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Improved naming in patients with Broca’s aphasia with tDCS
  1. Leonardo Bonilha1,
  2. Chris Rorden2,
  3. Rebecca Roth3,
  4. Souvik Sen1,
  5. Mark S George4,
  6. Julius Fridriksson5
  1. 1 Neurology, University of South Carolina School of Medicine, Columbia, South Carolina, USA
  2. 2 Psychology, University of South Carolina, Columbia, South Carolina, USA
  3. 3 Neurology, Emory University, Atlanta, Georgia, USA
  4. 4 Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA
  5. 5 Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA
  1. Correspondence to Dr Leonardo Bonilha, Department of Neurology, University of South Carolina, Columbia, SC, USA; leonardo.bonilha{at}emory.edu

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.