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

Published online by Cambridge University Press:  27 January 2020

Elodie Guillouët ,
Mélanie Cogné ,
Elisabeth Saverot ,
Nicolas Roche ,
Pascale Pradat-Diehl ,
Agnès Weill-Chounlamountry ,
Vanessa Ramel ,
Catherine Taratte ,
Anne-Gaëlle Lachasse  and
Jean-Arthur Haulot
...Show all authors
Elodie Guillouët
Affiliation:
Rehabilitation Unit, Raymond Poincaré Hospital, Garches 92380, France EA4047, HANDIReSP, Versailles Saint-Quentin University, Versailles 78180, France
Mélanie Cogné
Affiliation:
Rehabilitation Unit, University Hospital, Rennes 35000, France
Elisabeth Saverot
Affiliation:
Rehabilitation Unit, MGEN, Maisons-Laffitte 78600, France
Nicolas Roche
Affiliation:
Rehabilitation Unit, Raymond Poincaré Hospital, Garches 92380, France INSERM Unit 1179, Team 3, Technologies and Innovative Therapies Applied to Neuromuscular Diseases, UVSQ, CIC 429, Physiology-Functional Testing Ward, AP-HP, Raymond Poincaré Teaching Hospital, Garches 92380, France
Pascale Pradat-Diehl
Affiliation:
Rehabilitation Unit, hôpital Pitié-Salpêtrière, AP–HP, Paris 75013, France
Agnès Weill-Chounlamountry
Affiliation:
Rehabilitation Unit, hôpital Pitié-Salpêtrière, AP–HP, Paris 75013, France
Vanessa Ramel
Affiliation:
Rehabilitation Unit, hôpital Pitié-Salpêtrière, AP–HP, Paris 75013, France
Catherine Taratte
Affiliation:
Rehabilitation Unit, MGEN, Maisons-Laffitte 78600, France
Anne-Gaëlle Lachasse
Affiliation:
Rehabilitation Unit, MGEN, Maisons-Laffitte 78600, France
Jean-Arthur Haulot
Affiliation:
Rehabilitation Unit, MGEN, Maisons-Laffitte 78600, France
Isabelle Vaugier
Affiliation:
Inserm, Centre d’Investigation Clinique 1429, AP-HP, Raymond Poincaré hospital, Garches 92380, France
Frédéric Barbot
Affiliation:
Inserm, Centre d’Investigation Clinique 1429, AP-HP, Raymond Poincaré hospital, Garches 92380, France
Philippe Azouvi*
Affiliation:
Rehabilitation Unit, Raymond Poincaré Hospital, Garches 92380, France EA4047, HANDIReSP, Versailles Saint-Quentin University, Versailles 78180, France
Sophie Charveriat
Affiliation:
Rehabilitation Unit, Raymond Poincaré Hospital, Garches 92380, France EA4047, HANDIReSP, Versailles Saint-Quentin University, Versailles 78180, France
*
*Correspondence and reprint requests to: Philippe Azouvi, Rehabilitation Medicine Unit, Raymond Poincaré Hospital, 104 boulevard Raymond Poincaré, 92380 Garches, France. E-mail: philippe.azouvi@aphp.fr
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Abstract

Objective:

Aphasia recovery depends on neural reorganization, which can be enhanced by speech-language therapy and noninvasive brain stimulation. Several studies suggested that transcranial direct current stimulation (tDCS) associated with speech-language therapy may improve verbal performance evaluated by analytic tests, but none focused on spontaneous speech. We explored the effect of bihemispheric tDCS on spontaneous speech in patients with poststroke aphasia.

Methods:

In this multicentric controlled randomized cross-over double-blind study, we included 10 patients with poststroke aphasia (4 had aphasia >6 months and 6 with aphasia <6 months). We combined the sessions of speech-language therapy and bihemispheric tDCS (2 mA, 20 min). After three baseline speech evaluations (1/week), two different conditions were randomly consecutively proposed: active and sham tDCS over 3 weeks with 1 week of washout in between. The main outcome measure was the number of different nouns used in 2 min to answer the question “what is your job.”

Results:

There was no significant difference between conditions concerning the main outcome measure (p = .47) nor in the number of verbs, adjectives, adverbs, pronouns, repetitions, blank ideas, ideas, utterances with grammatical errors or paraphasias used. Other cognitive functions (verbal working memory, neglect, or verbal fluency) were not significantly improved in the tDCS group. No adverse events occurred.

Conclusion:

Our results differed from previous studies using tDCS to improve naming in patients with poststroke aphasia possibly due to bihemispheric stimulation, rarely used previously. The duration of the rehabilitation period was short given the linguistic complexity of the measure. This negative result should be confirmed by larger studies with ecological measures.

Keywords

StrokeLanguagetDCSRehabilitationSpontaneous discourseEcological assessment
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Special Issue 1: Rehabilitation , January 2020 , pp. 7 - 18
Copyright
Copyright © INS. Published by Cambridge University Press, 2020. 

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