Effects of Transcranial Direct Current Stimulation in writing: a case report of deep agraphia.
Nathani Cristine do Carmo Ramos, Cláudia Aparecida Pietrobon, Ricardo Marcio Garcia Rocha and 3 others
PMID 35137891WHAT IT FOUND
One man with deep agraphia improved writing after five sessions of dictation paired with brain stimulation.
Gains in sound-based spelling held at five months, but word-shape spelling reverted. This shows what happened to one person, not that the treatment works.
Key findings
01Writing accuracy for pseudowords and low-frequency words improved immediately after treatment, with some gains in sound-based spelling maintained at five months.
02Improvement in writing irregular words, which relies on visual word shape memory, was seen immediately but was not maintained at the five-month follow-up.
03The study did not separate the effects of the writing therapy from the brain stimulation, as both were delivered together in every session.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This is a single case report, so the results cannot be generalized to other patients. The writing therapy and tDCS were applied simultaneously, making it impossible to determine if the brain stimulation contributed to the improvement or if the writing practice alone was responsible. There was no control group or sham stimulation, so natural recovery or placebo effects cannot be ruled out. The number of assessment items was small (40 words), which limits the reliability of the measured changes. Standard language tests were not performed immediately after the tDCS intervention, preventing a direct comparison of pre- and post-stimulation effects on broader language skills.
Declared interests
The study was financed in part by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil), a Brazilian government agency. No commercial conflicts of interest were declared.
The easy way to misread this
Do not assume tDCS caused the improvement. The participant received standard writing therapy and brain stimulation at the same time, so the contribution of the stimulation cannot be separated from the effect of the writing practice itself.