Data_Sheet_1_Left Shifting of Language Related Activity Induced by Bihemispheric tDCS in Postacute Aphasia Following Stroke.docx

Both anodal transcranial direct current stimulation (tDCS) of the left IFG and cathodal stimulation of the right IFG were shown to improve rehabilitation of stroke patients with Broca’s aphasia. The study aimed at assessing the impact of a bihemispheric IFG stimulation compared to sham on postacute non-fluent aphasia. Twelve patients with non-fluent aphasia were included at least 4 weeks following cerebral stroke. Ten daily sessions of 2 mA bihemispheric verum or sham tDCS (anode on left IFG and cathode on right IFG) were performed concomitantly with individual language therapy in a double-blinded randomized controlled study with parallel group design. Language functions [i.e., communication (ANELT), picture naming and the Aachen aphasia test (AAT)] were assessed up to 1 month following tDCS. The picture naming task significantly improved (increased number of nouns) at the end of the tDCS procedure in the verum but not sham group. Improvements in the picture naming task and the communication task of the AAT at 4 weeks after tDCS procedure were only seen in the verum group. In patients with postacute cerebral stroke, repeated sessions of tDCS applied on both IFG concomitantly with language therapy were able to induce immediate effects on picture naming presumably due to an early left shift of language-associated function that maintained for 4 weeks. Effects on clinically relevant communicative abilities are likely.

左侧额下回（Inferior Frontal Gyrus, IFG）的阳极经颅直流电刺激（transcranial direct current stimulation, tDCS）与右侧额下回的阴极刺激均被证实可改善布洛卡失语症（Broca’s aphasia）脑卒中患者的康复效果。本研究旨在对比双侧额下回刺激与假刺激对急性后期非流利型失语症的影响。本研究共纳入12例脑卒中（cerebral stroke）发病至少4周后的非流利型失语症患者，采用平行组设计（parallel group design）的双盲随机对照试验方案，将患者随机分为两组，所有受试者在接受个体化语言治疗的同时，每日接受1次刺激，共完成10次2 mA双侧真实或假tDCS刺激（左侧额下回放置阳极、右侧额下回放置阴极）。在tDCS治疗结束后长达1个月的时间内，对受试者的语言功能[即交流能力（ANELT）、图片命名能力及亚琛失语症测验（Aachen aphasia test, AAT）]进行评估。结果显示，真实刺激组在tDCS疗程结束时的图片命名任务（名词产出数量）显著提升，而假刺激组未出现此类变化；在tDCS治疗结束后4周时，仅真实刺激组的图片命名任务与亚琛失语症测验的交流能力项出现改善。对于急性后期脑卒中患者，联合语言治疗的双侧额下回重复tDCS刺激可对图片命名能力产生即时改善效果，该效果可能源于语言相关功能的早期左侧偏倚转移，且该效应可维持4周；该疗法有望对临床相关的交流能力产生积极影响。