January 2024 and July 2024 at a university clinic. Recruitment was conducted through clinician referral and study advertisements placed at the clinic.

A total of 48 individuals who stutter were assessed for eligibility between January 2024 and July 2024. During the initial assessment session, four individuals showed no observable stuttering symptoms and were therefore excluded. One additional individual was excluded due to left-handedness (n = 1). Seven individuals withdrew from the study prior to enrollment. Thus, 36 participants met the eligibility criteria, provided informed consent, and were assigned to the study arms.

Participant milestones

Participant milestones
Measure
Transcranial Direct Current Stimulation Study Arm
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Overall Study
STARTED
19
17
Overall Study
COMPLETED
18
16
Overall Study
NOT COMPLETED
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Transcranial Direct Current Stimulation Study Arm
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Overall Study
Withdrawal by Subject
1
1

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
tDCS
n=19 Participants
Participants in the tDCS group received active transcranial direct current stimulation administered concurrently with a fluency intervention.
Sham
n=17 Participants
Participants in the sham group underwent a sham transcranial direct current stimulation procedure using the same electrode placement without active stimulation.
Total
n=36 Participants
Total of all reporting groups
Age, Categorical
<=18 years
1 Participants
n=19 Participants
0 Participants
n=17 Participants
1 Participants
n=36 Participants
Age, Categorical
Between 18 and 65 years
18 Participants
n=19 Participants
17 Participants
n=17 Participants
35 Participants
n=36 Participants
Age, Categorical
>=65 years
0 Participants
n=19 Participants
0 Participants
n=17 Participants
0 Participants
n=36 Participants
Age, Continuous
26.89 years
STANDARD_DEVIATION 6.85 • n=19 Participants
28.29 years
STANDARD_DEVIATION 8.49 • n=17 Participants
27.55 years
STANDARD_DEVIATION 7.59 • n=36 Participants
Sex: Female, Male
Female
4 Participants
n=19 Participants
1 Participants
n=17 Participants
5 Participants
n=36 Participants
Sex: Female, Male
Male
15 Participants
n=19 Participants
16 Participants
n=17 Participants
31 Participants
n=36 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
Turkey
19 participants
n=19 Participants
17 participants
n=17 Participants
36 participants
n=36 Participants
Passage Reading (%SS)
11.62 %syllables
STANDARD_DEVIATION 8.59 • n=19 Participants
7.34 %syllables
STANDARD_DEVIATION 10.11 • n=17 Participants
9.6 %syllables
STANDARD_DEVIATION 9.46 • n=36 Participants
Conversation (%SS)
11.49 %syllables
STANDARD_DEVIATION 10.16 • n=19 Participants
8.48 %syllables
STANDARD_DEVIATION 9.80 • n=17 Participants
10.07 %syllables
STANDARD_DEVIATION 9.96 • n=36 Participants
SSI-IV total
25.05 scores on a scale
STANDARD_DEVIATION 8.66 • n=19 Participants
20 scores on a scale
STANDARD_DEVIATION 9.69 • n=17 Participants
22.66 scores on a scale
STANDARD_DEVIATION 9.38 • n=36 Participants
Duration
3.03 Seconds (s)
STANDARD_DEVIATION 3.02 • n=19 Participants
1.65 Seconds (s)
STANDARD_DEVIATION 1.44 • n=17 Participants
2.38 Seconds (s)
STANDARD_DEVIATION 2.47 • n=36 Participants
Physical concomitants
4.47 Score (0-5 per item)
STANDARD_DEVIATION 3.59 • n=19 Participants
4.29 Score (0-5 per item)
STANDARD_DEVIATION 3.85 • n=17 Participants
4.38 Score (0-5 per item)
STANDARD_DEVIATION 3.66 • n=36 Participants
Speech naturalness
3.68 scores on scale
STANDARD_DEVIATION 2.18 • n=19 Participants
3.35 scores on scale
STANDARD_DEVIATION 2.14 • n=17 Participants
3.52 scores on scale
STANDARD_DEVIATION 2.14 • n=36 Participants
OASES-A Total Score
296.42 scores on scale
STANDARD_DEVIATION 39.02 • n=19 Participants
288.17 scores on scale
STANDARD_DEVIATION 64.10 • n=17 Participants
292.52 scores on scale
STANDARD_DEVIATION 51.76 • n=36 Participants
OASES-A General information
59.31 scores on a scale
STANDARD_DEVIATION 9.46 • n=19 Participants
53.47 scores on a scale
STANDARD_DEVIATION 9.55 • n=17 Participants
56.55 scores on a scale
STANDARD_DEVIATION 9.82 • n=36 Participants
OASES-A Reactions to stuttering
93 scores on a scale
STANDARD_DEVIATION 13.36 • n=19 Participants
94.17 scores on a scale
STANDARD_DEVIATION 23.76 • n=17 Participants
93.55 scores on a scale
STANDARD_DEVIATION 18.71 • n=36 Participants
OASES-A Communication in daily situation
68.52 scores on a scale
STANDARD_DEVIATION 12.55 • n=19 Participants
69.47 scores on a scale
STANDARD_DEVIATION 16.65 • n=17 Participants
68.97 scores on a scale
STANDARD_DEVIATION 14.42 • n=36 Participants
OASES-A Quality of life
75.57 scores on a scale
STANDARD_DEVIATION 17.68 • n=19 Participants
71.11 scores on a scale
STANDARD_DEVIATION 21.17 • n=17 Participants
73.47 scores on a scale
STANDARD_DEVIATION 19.25 • n=36 Participants

PRIMARY outcome

Timeframe: immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

Percentage of syllables stuttered (%SS) was calculated as the number of stuttered syllables divided by the total number of syllables produced, multiplied by 100. Repetitions, prolongations, syllable repetitions, tense pauses and pre-speech sound blocking were defined as moments of disfluency. Whole-word and whole-phrase repetitions were included in the total syllable count but were not counted as stuttered syllables.Video recordings have been used in assessment procedures and pre-speech sound blocking identified by postural fixations. For both reading and speaking measures, the first 300 syllables were used for analysis (syllable count ranged from 139-490 syllables).

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Stuttered Syllables in Passage Reading (Change in the Percentage of Stuttered Syllables After 5 Days of Intervention From Baseline)
-1.41 percentage of stuttered syllables
Standard Deviation 8.91
-0.81 percentage of stuttered syllables
Standard Deviation 2.44

PRIMARY outcome

Timeframe: immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

Percentage of syllables stuttered (%SS) was calculated as the number of stuttered syllables divided by the total number of syllables produced, multiplied by 100. Repetitions, prolongations, syllable repetitions, tense pauses and pre-speech sound blocking were defined as moments of disfluency. Whole-word and whole-phrase repetitions were included in the total syllable count but were not counted as stuttered syllables.Video recordings have been used in assessment procedures and pre-speech sound blocking identified by postural fixations. For both reading and speaking measures, the first 300 syllables were used for analysis (syllable count ranged from 139-490 syllables).

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Stuttered Syllables in Passage Reading (Change From Baseline in Percentage of Disfluent Syllables 1 Week After Intervention)
0.86 percentage of stuttered syllables
Standard Deviation 6.59
0.87 percentage of stuttered syllables
Standard Deviation 4.28

PRIMARY outcome

Timeframe: immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

Percentage of syllables stuttered (%SS) was calculated as the number of stuttered syllables divided by the total number of syllables produced, multiplied by 100. Repetitions, prolongations, syllable repetitions, tense pauses and pre-speech sound blocking were defined as moments of disfluency. Whole-word and whole-phrase repetitions were included in the total syllable count but were not counted as stuttered syllables.Video recordings have been used in assessment procedures and pre-speech sound blocking identified by postural fixations. For both reading and speaking measures, the first 300 syllables were used for analysis (syllable count ranged from 139-490 syllables).

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Stuttered Syllables in Conversation (Change in the Percentage of Stuttered Syllables After 5 Days of Intervention From Baseline)
-0.40 percentage of stuttered syllables
Standard Deviation 3.93
0.07 percentage of stuttered syllables
Standard Deviation 1.89

PRIMARY outcome

Timeframe: immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

Percentage of syllables stuttered (%SS) was calculated as the number of stuttered syllables divided by the total number of syllables produced, multiplied by 100. Repetitions, prolongations, syllable repetitions, tense pauses and pre-speech sound blocking were defined as moments of disfluency. Whole-word and whole-phrase repetitions were included in the total syllable count but were not counted as stuttered syllables.Video recordings have been used in assessment procedures and pre-speech sound blocking identified by postural fixations. For both reading and speaking measures, the first 300 syllables were used for analysis (syllable count ranged from 139-490 syllables).

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Stuttered Syllables in Conversation (Change From Baseline in Percentage of Disfluent Syllables 1 Week After Intervention)
-0.69 percentage of stuttered syllables
Standard Deviation 3.59
0.16 percentage of stuttered syllables
Standard Deviation 4.01

SECONDARY outcome

Timeframe: immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

The Stuttering Severity Instrument - Fourth Edition (SSI-4) is a standardized tool measuring stuttering severity based on three components: frequency of stuttering, duration of the three longest stuttering events, and physical concomitants. Each is converted to scaled scores-frequency and duration range from 2 to 18, and physical concomitants from 0 to 20-and summed to produce a Total Score ranging from 4 to 56, where higher scores indicate more severe stuttering. Speech naturalness is assessed separately on a 9-point scale (1 = highly natural, 9 = highly unnatural) and is not included in the Total Score. Scores are reported in scores on a scale.

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Change in Stuttering Severity Instrument (SSI-IV) Scores After 5 Days of Intervention From Baseline
-1.94 score on a scale
Standard Deviation 4.82
-1.76 score on a scale
Standard Deviation 3.35

SECONDARY outcome

Timeframe: immediately before and immediately after the stimulation on each day of the 5-day intervention, and at 1 week after the end of the intervention.

It measures stuttering severity in the following four areas of speech behavior: (1) frequency, (2) duration, (3) physical concomitants, and (4) naturalness of the individual's speech. Frequency is expressed in percent syllables stuttered and converted to scale scores of 2-18. Duration is timed to the nearest one tenth of a second and converted to scale scores of 2-18. The four types of Physical Concomitants (Distracting Sounds, Facial Grimaces, Head Movements, and Movements of the Extremities) are converted to scale scores of 0-20. Naturalness is ranked on a scale from 1 (Highly Natural Sound Speech) to 9 (Highly Unnatural Sound Speech). Overall naturalness is ranked at the discretion of the clinician. Scaled scores of Frequency, Duration, and Physical Concomitants are added together to derive a Total Score, Percentile Rank, and Severity Equivalent.

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Change From Baseline in Stuttering Severity Instrument (SSI-IV) Scores 1 Week After Intervention
-3.00 score on a scale
Standard Deviation 5.42
-2.06 score on a scale
Standard Deviation 3.60

SECONDARY outcome

Timeframe: baseline, after the 5-day stimulation and at the 1-week post-intervention time point

The Overall Assessment of the Speaker's Experience of Stuttering - Adult Version (OASES-A) is a self-assessment instrument that requires approximately 20 minutes to complete and is organized into four sections: General Information, Reactions to Stuttering, Communication in Daily Situations, and Quality of Life. It consists of 100 items scored on a 5-point Likert scale ranging from 1 to 5. For each item, higher scores indicate a greater negative impact of stuttering, while lower scores indicate less impact. Impact scores for each section range from a minimum of 20 (if the respondent answers 1 for every item) to a maximum of 100 (if the respondent answers 5 for every item). The total score ranges from 100 (minimum) to 500 (maximum), with higher scores indicating a greater negative impact of stuttering. Scores are reported as scores on a scale.

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Change in The Overall Assessment of the Speaker's Experience of Stuttering (OASES) Scores After 5 Days of Intervention From Baseline
-15.56 score on a scale
Standard Deviation 35.72
-8.53 score on a scale
Standard Deviation 41.13

SECONDARY outcome

Timeframe: baseline, after the 5-day stimulation and at the 1-week post-intervention time point

The Overall Assessment of the Speaker's Experience of Stuttering - Adult Version (OASES-A) is a self-assessment instrument that requires approximately 20 minutes to complete and is organized into four sections: General Information, Reactions to Stuttering, Communication in Daily Situations, and Quality of Life. It consists of 100 items scored on a 5-point Likert scale ranging from 1 to 5. For each item, higher scores indicate a greater negative impact of stuttering, while lower scores indicate less impact. Impact scores for each section range from a minimum of 20 (if the respondent answers 1 for every item) to a maximum of 100 (if the respondent answers 5 for every item). The total score ranges from 100 (minimum) to 500 (maximum), with higher scores indicating a greater negative impact of stuttering. Scores are reported as scores on a scale.

Outcome measures

Outcome measures
Measure
Transcranial Direct Current Stimulation Study Arm
n=19 Participants
For bi-hemispheric stimulation, the anode will be placed at the intersection of F7 and FC5 and the cathode will be placed at the intersection of F8 and FC6. For all stimulations, the stimulation will be increased for 15 seconds at a dosage of 1 mA (milliampere) for the entire 20 minute session duration and decreased for 15 seconds at the end of the stimulation. Transcranial direct current stimulation: TDCS involves applying a weak electrical current across the head through electrodes placed on the scalp and modulating the resting membrane potential of neurons in the underlying cortex.
Sham Stimulation Study Arm
n=17 Participants
In the sham condition, the same electrode placement will be used, during which the current will be increased for 15 seconds, kept at 1 mA for 15 seconds, decreased for 15 seconds and terminated, and the 20 minute session duration will be performed with 45 seconds of real stimulation accompanied by speech with a metronome.
Change From Baseline in The Overall Assessment of the Speaker's Experience of Stuttering (OASES) Scores 1 Week After Intervention
-14.72 score on a scale
Standard Deviation 25.57
-14.19 score on a scale
Standard Deviation 43.53

Adverse Events

Transcranial Direct Current Stimulation Study Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Sham Stimulation Study Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Slp. Feyzanur Ocak

Üsküdar University

Phone: 05313606661

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place