Home-Based Transcranial Direct Current Stimulation in Primary Progressive Aphasia: A Pilot Study

Abstract

Background: This study aims to determine (a) if home-based anodal transcranial direct current stimulation (a-tDCS) delivered to the left supramarginal gyrus (SMG) coupled with verbal short-term memory/working memory (vSTM/WM) treatment ("RAM", short for "Repeat After Me") is more effective than sham-tDCS in improving vSTM/WM in patients with primary progressive aphasia (PPA), and (b) whether tDCS effects generalize to other language and cognitive abilities.

Methods: Seven PPA participants received home-based a-tDCS and sham-tDCS coupled with RAM treatment in separate conditions in a double-blind design. The treatment task required participants to repeat word spans comprising semantically and phonologically unrelated words in the same and reverse order. The evaluation of treatment effects was carried out using the same tasks as in the treatment but with different items (near-transfer effects) and tasks that were not directly related to the treatment (far-transfer effects).

Results: A-tDCS showed (a) a significant effect in improving vSTM abilities, measured by word span backward, and (b) a generalization of this effect to other language abilities, namely, spelling (both real words and pseudowords) and learning (retention and delayed recall).

Conclusions: These preliminary results indicate that vSTM/WM intervention can improve performance in trained vSTM/WM tasks in patients with PPA, especially when augmented with home-based tDCS over the left SMG.

Keywords: home-based tDCS; primary progressive aphasia; transcranial direct current stimulation; verbal short-term memory; working memory.

Figure 1

Timeline of the study protocol: before- and after-therapy evaluations performed in-person at the research facility, with 2 weeks (10 sessions) of tDCS/Sham stimulation paired with RAM (“Repeat After Me”) therapy in-between evaluations, performed remotely, from home.