Transcranial direct current stimulation improves speech for those with subacute aphasia
Click Here to Manage Email Alerts
Key takeaways:
- Researchers analyzed 58 individuals with aphasia given transcranial direct current stimulation or sham treatment.
- Treatment resulted in speech improvement as soon as 1 week, with significant improvement at 5 weeks.
PHILADELPHIA — For those with aphasia, treatment with transcranial direct current stimulation resulted in speech improvement as early as 1 week, with significant results at 5 weeks compared with sham, according to research.
“People need about 100 hours of speech therapy to see real gains and that is really not an efficient usage of anyone’s time,” Melissa D. Stockbridge, PhD, research associate and speech therapist at Johns Hopkins University School of Medicine, told Healio at the American Neurological Association annual meeting. “We look at a lot of adjuvants to try and make therapy better.”
Stockbridge and colleagues sought to assess efficacy of anodal transcranial direct current stimulation (tDCS) augmented language therapy for improving outcomes in subacute aphasia.
Their single-center, randomized, double-blind, sham-controlled efficacy trial included 58 right-handed English speakers with aphasia less than 3 months after left hemisphere ischemic stroke, randomized 1:1 to receive either 20 minutes of tDCS (n=30) or sham-tDCS (n=28) during 15 sets of 45-minute sessions of naming treatment. Participants were assessed at intervals of 1, 5, and 20 weeks after the final treatment session.
The primary outcome for the study was measured improvement on a 175-item picture naming test from pre-treatment to 1 week following treatment, with secondary outcomes of conversational improvement and better overall quality of life.
According to results, baseline characteristics were similar between treatment and sham cohorts with respect to age, education, sex, and time since stroke onset.
In modified intent-to-treat analysis — including only those who participated in at least one treatment session — adjusted mean change from baseline to 1 week post treatment was 22.3 items (95% CI: 13.5, 31.2) for tDCS and 18.5 (9.6, 27.4) for sham.
However, the researchers found higher variability in the subacute phase, as those in the treatment group showed greater improvements in discourse and content when prompted to describe a picture at all timepoints, reaching significance at 5 weeks post-therapy.
Descriptive powers in those with tDCS were more efficient, resulting in significant differences at both 5 and 20 weeks post-treatment, when efficiency in the sham group decreased; conversely, quality of life was not impacted by treatment.
“Now that we have newer technology that does not have the safety concerns the older tech did, we see many different ways in which we see nice gains,” Stockbridge told Healio. “[Transcranial direct current stimulation] isn’t just making you a little bit better for the same amount of therapy, it’s helping you generalize those skills to be more applicable in your social life.”