Kim Ji Hyun, Cust Sarah, Lammers Becky, Sheppard Shannon M, Keator Lynsey M, Tippett Donna C, Hillis Argye E, Sebastian Rajani
Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.
Aphasiology. 2024;38(12):1895-1915. doi: 10.1080/02687038.2024.2328874. Epub 2024 Mar 14.
Transcranial direct current stimulation (tDCS) has emerged as a possible neuromodulatory tool to augment language therapy in post-stroke aphasia. However, there is limited information on whether tDCS may help to improve everyday functional communication.
To investigate whether cerebellar tDCS combined with computerized aphasia treatment improves functional communication skills in individuals with chronic aphasia.
In a randomized, double-blind, sham-controlled, within-subject crossover study, participants received 15 sessions of anodal (n=14) or cathodal (n=14) cerebellar tDCS plus computerized aphasia treatment then sham plus computerized aphasia treatment, or the opposite order. Linear mixed-effects regression models were performed to evaluate (1) the effect of tDCS treatment on change in functional communication skills on the two dimensions of the American Speech-Language-Hearing Association Functional Assessment of Communication Skills for Adults (ASHA-FACS): Communication Independence (CI) scale and Qualitative Dimension of Communication (QDC) scale, and (2) the relationship between functional communication skills and trained and untrained naming abilities.
The results showed significant tDCS-induced gains for the overall QDC mean score, but not for the overall CI mean score. Cerebellar stimulation was more effective than sham for the overall QDC mean score immediately post-treatment, 2-weeks post-treatment and 2-months post-treatment. Follow up analysis separated by group showed that the change in the overall QDC mean score (combining both phases) were similar in participants receiving anodal or cathodal stimulation. We also found a significant linear association between ASHA-FACS overall CI mean change scores and trained and untrained naming change scores for the tDCS condition but not sham.
Our study provides preliminary evidence that cerebellar tDCS coupled with computerized aphasia treatment has the potential to improve the overall qualitative dimensions of functional communication skills in individuals with chronic aphasia.
经颅直流电刺激（tDCS）已成为一种可能的神经调节工具，用于增强中风后失语症的语言治疗。然而，关于tDCS是否有助于改善日常功能交流的信息有限。
研究小脑tDCS联合计算机化失语症治疗是否能改善慢性失语症患者的功能交流技能。
在一项随机、双盲、假刺激对照的受试者内交叉研究中，参与者接受15次阳极（n = 14）或阴极（n = 14）小脑tDCS加计算机化失语症治疗，然后接受假刺激加计算机化失语症治疗，或相反顺序。采用线性混合效应回归模型评估：（1）tDCS治疗对美国言语语言听力协会成人沟通技能功能评估（ASHA - FACS）两个维度（沟通独立性（CI）量表和沟通质量维度（QDC）量表）上功能交流技能变化的影响；（2）功能交流技能与训练和未训练的命名能力之间的关系。
结果显示，tDCS显著提高了QDC总分，但未提高CI总分。在治疗后即刻、治疗后2周和治疗后2个月，小脑刺激对QDC总分的改善比假刺激更有效。按组进行的随访分析表明，接受阳极或阴极刺激的参与者在QDC总分（两个阶段合并）上的变化相似。我们还发现，在tDCS条件下，ASHA - FACS总体CI平均变化得分与训练和未训练的命名变化得分之间存在显著的线性关联，而在假刺激条件下则不存在。
我们的研究提供了初步证据，表明小脑tDCS联合计算机化失语症治疗有可能改善慢性失语症患者功能交流技能的整体质量维度。
