Sheppard Shannon M, Goldberg Emily B, Sebastian Rajani, Vitti Emilia, Ruch Kristina, Meier Erin L, Hillis Argye E
Department of Speech and Hearing Sciences, University of Washington, Seattle.
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.
Am J Speech Lang Pathol. 2025 Jan 7;34(1):155-173. doi: 10.1044/2024_AJSLP-24-00016. Epub 2024 Dec 12.
The purpose of the study was to evaluate Verb Network Strengthening Treatment (VNeST) paired with the transcranial direct current stimulation (tDCS) of the left inferior frontal gyrus, which was compared to VNeST paired with a sham stimulation in primary progressive aphasia (PPA).
A double-blind, within-subject, sham-controlled crossover design was used. Eight participants with PPA were enrolled. Participants were enrolled in two treatment phases, one with VNeST plus real tDCS and one with VNeST plus sham. Participants received fifteen 1-hr sessions of VNeST in each phase. Linear mixed-effects models were used to compare changes between baseline and two follow-up time points (1 week and 8 weeks posttreatment) in naming trained verbs, untrained verbs, and untrained nouns; sentence production and comprehension; and producing content units and complete utterances in discourse.
VNeST was effective for significantly improving naming trained verbs and producing more complete utterances in discourse at 1 week posttreatment in both tDCS and sham conditions. A significant tDCS advantage yielded generalization of treatment effects to untrained verbs (at 1 week and 8 weeks posttreatment), sentence production (at 1 week posttreatment), and sentence comprehension (at 8 weeks posttreatment). Untrained verb naming and sentence comprehension declined when VNeST was not augmented with tDCS.
Our findings provide emerging evidence that VNeST paired with tDCS can improve word finding, and other language abilities, in people with PPA. VNeST without neuromodulation can improve trained verb naming, but untrained verbs will likely decline faster when VNeST is not augmented with tDCS. Future research is required with a larger sample size to continue investigating the potential of treating word finding with VNeST and tDCS in PPA.
本研究旨在评估动词网络强化疗法（VNeST）与左侧额下回经颅直流电刺激（tDCS）相结合的效果，并将其与VNeST联合假刺激用于原发性进行性失语（PPA）的情况进行比较。
采用双盲、受试者内、假刺激对照的交叉设计。招募了8名PPA患者。参与者参与两个治疗阶段，一个阶段是VNeST加真正的tDCS，另一个阶段是VNeST加假刺激。每个阶段参与者接受15次每次1小时的VNeST治疗。使用线性混合效应模型比较基线与两个随访时间点（治疗后1周和8周）在命名训练过的动词、未训练的动词和未训练的名词方面的变化；句子生成和理解；以及在语篇中生成内容单元和完整话语的情况。
在tDCS和假刺激条件下，VNeST均能有效在治疗后1周显著改善命名训练过的动词，并在语篇中生成更完整的话语。tDCS具有显著优势，治疗效果可推广到未训练的动词（治疗后1周和8周）、句子生成（治疗后1周）和句子理解（治疗后8周）。当VNeST未辅以tDCS时，未训练动词的命名和句子理解能力下降。
我们的研究结果提供了新的证据，表明VNeST与tDCS相结合可以改善PPA患者的词汇查找及其他语言能力。未经神经调节的VNeST可以改善训练过的动词命名，但当VNeST未辅以tDCS时，未训练的动词可能会更快下降。未来需要更大样本量的研究来继续探究VNeST和tDCS治疗PPA中词汇查找问题的潜力。
