Individual Differences in Response to Transcranial Direct Current Stimulation With Language Therapy in Subacute Stroke.
Melissa D Stockbridge, Jordan Elm, Abeba A Teklehaimanot and 4 others
PMID 37592860WHAT IT FOUND
While tDCS did not improve naming overall, older patients over 55 gained more words than those receiving sham therapy.
Patients with college or graduate degrees also benefited more from tDCS than those with less education.
Key findings
01tDCS did not significantly augment language therapy for the primary outcome of naming untrained nouns.
02Older patients (over 55) who received tDCS showed greater improvement in naming than those who received sham.
03Patients with college or graduate education who received tDCS showed greater improvement in naming scores than those who received sham.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (46 completers), which reduced the power to detect effects and required exploratory subgroup analyses. The primary outcome was null, so the positive findings in subgroups are exploratory and require replication. Stimulation sites varied based on lesion location, which may have introduced variability in the dose of stimulation received. Most participants declined research MRI, so the analysis of stimulation site effects was underpowered. Patients were allowed to receive standard care rehabilitation and medications, which could have influenced recovery independent of the study intervention.
Declared interests
The authors declared no conflicts of interest related to the intervention. Dr. Hillis receives compensation from the American Heart Association and Elsevier for editorial roles. All authors receive salary support from NIH grants.
The easy way to misread this
Do not conclude that tDCS is generally effective for aphasia. The primary outcome was null, and the benefits seen in older and highly educated patients were from exploratory subgroup analyses that require confirmation in larger trials.