Treatment of Primary Progressive Aphasias by Transcranial Direct Current Stimulation Combined with Language Training

Cotelli, Maria; Manenti, Rosa; Petesi, Michela; Brambilla, Michela; Cosseddu, Maura; Zanetti, Orazio; Miniussi, Carlo; Padovani, Alessandro; Borroni, Barbara

doi:10.3233/jad-131427

Cited by 127 publications

(145 citation statements)

References 30 publications

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“…These studies have demonstrated that NIBS modalities may provide therapeutic benefits for a wide variety of disease-specific symptoms, such as aphasia [29–32], dystonia [33–35], depression [36–41], epilepsy [10, 42–47], migraine [48, 49], motor dysfunction [11, 50–53], neurocognitive impairments [54], and pain [55–57], and are generally safe when the safety guidelines are observed [3, 20, 58–61]. The majority of the NIBS safety studies have been conducted in adults, and there is a paucity of research specifically devoted to examining the safety of NIBS in children.…”

Section: Introductionmentioning

confidence: 99%

Safety of Noninvasive Brain Stimulation in Children and Adolescents

et al. 2015

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Background Noninvasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) and transcranial current stimulation (tCS) have the potential to mitigate a variety of symptoms associated with neurological and psychiatric conditions, including stroke, cerebral palsy, autism, depression, and Tourette syndrome. While the safety of these modalities has been established in adults, there is a paucity of research assessing the safety of NIBS among children. Objective To examine the existing literature regarding the safety of NIBS techniques in children and adolescents with neurologic and neuropsychiatric disorders. Methods An electronic search was performed on online databases for studies using NIBS in individuals less than 18 years of age. Non-English publications, diagnostic studies, electroconvulsive therapy, single/dual pulse TMS studies, and reviews were excluded. Adverse events reported in the studies were carefully examined and synthesized to understand the safety and tolerability of NIBS among children and adolescents. Results The data from 48 studies involving more than 513 children/adolescents (2.5–17.8 years of age) indicate that the side-effects of NIBS were, in general, mild and transient [TMS: headache (11.5%), scalp discomfort (2.5%), twitching (1.2%), mood changes (1.2%), fatigue (0.9%), tinnitus (0.6%); tCS: tingling (11.5%), itching (5.8%), redness (4.7%), scalp discomfort (3.1%)] with relatively few serious adverse events. Conclusion Our findings indicate that both repetitive TMS and tCS are safe modalities in children and adolescents with various neurological conditions, especially when safety guidelines are followed. The incidence of adverse events appears to be similar to that observed in adults; however, further studies with longer treatment and follow-up periods are needed to better understand the benefits and tolerance of long-term use of NIBS in children.

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Section: Introductionmentioning

confidence: 99%

Safety of Noninvasive Brain Stimulation in Children and Adolescents

et al. 2015

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“…In clinical populations, tDCS has been used mainly to improve motor and language recovery, primarily after stroke 59–61, 86–93 A wide range of tasks have been targeted in post-stroke aphasia including: verb naming 89 , auditory verbal working memory 93 , repetition of syllables and words for treatment of speech apraxia 94 , word retrieval or picture naming for anomia treatment 61, 70, 75, 88, 92, 95 . Despite the plethora of reports on language recovery using tDCS after stroke, only a few studies have examined it in neurodegenerative diseases (see recent reviews 96, 97 ): three studies on AD 62, 77, 98 , including only one study in which tDCS was applied for more than one session (five sessions) 80 and which showed greater improvement with tDCS vs. sham in a visual recognition task (9% vs. 2.6%) but without any task performed during either tDCS or sham conditions, two studies on frontotemporal dementia (FTD) 99, 100 (one session only with no effect of tDCS 99 but also no task practiced during treatment, and 10 sessions with more improvement over tDCS vs. sham 100 coupled with an oral naming task), and ours in PPA 101 where (after 15 treatment sessions coupled with a spelling task) we found greater improvement with tDCS vs. sham (35% of patients made significant improvement on untrained words with tDCS vs. 16% of patients made significant improvement on untrained words with sham). The tasks used during tDCS were verbal and visual recognition memory in AD, spoken verbal fluency and naming in FTD, and spelling in our study in PPA.…”

Section: Introductionmentioning

confidence: 99%

“…Determining the duration of therapeutic effects is critical, especially in neural degeneration, because it enables more effective planning of whether and when treatment should be repeated. In both recent studies using tDCS in PPA 100, 101 , long-term effects (up to two months) have been identified, offering promise of the proposed intervention as a tool of slowing down the rate of decline in neurodegeneration.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Primary Progressive Aphasia

Tippett

Hillis

Tsapkini

2015

Curr Treat Options Neurol

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Primary progressive aphasia (PPA) is a neurodegenerative disease that primarily affects language functions and often begins in the fifth or sixth decade of life. The devastating effects on work and home life call for the investigation of treatment alternatives. In this paper, we present a review of the literature on treatment approaches for this neurodegenerative disease. We also present new data from two intervention studies we have conducted, a behavioral one and a neuromodulatory one using transcranial direct current stimulation (tDCS) combined with written production intervention. We show that speech-language intervention improves language outcomes in individuals with PPA; and especially in the short term, tDCS augments generalization and maintenance of positive language outcomes. We also outline current issues and challenges in intervention approaches in PPA.

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“…To date, all NIBS studies were carried out using tDCS and generally reported language enhancement. While there is some variability among studies in the target region, the majority stimulated areas involved in language, such as the left perisylvian cortex [102, 104], left anterior temporal pole [105], left frontotemporal cortex [101], but also areas within the dorsal frontal cortex (left DLPFC and IFG) [99, 100, 106]. Interestingly, 7 of the 8 studies were designed as multiple-session paradigm [99-104, 106] and 4 of them combined a cognitive training with the stimulation protocol [100, 102, 104, 106].…”

Section: Nibs and Dementiamentioning

confidence: 99%

Non-Invasive Brain Stimulation in Dementia: A Complex Network Story

et al. 2018

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Non-invasive brain stimulation (NIBS) is emerging as a promising rehabilitation tool for a number of neurodegenerative diseases. However, the therapeutic mechanisms of NIBS are not completely understood. In this review, we will summarize NIBS results in the context of brain imaging studies of functional connectivity and metabolites to gain insight into the possible mechanisms underlying recovery. We will briefly discuss how the clinical manifestations of common neurodegenerative disorders may be related with aberrant connectivity within large-scale neural networks. We will then focus on recent studies combining resting-state functional magnetic resonance imaging with NIBS to delineate how stimulation of different brain regions induce complex network modifications, both at the local and distal level. Moreover, we will review studies combining magnetic resonance spectroscopy and NIBS to investigate how microscale changes are related to modifications of large-scale networks. Finally, we will re-examine previous NIBS studies in dementia in light of this network perspective. A better understanding of NIBS impact on the functionality of large-scale brain networks may be useful to design beneficial treatments for neurodegenerative disorders.

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Treatment of Primary Progressive Aphasias by Transcranial Direct Current Stimulation Combined with Language Training

Abstract: Our results support the beneficial effect of targeted language training in combination with brain stimulation in avPPA patients. tDCS should be considered a useful tool for the improvement of language functions in patients with neurodegenerative diseases in future trials.

Cited by 127 publications

References 30 publications

Safety of Noninvasive Brain Stimulation in Children and Adolescents

Safety of Noninvasive Brain Stimulation in Children and Adolescents

Treatment of Primary Progressive Aphasia

Non-Invasive Brain Stimulation in Dementia: A Complex Network Story

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