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The Effectiveness of tDCS associated with Executive Function Training in Functional Communication: Evidence from poststroke aphasia
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Poster A13 in Poster Session A, Tuesday, October 24, 10:15 am - 12:00 pm CEST, Espace Vieux-Port
Francesca Pisano1, Alessio Manfredini1, Andrea Castellano2, Carlo Caltagirone3, Paola Marangolo1; 1University Federico II, Naples, 2University La Sapienza, Rome, 3IRCCS Santa Lucia Foundation, Rome
Introduction: New approaches in aphasia rehabilitation have recently identified the crucial role of executive functions (EFs) in language recovery, especially for people with severe aphasia (PWSA) (Olsson et al., 2019; 2020; Schumacher et al., 2019). Indeed, EFs include high-order cognitive abilities such as planning and problem-solving, which enable humans to adapt to novel situations and are essential for everyday functional communication (Miyake et al., 2000; Miyake & Friedman, 2012). To date, different studies have already emphasized the role of non-invasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS), in enhancing language improvement in aphasic individuals (Marangolo, 2020). Aim: To investigate whether anodal tDCS over the right dorsolateral prefrontal cortex (DLPFC) combined with different executive function training would enhance the ability to communicate in everyday life in twenty PWSA. Method: In a randomized double-blind crossover design, twenty chronic Italian PWSA underwent ten days of transcranial direct current stimulation (tDCS) (20 min, 2 mA) over the right dorsolateral prefrontal cortex (DLPFC). Two conditions were considered: 1) anodal and 2) sham while performing four types of cognitive training (alertness, selective attention, visuo-spatial working memory, and planning), all of which were related to executive functions. Results: After anodal tDCS, a greater improvement in selective attention, visuospatial working memory, and planning abilities was found compared to the sham condition; this improvement persisted one month after the intervention. Notably, a significant improvement was also observed in functional communication, as measured through the Communication Activities of Daily Living Scale, in noun and verb naming, auditory and written language comprehension tasks, and executive function abilities. Discussion: Our study highlights several important aspects to consider when making treatment decisions for people with severe aphasia. First, it points to the possibility of training cognitive functions other than language. Indeed, from a connectionist perspective which considers the language system as part of a network largely distributed across the brain, this allows planning different cognitive treatments, which, in turn, facilitate aphasia recovery. It also emphasizes the need to assess the person’s functional communication skills, whose recovery, even in the most severe patients, ensures the patient to socially interact in everyday life contexts. Finally, it confirms several previous reports which suggest that post-stroke aphasics in the chronic phase can still benefit from combining the treatment with tDCS.
Topic Areas: Meaning: Discourse and Pragmatics, Language Production