Broca's Area Damage is Necessary but not Sufficient to Induce After-effects of cathodal tDCS on the Unaffected Hemisphere in Post-stroke Aphasia

Rosso, Charlotte; Perlbarg, Vincent; Valabrègue, Romain; Arbizu, Céline; Ferrieux, Sophie; Alshawan, B.; Vargas, Patrícia A.; Léger, A.; Zavanone, Chiara; Corvol, Jean‐Christophe; Meunier, Sabine; Lehericy, Stéphane; Samson, Yves

doi:10.1016/j.brs.2014.06.004

Cited by 45 publications

(43 citation statements)

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“…On first glance, these findings appear at odds with those reported previously Kang et al, 2011;Meinzer et al, 2016;Rosso et al, 2014;Vestito et al, 2014). However, there are several potential explanations for these discrepant results.…”

Section: Introductioncontrasting

confidence: 71%

“…Our results are in keeping with neuroimaging research highlighting the important role of left frontal perilesional areas in language recovery for patients in the chronic stage post-stroke, both spontaneously and following therapy (Fridriksson, Richardson et al, 2012;Marcotte et al, 2012;Meinzer et al, 2008). In contrast, cathodal stimulation applied to the right Broca's homologue did not significantly enhance JSc's naming accuracy, and therefore our results are not consistent with those reported by Kang et al (2011) and Rosso et al (2014), or more generally with the transcallosal disinhibition hypothesis (Geranmayeh et al, 2014;Karbe et al, 1998).…”

Section: Discussionsupporting

confidence: 56%

“…Kang, Kim, Sohn, Cohen, and Paik (2011) showed that administering 20 min of 2 mA cathodal stimulation to the right Broca's homologue each weekday for a fortnight alongside tailored noun retrieval therapy resulted in a trend towards increased naming accuracy in a group of 10 patients with chronic anomia. More recently, Rosso et al (2014) reported significant increases in picture naming accuracy following a single 15 min session of 1 mA cathodal tDCS to the right IFG, despite the absence of a concurrent therapy task. However, this effect held true only for patients whose lesions incorporated Broca's area.…”

Section: Introductionmentioning

confidence: 99%

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Manipulating laterality and polarity of transcranial direct current stimulation to optimise outcomes for anomia therapy in an individual with chronic Broca’s aphasia

2017

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To cite this article: Margaret Sandars, Lauren Cloutman & Anna M. Woollams (2018) Manipulating laterality and polarity of transcranial direct current stimulation to optimise outcomes for anomia therapy in an individual with chronic Broca's aphasia, Aphasiology, 32:7, 814-838, ABSTRACT Background: Previous research indicates that combining behavioural therapy with transcranial direct current stimulation (tDCS) may be more effective than therapy alone in increasing naming ability in stroke survivors with chronic anomia. Anodal (excitatory) stimulation targeting left perilesional areas and/or cathodal (inhibitory) stimulation targeting right contralesional areas may particularly benefit non-fluent patients with localised damage to the left frontal lobe. However, studies have yet to systematically compare the effects of varying the laterality and polarity of tDCS within individual patients in order to determine optimal stimulation parameters. Aims: The primary purpose of the current study was to determine which tDCS parameters would result in the greatest improvements in naming ability in an individual (JSc) with chronic Broca's aphasia (9 years post-stroke) due to a left frontal lesion. A range of secondary outcome measures were also collected to explore the potential effects of therapy on JSc's connected speech, emotional well-being, and communicative effectiveness. Methods & Procedures: Following baseline naming assessment, JSc completed six, 4-week long cycles of therapy, each involving a different stimulation condition: four active (perilesional anodal, perilesional cathodal, contralesional anodal, and contralesional cathodal) and two sham control conditions (perilesional and contralesional). In the first week of each cycle, he completed three, 20min therapy sessions, during which he carried out a personalised picture name repetition therapy task at the same time as receiving tDCS. Naming ability was measured before, immediately after, 1 week after, and 3 weeks after each week of therapy. The secondary outcome measures were completed before, 1 week after, and 3 weeks after each week of therapy. Outcomes & Results: Naming accuracy immediately after stimulation increased significantly more following perilesional anodal stimulation than following perilesional sham stimulation, and this effect remained significant at 3 weeks post-therapy. Treatment effects on the secondary outcome measures were less consistent. Conclusions: The results agree with previous work demonstrating the importance of activation in left frontal perilesional regions for accurate picture naming in stroke survivors with non-fluent ARTICLE HISTORY

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Section: Introductioncontrasting

confidence: 71%

Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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Manipulating laterality and polarity of transcranial direct current stimulation to optimise outcomes for anomia therapy in an individual with chronic Broca’s aphasia

2017

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“…In a different study with patients receiving ctDCS to the undamaged right hemisphere, Rosso and colleagues found improvements in picture naming were predicated on whether or not the arcuate fasciculus had been damaged. The authors also found that patients who had an abnormal interhemispheric balance responded well to inhibition of the undamaged hemisphere (Rosso et al, 2014), which suggests that the right hemisphere contribution to language recovery may, in some circumstances, be deleterious.…”

Section: Tms and Tdcs In The Treatment Of Post-stroke Aphasiamentioning

confidence: 99%

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

Norise

Hamilton

2017

Front. Hum. Neurosci.

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Numerous studies over the span of more than a decade have shown that non-invasive brain stimulation (NIBS) techniques, namely transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), can facilitate language recovery for patients who have suffered from aphasia due to stroke. While stroke is the most common etiology of aphasia, neurodegenerative causes of language impairment—collectively termed primary progressive aphasia (PPA)—are increasingly being recognized as important clinical phenotypes in dementia. Very limited data now suggest that (NIBS) may have some benefit in treating PPAs. However, before applying the same approaches to patients with PPA as have previously been pursued in patients with post-stroke aphasia, it will be important for investigators to consider key similarities and differences between these aphasia etiologies that is likely to inform successful approaches to stimulation. While both post-stroke aphasia and the PPAs have clear overlaps in their clinical phenomenology, the mechanisms of injury and theorized neuroplastic changes associated with the two etiologies are notably different. Importantly, theories of plasticity in post-stroke aphasia are largely predicated on the notion that regions of the brain that had previously been uninvolved in language processing may take on new compensatory roles. PPAs, however, are characterized by slow distributed degeneration of cellular units within the language system; compensatory recruitment of brain regions to subserve language is not currently understood to be an important aspect of the condition. This review will survey differences in the mechanisms of language representation between the two etiologies of aphasia and evaluate properties that may define and limit the success of different neuromodulation approaches for these two disorders.

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“…Fourteen events led to discontinuation of the treatment (Gillick et al, 2015; Jo et al, 2009; Kim et al, 2010; Làdavas et al, 2015; Mortensen et al, 2016; Polanowska et al, 2013; Rosso et al, 2014; Shigematsu et al, 2013; Smit et al, 2015; Sparing et al, 2009; Straudi et al, 2016; Sunwoo et al, 2013; Triccas et al, 2015; Wang et al, 2014; You et al, 2011). …”

Section: The Application Of Low Intensity Tes In Human Studies: Aementioning

confidence: 99%

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

Antal

Alekseichuk

Bikson

et al. 2017

Clinical Neurophysiology

931

728

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Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Very rarely mania or hypomania was induced in patients with depression (11 documented cases), yet a causal relationship is difficult to prove because of the low incidence rate and limited numbers of subjects in controlled trials. Mild AEs (MAEs) include headache and fatigue following stimulation as well as prickling and burning sensations occurring during tDCS at peak-to-baseline intensities of 1–2 mA and during tACS at higher peak-to-peak intensities above 2 mA. The prevalence of published AEs is different in studies specifically assessing AEs vs. those not assessing them, being higher in the former. AEs are frequently reported by individuals receiving placebo stimulation. The profile of AEs in terms of frequency, magnitude and type is comparable in healthy and clinical populations, and this is also the case for more vulnerable populations, such as children, elderly persons, or pregnant women. Combined interventions (e.g., co-application of drugs, electrophysiological measurements, neuroimaging) were not associated with further safety issues. Safety is established for low-intensity ‘conventional’ TES defined as <4 mA, up to 60 min duration per day. Animal studies and modeling evidence indicate that brain injury could occur at predicted current densities in the brain of 6.3–13 A/m2 that are over an order of magnitude above those produced by tDCS in humans. Using AC stimulation fewer AEs were reported compared to DC. In specific paradigms with amplitudes of up to 10 mA, frequencies in the kHz range appear to be safe. In this paper we provide structured interviews and recommend their use in future controlled studies, in particular when trying to extend the parameters applied. We also discuss recent regulatory issues, reporting practices and ethical issues. These recommendations achieved consensus in a meeting, which took place in Göttingen, Germany, on September 6–7, 2016 and were refined thereafter by email correspondence.

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Broca's Area Damage is Necessary but not Sufficient to Induce After-effects of cathodal tDCS on the Unaffected Hemisphere in Post-stroke Aphasia

Cited by 45 publications

References 53 publications

Manipulating laterality and polarity of transcranial direct current stimulation to optimise outcomes for anomia therapy in an individual with chronic Broca’s aphasia

Manipulating laterality and polarity of transcranial direct current stimulation to optimise outcomes for anomia therapy in an individual with chronic Broca’s aphasia

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

Low intensity transcranial electric stimulation: Safety, ethical, legal regulatory and application guidelines

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