TY - JOUR
T1 - Transcranial Direct-Current Stimulation in Subacute Aphasia
T2 - A Randomized Controlled Trial
AU - Stockbridge, Melissa D.
AU - Elm, Jordan
AU - Breining, Bonnie L.
AU - Tippett, Donna C.
AU - Sebastian, Rajani
AU - Cassarly, Christy
AU - Teklehaimanot, Abeba
AU - Spell, Leigh Ann
AU - Sheppard, Shannon M.
AU - Vitti, Emilia
AU - Ruch, Kristina
AU - Goldberg, Emily B.
AU - Kelly, Catherine
AU - Keator, Lynsey M.
AU - Fridriksson, Julius
AU - Hillis, Argye E.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Background: Transcranial direct-current stimulation (tDCS) is a promising adjunct to therapy for chronic aphasia. Methods: This single-center, randomized, double-blind, sham-controlled efficacy trial tested the hypothesis that anodal tDCS augments language therapy in subacute aphasia. Secondarily, we compared the effect of tDCS on discourse measures and quality of life and compared the effects on naming to previous findings in chronic stroke. Right-handed English speakers with aphasia <3 months after left hemisphere ischemic stroke were included, unless they had prior neurological or psychiatric disease or injury or were taking certain medications (34 excluded; final sample, 58). Participants were randomized 1:1, controlling for age, aphasia type, and severity, to receive 20 minutes of tDCS (1 mA) or sham-tDCS in addition to fifteen 45-minute sessions of naming treatment (plus standard care). The primary outcome variable was change in naming accuracy of untrained pictures pretreatment to 1-week posttreatment. Results: Baseline characteristics were similar between the tDCS (N=30) and sham (N=28) groups: patients were 65 years old, 53% male, and 2 months from stroke onset on average. In intent-to-treat analysis, the adjusted mean change from baseline to 1-week posttreatment in picture naming was 22.3 (95% CI, 13.5-31.2) for tDCS and 18.5 (9.6-27.4) for sham and was not significantly different. Content and efficiency of picture description improved more with tDCS than sham. Groups did not differ in quality of life improvement. No patients were withdrawn due to adverse events. Conclusions: tDCS did not improve recovery of picture naming but did improve recovery of discourse. Discourse skills are critical to participation. Future research should examine tDCS in a larger sample with richer functional outcomes.
AB - Background: Transcranial direct-current stimulation (tDCS) is a promising adjunct to therapy for chronic aphasia. Methods: This single-center, randomized, double-blind, sham-controlled efficacy trial tested the hypothesis that anodal tDCS augments language therapy in subacute aphasia. Secondarily, we compared the effect of tDCS on discourse measures and quality of life and compared the effects on naming to previous findings in chronic stroke. Right-handed English speakers with aphasia <3 months after left hemisphere ischemic stroke were included, unless they had prior neurological or psychiatric disease or injury or were taking certain medications (34 excluded; final sample, 58). Participants were randomized 1:1, controlling for age, aphasia type, and severity, to receive 20 minutes of tDCS (1 mA) or sham-tDCS in addition to fifteen 45-minute sessions of naming treatment (plus standard care). The primary outcome variable was change in naming accuracy of untrained pictures pretreatment to 1-week posttreatment. Results: Baseline characteristics were similar between the tDCS (N=30) and sham (N=28) groups: patients were 65 years old, 53% male, and 2 months from stroke onset on average. In intent-to-treat analysis, the adjusted mean change from baseline to 1-week posttreatment in picture naming was 22.3 (95% CI, 13.5-31.2) for tDCS and 18.5 (9.6-27.4) for sham and was not significantly different. Content and efficiency of picture description improved more with tDCS than sham. Groups did not differ in quality of life improvement. No patients were withdrawn due to adverse events. Conclusions: tDCS did not improve recovery of picture naming but did improve recovery of discourse. Discourse skills are critical to participation. Future research should examine tDCS in a larger sample with richer functional outcomes.
KW - aphasia
KW - electrical stimulation
KW - ischemic stroke
KW - language
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85151044161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85151044161&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.122.041557
DO - 10.1161/STROKEAHA.122.041557
M3 - Article
C2 - 36912144
AN - SCOPUS:85151044161
SN - 0039-2499
VL - 54
SP - 912
EP - 920
JO - Stroke
JF - Stroke
IS - 4
ER -