Article Text
Abstract
Background Language impairment (aphasia) is a common neurological deficit after strokes. For individuals with chronic aphasia (beyond 6 months after the stroke), language improvements with speech therapy (ST) are often limited. Transcranial direct current stimulation (tDCS) is a promising approach to complement language recovery but interindividual variability in treatment response is common after tDCS, suggesting a possible relationship between tDCS and type of linguistic impairment (aphasia type).
Methods This current study is a subgroup analysis of a randomised controlled phase II futility design clinical trial on tDCS in chronic post-stroke aphasia. All participants received ST coupled with tDCS (n=31) vs sham tDCS (n=39). Confrontation naming was tested at baseline, and 1, 4, and 24 weeks post-treatment.
Results Broca’s aphasia was associated with maximal adjunctive benefit of tDCS, with an average improvement of 10 additional named items with tDCS+ST compared with ST alone at 4 weeks post-treatment. In comparison, tDCS was not associated with significant benefits for other aphasia types F(1)=4.23, p=0.04. Among participants with Broca’s aphasia, preservation of the perilesional posterior inferior temporal cortex was associated with higher treatment benefit (R=0.35, p=0.03).
Conclusions These results indicate that adjuvant tDCS can enhance ST to treat naming in Broca’s aphasia, and this may guide intervention approaches in future studies.
- APHASIA
- STROKE
- ELECTRICAL STIMULATION
- SPEECH
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Footnotes
Contributors LB: conceptualisation, formal analysis, writing-original draft. CR: conceptualisation, writing-review and editing. RR: writing-review and editing. SS: writing-review and editing. MSG: conceptualisation, writing-review and editing, funding acquisition. JF: conceptualisation, writing-review and editing, funding acquisition. LD is the overall guarantor of this study.
Disclaimer The study was funded by National Institute on Deafness and Other Communication Disorders (DC011739 - JF and DC01421 - LB) .
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.