Background: Transcranial direct current stimulation (tDCS) is a safe, portable, and inexpensive form of noninvasive brain stimulation that appears to augment the effects of concurrent therapy. However, several methodological issues in existing studies distance tDCS from current clinical practice. In this study, we offered (and administered) tDCS to individuals seeking typical behavioral aphasia therapy on an outpatient basis. Methods: We approached clients (n = 10) planning to receive standard aphasia therapy at a university clinic. Following a brief description of tDCS, we offered to provide stimulation during their therapy. Those interested and without contraindications participated in a double-blind, sham-controlled crossover study of tDCS paired with speech-language therapy provided twice weekly. Participants received active (2 mA) or sham tDCS during two eight-week therapy phases (separated by ten weeks) with the anode over Broca's area and the cathode on the contralateral forehead. Stimulation was provided for the first 20 minutes of each one-hour session. Prior to and following each phase, participants were video recorded telling the Cinderella narrative. Recordings were transcribed and analyzed for correct information units (CIUs). Results: Seven individuals (70%) were interested in and eligible for tDCS. Data from four participants who completed the study indicated a large effect size favoring active over sham tDCS (Cohen's d = 1.32). The participant with the most severe deficits did not benefit from therapy in either condition. Conclusion: There is potential for tDCS to enhance meaningful communication outcomes in standard clinical practice. Further investigation is needed to replicate findings and determine individual characteristics predictive of treatment response.


中文翻译：

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经颅直流电刺激与标准失语症治疗相结合的临床可行性


背景：经颅直流电刺激 (tDCS) 是一种安全、便携且廉价的无创脑刺激形式，似乎可以增强同步治疗的效果。然而，现有研究中的几个方法学问题使 tDCS 与当前的临床实践相距甚远。在这项研究中，我们向在门诊寻求典型行为性失语症治疗的个人提供（和管理）tDCS。方法：我们接触了计划在大学诊所接受标准失语症治疗的客户 (n = 10)。在简要描述 tDCS 之后，我们提出在他们的治疗期间提供刺激。那些感兴趣且没有禁忌症的人参加了一项双盲、假对照的 tDCS 交叉研究，该研究与每周两次提供的语言治疗相结合。参与者在两个为期 8 周的治疗阶段（相隔 10 周）期间接受了主动 (2 mA) 或假 tDCS，阳极位于 Broca 区域，阴极位于对侧前额。在每个一小时会议的前 20 分钟提供刺激。在每个阶段之前和之后，参与者都被录下讲述灰姑娘故事的视频。记录被转录并分析正确​​的信息单元（CIU）。结果：七个人 (70%) 对 tDCS 感兴趣并符合条件。完成该研究的四名参与者的数据表明，有利于积极而不是假 tDCS (Cohen's d = 1.32) 的大效应量。在这两种情况下，缺陷最严重的参与者都没有从治疗中受益。结论： tDCS 有可能在标准临床实践中增强有意义的沟通结果。需要进一步调查以复制结果并确定预测治疗反应的个体特征。