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. 2024;38(12):1895-1915.
doi: 10.1080/02687038.2024.2328874. Epub 2024 Mar 14.

Cerebellar tDCS Enhances Functional Communication Skills in Chronic Aphasia

Ji Hyun Kim  1 , Sarah Cust  1 , Becky Lammers  1 , Shannon M Sheppard  2   3 , Lynsey M Keator  4 , Donna C Tippett  1   2   5 , Argye E Hillis  1   2   6 , Rajani Sebastian  1
Affiliations

Cerebellar tDCS Enhances Functional Communication Skills in Chronic Aphasia

Ji Hyun Kim et al. Aphasiology. 2024.

Abstract

Background: 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.

Aims: To investigate whether cerebellar tDCS combined with computerized aphasia treatment improves functional communication skills in individuals with chronic aphasia.

Methods and procedures: 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.

Outcomes and results: 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.

Conclusions: 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.

Keywords: Aphasia; Cerebellar tDCS; Functional Communication; Language Therapy; Stroke.

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Conflict of interest statement

Disclosure Statement The authors report there are no competing interests to declare.

Figures

Figure 1.
Figure 1.
Participant flow diagram; Tx: Treatment; Ax: Assessment; 2W: 2 weeks; 2M: 2 months.
Figure 2.
Figure 2.
Overall Qualitative Dimension of Communication (QDC) mean score across the four time points. Error bars show standard deviations.
Figure 3.
Figure 3.
Spaghetti plots showing individual data points for the Qualitative Dimensions of Communication (QDC) scores across the four timepoints. Mean value is indicated by the red line. Blue line indicates data for Participant P3. Purple line indicates data for Participant 19. Participant 3 and Participant 19 represent participants who had baseline Boston Diagnostic Aphasia Examination (BDAE) score of 1.
Figure 4.
Figure 4.
Overall Communication Independence (CI) mean score across the four time points. Error bars show standard deviations.
Figure 5.
Figure 5.
Spaghetti plots showing individual data points for the Communication Independence (CI) scores across the four timepoints. Mean value is indicated by the red line. Blue line indicates data for Participant P3. Purple line indicates data for Participant 19. Participant 3 and Participant 19 represent participants who had baseline Boston Diagnostic Aphasia Examination (BDAE) score of 1.
See this image and copyright information in PMC

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