Proceedings #10: Transcranial Direct Current Stimulation Mediates Improvements in Verbal Fluency for Patients with Primary Progressive Aphasia

Hosseini, Mahdieh; McConathey, Eric M.; Ungrady, Molly; Grossman, Murray; Coslett, H. Branch; Hamilton, Roy H.

doi:10.1016/j.brs.2018.12.179

Cited by 9 publications

(3 citation statements)

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“…The sample size was small ( N = 12) which reduces statistical power. However, this sample size is in line with previously published research involving tDCS in PPA patients that also report positive results on language tasks ( Gervits et al, 2017 ; Fenner et al, 2019 ; Hosseini et al, 2019 ), suggesting it is a promising intervention in this population. It is possible that stimulation could increase general arousal.…”

Section: Discussionsupporting

confidence: 89%

Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia

Nissim

Harvey

Haslam

et al. 2022

Front. Hum. Neurosci.

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ObjectivesWe hypothesized that measures of cortical thickness and volume in language areas would correlate with response to treatment with high-definition transcranial direct current stimulation (HD-tDCS) in persons with primary progressive aphasia (PPA).Materials and MethodsIn a blinded, within-group crossover study, PPA patients (N = 12) underwent a 2-week intervention HD-tDCS paired with constraint-induced language therapy (CILT). Multi-level linear regression (backward-fitted models) were performed to assess cortical measures as predictors of tDCS-induced naming improvements, measured by the Western Aphasia Battery-naming subtest, from baseline to immediately after and 6 weeks post-intervention.ResultsGreater baseline thickness of the pars opercularis significantly predicted naming gains (p = 0.03) immediately following intervention, while greater thickness of the middle temporal gyrus (MTG) and lower thickness of the superior temporal gyrus (STG) significantly predicted 6-week naming gains (p’s < 0.02). Thickness did not predict naming gains in sham. Volume did not predict immediate gains for active stimulation. Greater volume of the pars triangularis and MTG, but lower STG volume significantly predicted 6-week naming gains in active stimulation. Greater pars orbitalis and MTG volume, and lower STG volume predicted immediate naming gains in sham (p’s < 0.05). Volume did not predict 6-week naming gains in sham.ConclusionCortical thickness and volume were predictive of tDCS-induced naming improvement in PPA patients. The finding that frontal thickness predicted immediate active tDCS-induced naming gains while temporal areas predicted naming changes at 6-week suggests that a broader network of regions may be important for long-term maintenance of treatment gains. The finding that volume predicted immediate naming performance in the sham condition may reflect the benefits of behavioral speech language therapy and neural correlates of its short-lived treatment gains. Collectively, thickness and volume were predictive of treatment gains in the active condition but not sham, suggesting that pairing HD-tDCS with CILT may be important for maintaining treatment effects.

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Section: Discussionsupporting

confidence: 89%

Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia

Nissim

Harvey

Haslam

et al. 2022

Front. Hum. Neurosci.

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“…For example, Marangolo et al (2011) report that oral naming improved in post-stroke aphasia following apraxia of speech (AOS) training in conjunction with tDCS over the left IFG (Marangolo et al 2011), and Meinzer et al (2014) report that oral naming improved in mild cognitive impairment (MCI) after stimulation over the left motor cortex (M1)(Meinzer et al 2014). With regard to tDCS studies in PPA, our study aligns with previous tDCS transfer effects on verbal fluency in smaller studies that targeted a variety of other language functions and tasks (Gervits et al 2015; Roncero et al 2017; Hosseini et al 2019) ranging from generic tasks such as story-telling (Gervits et al 2015) to oral naming (Roncero et al 2017; Hosseini et al 2019). The present study, thus, confirms in a large group of patients with adequate power that stimulation over the left IFG improves selective semantic retrieval even if not explicitly trained.…”

Section: Discussionsupporting

confidence: 85%

The left inferior frontal gyrus is causally involved in selective semantic retrieval: Evidence from tDCS in primary progressive aphasia

Wang

Ficek

Webster

et al. 2020

Preprint

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Lesion and imaging studies have shown that the left inferior frontal gyrus (IFG) is involved in selective semantic retrieval of information from the temporal lobes. However, causal, i.e., interventional, evidence is sparse. In the present study we addressed this question by testing whether transcranial direct current stimulation (tDCS) over the left IFG in a group of individuals with primary progressive aphasia may improve semantic fluency, a task that relies to selective semantic retrieval. Semantic fluency improved significantly more in the tDCS vs. sham condition immediately post-treatment and improvement lasted up to 2 months. We further addressed the question of who will benefit most from such an intervention by testing possible demographic, clinical and functional connectivity variables that may predict the behavioral tDCS effect. We found that patients with stronger baseline functional connectivity between the subareas of the left IFG opercularis and triangularis, and between the middle temporal pole and superior temporal gyrus. were the most likely to benefit from tDCS over the left IFG. We thus provided causal evidence that the left IFG is the neural substrate of selective semantic retrieval and tDCS over the left IFG may improve semantic fluency in individuals with stronger baseline functional connectivity.

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“…Behavioral language therapies are currently the standard of care for patients with PPA, and many studies that have investigated NIBS approaches in this patient population have employed neuromodulation as an adjunct to conventional speech language therapy [25][26][27][28]. Evidence suggests that behavioral therapies on their own can be modestly effective [23,29].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Noninvasive Brain Stimulation (tDCS or TMS) Paired with Language Therapy in the Treatment of Primary Progressive Aphasia: An Exploratory Meta-Analysis

2020

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Noninvasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), paired with behavioral language therapy, have demonstrated the capacity to enhance language abilities in primary progressive aphasia (PPA), a debilitating degenerative neurological syndrome that leads to declines in communication abilities. The aim of this meta-analysis is to systematically evaluate the efficacy of tDCS and TMS in improving language outcomes in PPA, explore the magnitude of effects between stimulation modalities, and examine potential moderators that may influence treatment effects. Standard mean differences for change in performance from baseline to post-stimulation on language-related tasks were evaluated. Six tDCS studies and two repetitive TMS studies met inclusion criteria and provided 22 effects in the analysis. Random effect models revealed a significant, heterogeneous, and moderate effect size for tDCS and TMS in the enhancement of language outcomes. Findings demonstrate that naming ability significantly improves due to brain stimulation, an effect found to be largely driven by tDCS. Future randomized controlled trials are needed to determine long-term effectiveness of noninvasive brain stimulation techniques on language abilities, further delineate the efficacy of tDCS and TMS, and identify optimal parameters to enable the greatest gains for persons with PPA.

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Proceedings #10: Transcranial Direct Current Stimulation Mediates Improvements in Verbal Fluency for Patients with Primary Progressive Aphasia

Cited by 9 publications

References 0 publications

Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia

Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia

The left inferior frontal gyrus is causally involved in selective semantic retrieval: Evidence from tDCS in primary progressive aphasia

Efficacy of Noninvasive Brain Stimulation (tDCS or TMS) Paired with Language Therapy in the Treatment of Primary Progressive Aphasia: An Exploratory Meta-Analysis

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