Aphasia is an acquired impairment of language secondary to neurological brain damage commonly seen in stroke, and is defined by impairment to communication through speech and language which can limit participation in work, family, and social settings. Standard aphasia treatment consists of behavioral therapy to restore or compensate for this impairment. Unfortunately, recovery is often incomplete with long-lasting residual communication deficits.
Enhancing the effects of behavioral therapy has long been a goal of aphasia researchers. Behavioral therapy takes advantage of neuroplasticity, the brain’s ability to change, and a recent direction has been to use adjuvants to behavioral treatment to enhance these effects, even in the chronic stage of recovery. The two studies reported here use transcranial direct current stimulation (tDCS) for this purpose. tDCS provides low-level current that can hyper- or depolarize cortical neurons, to build on the neuroplastic capacity of the brain. In the studies reported here, the anode was placed over the left primary motor cortex, with the cathode over the right supraorbital region. Study one investigated whether tDCS administered prior to robotic motor therapy (36 sessions over 12 weeks) resulted in improvements in speech/language outcome measures, comparing a group receiving active tDCS with a group receiving sham tDCS. This study revealed some overall differences on selected speech and language measures from pre-test to post-test, although tDCS condition did not affect performance. One important finding this work revealed was a possible cross domain synergy between motor and speech-language therapy, even when no speech therapy was provided.
Study two examined whether the timing of tDCS relative to a speech/language treatment affects treatment outcomes. This study compared participants receiving tDCS immediately preceding computerized aphasia treatment to participants receiving tDCS and treatment simultaneously. A crossover design was employed so each participant also received sham tDCS for comparison. No interaction was found between stimulation type and timing (preceding or during) of aphasia treatment. Accordingly, the results were somewhat equivocal with respect to the best approach. Further investigation with larger sample sizes, longer times between tDCS conditions or multiple consecutive sessions may help clarify the role of tDCS timing in aphasia treatment.
|Advisor:||Buchwald, Adam B.|
|Commitee:||Edwards, Dylan J., Reuterskiöld, Christina|
|School:||New York University|
|Department:||Communicative Sciences and Disorders|
|School Location:||United States -- New York|
|Source:||DAI-B 79/10(E), Dissertation Abstracts International|
|Subjects:||Neurosciences, Speech therapy, Occupational Therapy|
|Keywords:||"speech language pathology", "transcranial direct current stimulation", Aphasia, Neuromodulation, Rehabilitation, Stroke|
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