Estimulação transcraniana por corrente contínua: estudo sobre respostas em tarefas de nomeação em afásicos

Abstract

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.

Innovative Approaches to Aphasia Rehabilitation: a Review on Efficacy, Safety and Controversies

“…Similar to stroke motor function parameters, in tDCS studies, the electrode placement aims to restore the interhemispheric unbalance between the residual left language areas and the right hemispheric ones [169,170]. Thus, two broad approaches have been usually adopted: facilitation of activity in lesioned or perilesional areas through anodal stimulation [19][20][21][22][23][24]27,28,30,[145][146][147]149,150,[152][153][154][155]157,158,[161][162][163]165,168] or inhibition of the intact right hemisphere to diminish abnormal transcallosal inhibition through cathodal stimulation [20,144,148,151,157,164,166].…”

“…to their extreme heterogeneity [126]. The classical modular approach has been most often adopted, thus, positioning the active electrode either over the left Broca's area [19,21,[23][24][25][26][27][28][29][30]142,146,153,155,157,162,163,168], the left Wernicke's area [19,[21][22][23]28,30,149,150,164,165] or the right homologues [20,144,148,157,159,164,166,167]. Indeed, most of the research has proved that anodal stimulation over these areas combined with language therapy increases different aspects of language.…”

“…More specifically, a significant improvement has been shown in noun naming after anodal tDCS over the left frontal gyrus [27,29,157,162,163,168] the left temporal gyrus [21][22][23]149,150,165] or the right homologues [148,157,164,166]. Some other studies have targeted the left inferior frontal gyrus in order to improve verb naming [21,23,[27][28][29]160], speech fluency [27][28][29][30], repetition [24][25][26]146] and reading [153].…”

“…Finally, two studies have targeted the dorsolateral prefrontal cortex [152,20] As reported in Table 3, the studies were not homogeneous on the number of sessions included varying from one [147,152,155,154,163] to five [21][22][23][24][25][142][143][144]146,148,151,153,156,165,166,168] to fifteen sessions [26,149,150,159]. While, for current intensity there was a substantial agreement to use 1mA [19,[21][22][23][24][25]28,30,[144][145][146]149,150,152,154,158,160,161,164,…”

“…and, in the remaining studies, tDCS effects were measured up to 1-4 weeks after the treatment [20,21-23,25,26,28,29,144,146,148,150,151,156,157,159,161,162,164,165,168 but see 20,24,145,149,153,157,158].Anyway, beyond this variability, the literature agrees on some aspects which might assure the longterm maintenance of stimulation efficacy. Long term effects are more easily obtained stimulating the subjects for several consecutive days[20][21][22][23][24][25][26]28,29,[143][144][145][146][148][149][150][151]153,[156][157][158][159]161,162,165,168].…”