EARLY CONSIDERATIONS OF GENETICS IN APHASIA REHABILITATION: A NARRATIVE REVIEW.
Stacy M Harnish, Victoria A Diedrichs, Christopher W Bartlett
PMID 37346093WHAT IT FOUND
Genetic factors like BDNF and APOE may influence how well patients recover language after a stroke.
This review suggests these genes could help match patients to specific therapies, such as brain stimulation, but no genetic testing is currently used in routine clinical care.
Key findings
01In a randomized trial, patients with the typical BDNF gene who received anodal transcranial direct current stimulation (A-tDCS) showed significantly greater improvement in confrontation naming than those with the atypical gene or those receiving sham stimulation.
02In an acute rehabilitation study, there was no significant difference in language recovery outcomes between BDNF Met carriers and noncarriers, though methodological limitations and spontaneous recovery variability may have obscured differences.
03The APOE ε4 allele is associated with poorer cognitive and functional outcomes after stroke, including worse verbal learning and memory, but its direct impact on aphasia rehabilitation has not yet been studied.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not a systematic review, so the selection of studies is not comprehensive or unbiased. The underlying evidence is sparse: only one study examined BDNF in acute recovery and one in chronic recovery with tDCS. Many genetic associations cited are from studies of motor recovery or general cognitive decline, not specifically aphasia rehabilitation. Genomic data is not currently accessible for routine diagnostic purposes in allied health professions. Methodological issues in the cited trials, such as varied therapy doses and spontaneous recovery, make it difficult to isolate genetic effects.
Declared interests
The authors declare no competing interests.
The easy way to misread this
Do not begin ordering genetic tests for your patients or changing your therapy plan based on this review. The evidence is preliminary, and the authors explicitly state that genomic data is not currently accessible for routine diagnostic purposes in allied health.