CONTEXT AND OBJECTIVE: Patients undergoing the same neuromodulation protocol may present different responses. Computational models may help in understanding such differences.

CONTEXT AND OBJECTIVE: Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. DESIGN AND SETTING: Prospective cohort study developed in a public university hospital. METHODS: Nineteen patients with chronic aphasia received 10 transcranial direct current stimulation sessions lasting 20 minutes each on consecutive days, using a current of 2 mA. The anode was positioned over the supraorbital area and the cathode over the contralateral motor cortex. The following variables were analyzed before and after the 10 neuromodulation sessions: oral language comprehension, copying, dictation, reading, writing, naming and verbal fluency. RESULTS: There were no adverse effects in the study. We found statistically significant differences from before to after stimulation in relation to simple sentence comprehension (P = 0.034), naming (P = 0.041) and verbal fluency for names of animals (P = 0.038). Improved scores for performing these three tasks were seen after stimulation. CONCLUSIONS: We observed that excitability of the primary motor cortex through transcranial direct current stimulation was associated with effects on different aspects of language. This can contribute towards future testing in randomized controlled trials.RESUMO CONTEXTO E OBJETIVO: Estudos prévios em animais e humanos mostram que a estimulação transcraniana por corrente contínua pode induzir neuroplasticidade significante e duradoura e pode melhorar a recuperação de linguagem na afasia. O objetivo do estudo foi descrever uma coorte de pacientes com afasia após acidente vascular cerebral que foi tratada com estimulação transcraniana por corrente contínua. TIPO DO ESTUDO E LOCAL: Estudo de coorte único prospectivo realizado em um hospital público universitário. MÉTODO: Dezenove pacientes com afasia crônica receberam 10 sessões de estimulação transcraniana por corrente contínua com duração de 20 minutos de cada, corrente de 2 mA em dias consecutivos (anodo posicionado em área supraorbital e catodo no cortes motor contraleral). Foram analisadas as seguintes variáveis antes e depois de 10 sessões de neuromodulação: compreensão de linguagem oral, cópia, ditado, leitura, escrita, nomeação e fluência verbal. RESULTADOS: Não houve efeitos adversos no estudo. Encontramos diferença estatisticamente significante pré e pós-estimulação para compreensão de frases simples (P = 0.034), nomeação (P = 0.041) e fluência verbal para nomes de animais (P = 0.038). Houve melhora no desempenho em três tarefas após estimulação. CONCLUSÃO: Observamos que a excitabilidade no córtex motor primário através de estimulação transcraniana por corrente contínua está associada a efeitos em diferentes aspectos da linguagem, além de contribuir para futuras testagens em estudos randomizados.

The results suggest that simultaneous transcranial direct current stimulation (anodic and cathodic) is a method that can improve the rehabilitation of patients with anomic and Broca's aphasia after stroke, and that language strategies should be considered in the analysis of naming task responses.

Aphasia is a language disorder associated with focal brain lesions. Although the topographic definition of the language area has been widely accepted, there is not necessarily any direct correlation between the lesion site and the manifested symptoms. Objective: To analyze aspects of language in aphasics in relation to lesion topography. Methods: A prospective, descriptive study of qualitative nature was conducted on 31 individuals, aged older than 15 years, with at least three years of schooling, and a confirmed diagnosis of stroke. Language assessment was carried out using the Montreal Toulouse battery (alpha version), Boston naming test, and FAS test. Language test results were compared against lesion topography findings from magnetic resonance imaging. Results: Heterogeneous results were found when comparing topography with aphasia, non-aphasia, and performance on language scales. Conclusion: No direct relationship was evident between lesion topography, aphasia, and language test performance.

Este trabajo describe el discurso oral de adultos mayores sanos, bajo la mirada de la funcionalidad discursivo–pragmática, cuya unidad básica es el discurso como producción textual, como interacción y como contexto de enunciación. El estudio es descriptivo, transversal y se apoya en el desempeño oral de dos ancianas en la tarea descriptiva de la Lámina Robo de Galletas y en los diálogos de una entrevista semiestructurada. Los datos fueron analizados según el número de unidades de información de la Lámina y el Protocolo de Funcionalidad Discursiva. Estos datos indican que los dos sujetos utilizaron movimientos lenguajeros del discurso oral, de tipo retomada y reformulación, a través de la expansión, vacilación, sustitución, repetición, inserción y modificación del discurso. Estos movimientos favorecieron el desarrollo y mantenimiento natural de la interacción. El 80% de las unidades informativas de la Lámina Robo de Galletas fue nombrado por ambas mujeres.