Duncan E Susan, Nakkawita Surani G
Department of Communication Sciences and Disorders, Louisiana State University, Baton Rouge, Louisiana, USA.
Ann Indian Acad Neurol. 2020 Sep;23(Suppl 2):S102-S108. doi: 10.4103/aian.AIAN_540_20. Epub 2020 Sep 25.
Transcranial direct current stimulation (tDCS) is a safe, portable, and inexpensive form of noninvasive brain stimulation that appears to augment the effects of concurrent therapy. However, several methodological issues in existing studies distance tDCS from current clinical practice. In this study, we offered (and administered) tDCS to individuals seeking typical behavioral aphasia therapy on an outpatient basis.
We approached clients (n = 10) planning to receive standard aphasia therapy at a university clinic. Following a brief description of tDCS, we offered to provide stimulation during their therapy. Those interested and without contraindications participated in a double-blind, sham-controlled crossover study of tDCS paired with speech-language therapy provided twice weekly. Participants received active (2 mA) or sham tDCS during two eight-week therapy phases (separated by ten weeks) with the anode over Broca's area and the cathode on the contralateral forehead. Stimulation was provided for the first 20 minutes of each one-hour session. Prior to and following each phase, participants were video recorded telling the Cinderella narrative. Recordings were transcribed and analyzed for correct information units (CIUs).
Seven individuals (70%) were interested in and eligible for tDCS. Data from four participants who completed the study indicated a large effect size favoring active over sham tDCS (Cohen's = 1.32). The participant with the most severe deficits did not benefit from therapy in either condition.
There is potential for tDCS to enhance meaningful communication outcomes in standard clinical practice. Further investigation is needed to replicate findings and determine individual characteristics predictive of treatment response.
经颅直流电刺激（tDCS）是一种安全、便携且廉价的非侵入性脑刺激形式，似乎可以增强同步治疗的效果。然而，现有研究中的几个方法学问题使tDCS与当前临床实践存在差距。在本研究中，我们为寻求门诊典型行为性失语症治疗的个体提供（并实施）了tDCS。
我们联系了计划在大学诊所接受标准失语症治疗的客户（n = 10）。在简要介绍tDCS后，我们提出在他们治疗期间提供刺激。那些感兴趣且无禁忌症的人参加了一项双盲、假刺激对照的交叉研究，该研究将tDCS与每周两次的言语语言治疗相结合。参与者在两个为期八周的治疗阶段（相隔十周）接受有源（2 mA）或假tDCS，阳极置于布洛卡区上方，阴极置于对侧前额。在每个一小时疗程的前20分钟提供刺激。在每个阶段之前和之后，对参与者讲述灰姑娘故事的过程进行录像。对录像进行转录并分析正确信息单元（CIU）。
七个人（70%）对tDCS感兴趣且符合条件。来自四名完成研究的参与者的数据表明，与假tDCS相比，有源tDCS的效应量较大（科恩d = 1.32）。在两种情况下，缺陷最严重的参与者都没有从治疗中受益。
在标准临床实践中，tDCS有增强有意义沟通结果的潜力。需要进一步研究以重复研究结果并确定预测治疗反应的个体特征。
