Improved naming in patients with Broca’s aphasia with tDCS
Leonardo Bonilha, Chris Rorden, Rebecca Roth, Souvik Sen, Mark S. George, Julius Fridriksson
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.