Antoni Valero-Cabré1, Clara Sanches2, Juliette Godard2, Oriane Fracchia2, Bruno Dubois2, Richard Levy2, Dennis Q Truong2, Marom Bikson2, Marc Teichmann1. 1. From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY. marc.teichmann@psl.aphp.fr antoni.valerocabre@icm-institute.org. 2. From Groupe de Dynamiques Cérébrales, Plasticité et Rééducation (A.V.-C., C.S., J.G., O.F.) and Frontlab Team (A.V.-C., C.S., J.G., O.F., B.D., R.L., M.T.), Institut du Cerveau et de la Moelle Epinière (ICM), INSERM 1127, CNRS, UMR 7225 and Sorbonne Université (SO), Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation (A.V.-C.), Boston University School of Medicine, MA; Cognitive Neuroscience and Information Technology Research Program (A.V.-C.), Open University of Catalonia (UOC), Barcelona, Spain; Department of Neurology (B.D., R.L., M.T.), National Reference Center for "PPA and Rare Dementias," Pitié Salpêtrière Hospital, AP-HP, Paris, France; and Neural Engineering Laboratory, Department of Biomedical Engineering (D.Q.T., M.B.), the City College of City University of New York, NY.
Abstract
OBJECTIVE: To explore whether transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) can improve language capacities in patients with progressive supranuclear palsy (PSP). METHODS: We used a sham-controlled double-blind crossover design to assess the efficiency of tDCS over the DLPFC in a cohort of 12 patients with PSP. In 3 separate sessions, we evaluated the ability to boost the left DLPFC via left-anodal (excitatory) and right-cathodal (inhibitory) tDCS, while comparing them to sham tDCS. Tasks assessing lexical access (letter fluency task) and semantic access (category judgment task) were applied immediately before and after the tDCS sessions to provide a marker of potential language modulation. RESULTS: The comparison with healthy controls showed that patients with PSP were impaired on both tasks at baseline. Contrasting poststimulation vs prestimulation performance across tDCS conditions revealed language improvement in the category judgment task following right-cathodal tDCS, and in the letter fluency task following left-anodal tDCS. A computational finite element model of current distribution corroborated the intended effect of left-anodal and right-cathodal tDCS on the targeted DLPFC. CONCLUSIONS: Our results demonstrate tDCS-driven language improvement in PSP. They provide proof-of-concept for the use of tDCS in PSP and set the stage for future multiday stimulation regimens, which might lead to longer-lasting therapeutic effects promoted by neuroplasticity. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with PSP, tDCS over theDLPFC improves performance in some language tasks.
RCT Entities:
OBJECTIVE: To explore whether transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) can improve language capacities in patients with progressive supranuclear palsy (PSP). METHODS: We used a sham-controlled double-blind crossover design to assess the efficiency of tDCS over the DLPFC in a cohort of 12 patients with PSP. In 3 separate sessions, we evaluated the ability to boost the left DLPFC via left-anodal (excitatory) and right-cathodal (inhibitory) tDCS, while comparing them to sham tDCS. Tasks assessing lexical access (letter fluency task) and semantic access (category judgment task) were applied immediately before and after the tDCS sessions to provide a marker of potential language modulation. RESULTS: The comparison with healthy controls showed that patients with PSP were impaired on both tasks at baseline. Contrasting poststimulation vs prestimulation performance across tDCS conditions revealed language improvement in the category judgment task following right-cathodal tDCS, and in the letter fluency task following left-anodal tDCS. A computational finite element model of current distribution corroborated the intended effect of left-anodal and right-cathodal tDCS on the targeted DLPFC. CONCLUSIONS: Our results demonstrate tDCS-driven language improvement in PSP. They provide proof-of-concept for the use of tDCS in PSP and set the stage for future multiday stimulation regimens, which might lead to longer-lasting therapeutic effects promoted by neuroplasticity. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for patients with PSP, tDCS over the DLPFC improves performance in some language tasks.
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