In this project, we will investigate the effects of transcranial direct current (tDCS) stimulation during speech and language therapy for naming in individuals with aphasia in the acute and subacute post stroke period (i.e., within three months post stroke). tDCS is a safe, non-invasive, non-painful electrical stimulation of the brain. Most tDCS studies are conducted in the chronic phase after stroke. However, because neuroplasticity is greatest early after stroke, there is reason to believe tDCS might be most effective in the acute-subacute period.
Questions this project will address include:
- Does tDCS combined with language therapy augment greater gains in picture naming accuracy than speech and language therapy alone?
- Does tDCS combined with speech and language therapy result in gains for a greater duration than speech and language therapy alone?
- What is the influence of selective serotonin reuptake inhibitor use since stroke onset on the effectiveness of tDCS and language therapy in the subacute phase?
- What are the lasting changes in quality of life and social engagement after tDCS with speech and language therapy compared to speech and language therapy alone?
- What is the effect of tDCS on functional connectivity between language networks in the brain?
Participants will take part in a randomized, double-blind, sham controlled trial. Participants will receive tDCS with speech and language therapy or speech and language therapy alone (sham) for 3 weeks (5 sessions per week, with a total of 15 sessions). Participants will be evaluated 1 week, 5-weeks, and 20 weeks after treatment ends. All participants who agree and have no contraindication will have brain MRI scans. The primary outcome variable is change in accuracy of picture naming before and after treatment. Researchers will also analyze brain MRI scans to study the effect of tDCS.
We will use this information to help us understand factors that influence recovery in the acute-subacute phase after stroke, and to optimize post stroke speech and language therapy.