Translational treatment of aphasia combining neuromodulation and behavioral intervention for lexical retrieval: implications from a single case study

Abstract

Background: Transcranial direct current stimulation (tDCS), a non-invasive method of brain stimulation, is an adjunctive research-therapy for aphasia. The concept supporting translational application of tDCS is that brain plasticity, facilitated by language intervention, can be enhanced by non-invasive brain stimulation. This study combined tDCS with an ecologically focused behavioral approach that involved training nouns and verbs in sentences.Method: Participant: A 43-year-old, right-handed male with fluent-anomic aphasia who sustained a single-left-hemisphere-temporal-parietal stroke was recruited.Treatment: Instrumentation included the Soterix Medical 1 × 1 Device. Anodal tDCS was applied over Broca’s area. Behavioral materials included: sentence production, naming in the sentence context, and implementation of a social-conversational-discourse treatment.Design and Procedures: The independent variable of this crossover case-study was tDCS, and the dependent variables were language and quality-of-life measures. In each session the subject received language treatment with the first 20 minutes additionally including tDCS.Results: Performance in naming nouns and verbs in single words and sentences were obtained. Verb production in the sentence context increased after active anodal tDCS and speech-language treatment.Conclusion: Aphasia treatment that involves naming in the sentence context in conjunction with translational application of tDCS may be a promising approach for language-recovery post stroke.

Cognitive behavioural therapy for visual hallucinations: an investigation using a single-case experimental design

“…This method is based on the principals of non-overlapping data across phases, and was chosen as it is a robust method of analysis to control for baseline trend (Parker et al ., 2011). Tau-U values between 0.2 and 0.5 represent a small effect size; values between 0.5 and 0.8 are moderate to large (Galletta and Vogel-Eyny, 2015). An online calculator was used to determine Tau-U (Vannest et al ., 2011).…”

Impact of Combined Transcranial Direct Current Stimulation and Speech-language Therapy on Spontaneous Speech in Aphasia: A Randomized Controlled Double-blind Study

“…The two main naming tasks found in the literature are naming of nouns and naming of verbs. The share is larger for nouns naming because of its use when authors use standardized language evaluation batteries (Baker et al, 2010;Branscheidt et al, 2018;Campana et al, 2015;Cherney et al, 2013;Fiori et al, 2011;Flöel et al, 2011;Fridriksson et al, 2018;Galletta et al, 2015;Kang et al, 2011;Lee et al, 2011;Marangolo et al, 2013aMarangolo et al, , 2013bMarangolo et al, , 2014Marangolo et al, , 2016Marangolo et al, , 2017Marangolo et al, , 2018Meinzer et al, 2016;Monti et al, 2008;Pestalozzi et al, 2018;Polanowska et al, 2013;Sandars et al, 2017;Santos et al, 2013Santos et al, , 2017Shah-Basak et al, 2015;Spielmann et al, 2018;Vestito et al, 2014;Vines et al, 2011;Volpato et al, 2013;You et al, 2011). Furthermore, generalization has been measured in several studies: some of them assessed the transfer of competence on an untrained task (Lee et al, 2011;Marangolo et al, 2011Marangolo et al, , 2013aMarangolo et al, , 2013bMarangolo et al, , 2014Marangolo et al, , 2016Marangolo et al, , 2017Manenti et al, 2015;…”

“…All language levels come into play in the spontaneous discourse of the patients with poststroke aphasia (Chapman & Ulatowska, 1989), which is why current studies tend towards a mixed analysis that combines both sides (Falconer & Antonucci, 2012;Marini, Andreetta, del Tin, & Carlomagno, 2011;Pritchard, Hilari, Cocks, & Dipper, 2018). Until now, only few studies using tDCS explored more functional activities such as spontaneous speech, but the selected tasks remained mostly semidirected tasks of image or video clip descriptions (Campana et al, 2015;Galletta & Vogel-Eyny, 2015;Marangolo et al, 2013aMarangolo et al, , 2014Norise, Sacchetti, & Hamilton, 2017). Marangolo et al (2014), in a double-blind randomized controlled study including eight patients receiving 10 days of rehabilitation with a monohemispheric tDCS stimulation of 1 mA during 20 min, studied the effects of a conversational therapy on a video clip description task.…”

Transcranial Direct-Current Stimulation as an Adjunct to Verb Network Strengthening Treatment in Post-stroke Chronic Aphasia: A Double-Blinded Randomized Feasibility Study

“…Non-invasive brain stimulation techniques like anodal tDCS which increases spontaneous cortical activity through subthreshold depolarization (12,13) and promotes neuroplasticity (14,15) may be effective in enhancing aphasia treatment effects in stroke survivors (16)(17)(18)(19). People with poststroke chronic aphasia have experienced improvement in naming accuracy and speed after application of anodal tDCS (16,20,21).…”