Faculty Publications

Extended Fmri-Guided Anodal And Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas In Post-Stroke Aphasia: A Pilot Randomized Clinical Trial

Document Type

Article

Keywords

Aphasia, Interhemispheric inhibition (IHI), Non-invasive brain stimulation (NIBS), nonfluent, Speech language therapy, Transcranial direct current stimulation (tDCS)

Journal/Book/Conference Title

Brain Sciences

Volume

11

Issue

3

First Page

1

Last Page

24

Abstract

Transcranial direct current stimulation (tDCS) may enhance speech and language treatment (SLT) for stroke survivors with aphasia; however, to date, there is no standard protocol for the application of tDCS in post-stroke aphasia. We explored the safety and efficacy of fMRI-guided tDCS on functional language and cortical activity when delivered to the lesioned left hemisphere concurrently with SLT across an extended, six-week treatment period. Twelve persons with chronic, nonfluent aphasia following a single left-hemisphere stroke participated in the three-arm (anodal vs. cathodal vs. sham) single-blind, parallel, pilot trial. No serious adverse events occurred during 30 treatment sessions or in the following six weeks. All groups demonstrated functional language gains following intensive treatment; however, active tDCS resulted in greater gains in standardized, probe, and caregiver-reported measures of functional language than sham. Evidence declaring one polarity as superior for inducing language recovery was mixed. However, cathodal stimulation to the lesioned left hemisphere, expected to have a down-regulating effect, resulted in increased areas of cortical activation across both hemispheres, and specifically perilesionally. Generalization of these preliminary findings is limited; however, results are nevertheless compelling that tDCS combined with SLT can be safely applied across extended durations, with the potential to enhance functional language and cortical activation for persons with aphasia.

Department

Department of Communication Sciences and Disorders

Original Publication Date

3-1-2021

DOI of published version

10.3390/brainsci11030306

Repository

UNI ScholarWorks, Rod Library, University of Northern Iowa

Language

en

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