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Article

Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial

1
Think + Speak Lab, Shirley Ryan AbilityLab, Chicago, IL 60611, USA
2
Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
3
Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA
4
Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
5
Department of Communication Sciences and Disorders, University of Northern Iowa, Cedar Falls, IA 50614, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paola Marangolo
Brain Sci. 2021, 11(3), 306; https://doi.org/10.3390/brainsci11030306
Received: 23 December 2020 / Revised: 22 February 2021 / Accepted: 25 February 2021 / Published: 28 February 2021
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. View Full-Text
Keywords: transcranial direct current stimulation (tDCS); aphasia; speech language therapy; noninvasive brain stimulation (NIBS); nonfluent; interhemispheric inhibition (IHI) transcranial direct current stimulation (tDCS); aphasia; speech language therapy; noninvasive brain stimulation (NIBS); nonfluent; interhemispheric inhibition (IHI)
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MDPI and ACS Style

Cherney, L.R.; Babbitt, E.M.; Wang, X.; Pitts, L.L. Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial. Brain Sci. 2021, 11, 306. https://doi.org/10.3390/brainsci11030306

AMA Style

Cherney LR, Babbitt EM, Wang X, Pitts LL. Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial. Brain Sciences. 2021; 11(3):306. https://doi.org/10.3390/brainsci11030306

Chicago/Turabian Style

Cherney, Leora R., Edna M. Babbitt, Xue Wang, and Laura L. Pitts. 2021. "Extended fMRI-Guided Anodal and Cathodal Transcranial Direct Current Stimulation Targeting Perilesional Areas in Post-Stroke Aphasia: A Pilot Randomized Clinical Trial" Brain Sciences 11, no. 3: 306. https://doi.org/10.3390/brainsci11030306

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