Elodie Guillouët1,2, Mélanie Cogné3, Elisabeth Saverot4, Nicolas Roche1,5, Pascale Pradat-Diehl6, Agnès Weill-Chounlamountry6, Vanessa Ramel6, Catherine Taratte4, Anne-Gaëlle Lachasse4, Jean-Arthur Haulot4, Isabelle Vaugier7, Frédéric Barbot7, Philippe Azouvi1,2, Sophie Charveriat1,2. 1. Rehabilitation Unit, Raymond Poincaré Hospital, Garches 92380, France. 2. EA4047, HANDIReSP, Versailles Saint-Quentin University, Versailles 78180, France. 3. Rehabilitation Unit, University Hospital, Rennes 35000, France. 4. Rehabilitation Unit, MGEN, Maisons-Laffitte 78600, France. 5. INSERM Unit 1179, Team 3, Technologies and Innovative Therapies Applied to Neuromuscular Diseases, UVSQ, CIC 429, Physiology-Functional Testing Ward, AP-HP, Raymond Poincaré Teaching Hospital, Garches 92380, France. 6. Rehabilitation Unit, hôpital Pitié-Salpêtrière, AP-HP, Paris 75013, France. 7. Inserm, Centre d'Investigation Clinique 1429, AP-HP, Raymond Poincaré hospital, Garches 92380, France.
Abstract
OBJECTIVE: Aphasia recovery depends on neural reorganization, which can be enhanced by speech-language therapy and noninvasive brain stimulation. Several studies suggested that transcranial direct current stimulation (tDCS) associated with speech-language therapy may improve verbal performance evaluated by analytic tests, but none focused on spontaneous speech. We explored the effect of bihemispheric tDCS on spontaneous speech in patients with poststroke aphasia. METHODS: In this multicentric controlled randomized cross-over double-blind study, we included 10 patients with poststroke aphasia (4 had aphasia >6 months and 6 with aphasia <6 months). We combined the sessions of speech-language therapy and bihemispheric tDCS (2 mA, 20 min). After three baseline speech evaluations (1/week), two different conditions were randomly consecutively proposed: active and sham tDCS over 3 weeks with 1 week of washout in between. The main outcome measure was the number of different nouns used in 2 min to answer the question "what is your job." RESULTS: There was no significant difference between conditions concerning the main outcome measure (p = .47) nor in the number of verbs, adjectives, adverbs, pronouns, repetitions, blank ideas, ideas, utterances with grammatical errors or paraphasias used. Other cognitive functions (verbal working memory, neglect, or verbal fluency) were not significantly improved in the tDCS group. No adverse events occurred. CONCLUSION: Our results differed from previous studies using tDCS to improve naming in patients with poststroke aphasia possibly due to bihemispheric stimulation, rarely used previously. The duration of the rehabilitation period was short given the linguistic complexity of the measure. This negative result should be confirmed by larger studies with ecological measures.
RCT Entities:
OBJECTIVE: Aphasia recovery depends on neural reorganization, which can be enhanced by speech-language therapy and noninvasive brain stimulation. Several studies suggested that transcranial direct current stimulation (tDCS) associated with speech-language therapy may improve verbal performance evaluated by analytic tests, but none focused on spontaneous speech. We explored the effect of bihemispheric tDCS on spontaneous speech in patients with poststroke aphasia. METHODS: In this multicentric controlled randomized cross-over double-blind study, we included 10 patients with poststroke aphasia (4 had aphasia >6 months and 6 with aphasia <6 months). We combined the sessions of speech-language therapy and bihemispheric tDCS (2 mA, 20 min). After three baseline speech evaluations (1/week), two different conditions were randomly consecutively proposed: active and sham tDCS over 3 weeks with 1 week of washout in between. The main outcome measure was the number of different nouns used in 2 min to answer the question "what is your job." RESULTS: There was no significant difference between conditions concerning the main outcome measure (p = .47) nor in the number of verbs, adjectives, adverbs, pronouns, repetitions, blank ideas, ideas, utterances with grammatical errors or paraphasias used. Other cognitive functions (verbal working memory, neglect, or verbal fluency) were not significantly improved in the tDCS group. No adverse events occurred. CONCLUSION: Our results differed from previous studies using tDCS to improve naming in patients with poststroke aphasia possibly due to bihemispheric stimulation, rarely used previously. The duration of the rehabilitation period was short given the linguistic complexity of the measure. This negative result should be confirmed by larger studies with ecological measures.