title: Treatment of primary progressive aphasias by transcranial direct current stimulation combined with language training.
abstract: BACKGROUND
  Primary progressive aphasia (PPA) is an untreatable neurodegenerative disorder that disrupts language functions. Previous studies have demonstrated transcranial direct current stimulation (tDCS) may improve language symptoms in patients with post stroke aphasia or neurodegenerative diseases.
  
  
  OBJECTIVE
  The present study investigated whether the application of anodal tDCS (AtDCS) to the scalp overlying the left dorsolateral prefrontal cortex (DLPFC), which may increase cortical excitability, in combination with individualized speech therapy would improve naming accuracy in the agrammatic variant of PPA (avPPA).
  
  
  METHODS
  Sixteen avPPA patients were randomly allocated into two subgroups: AtDCS (n = 8) or placebo tDCS (PtDCS). tDCS was applied over the left DLPFC (BA 8/9) 25 minutes per day for two weeks (10 days). Each patient underwent 25 minutes of individualized speech therapy with either AtDCS or PtDCS during each treatment session. Neuropsychological assessment, experimental naming, and linguistic abilities in daily living were assessed at baseline (T0), after two weeks of intervention (T1) and at a 12-week follow-up (T2).
  
  
  RESULTS
  Significant improvement in experimental naming was observed in both groups at T1 and T2, but this effect was significantly greater in AtDCS than PtDCS patients. Naming correctness, as assessed using the Aachener Aphasie Test, increased selectively in the AtDCS group from T0 to T1, and this effect remained significant at T2. The analysis of daily living language abilities improved selectively in AtDCS group.
  
  
  CONCLUSIONS
  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.
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Cotelli
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Manenti
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Petesi
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Brambilla
authors.affiliation: Centre for Aging Brain and Neurodegenerative Disorders, Neurology unit, University of Brescia, Brescia, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Cosseddu
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
authors.forename: Orazio
authors.initials: O
authors.lastname: Zanetti
authors.affiliation: IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy Department of Clinical and Experimental Sciences, National Institute of Neuroscience, University of Brescia, Brescia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Miniussi
authors.affiliation: Centre for Aging Brain and Neurodegenerative Disorders, Neurology unit, University of Brescia, Brescia, Italy E.U.L.O Ente Universitario Lombardia Orientale, Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
authors.affiliation: Centre for Aging Brain and Neurodegenerative Disorders, Neurology unit, University of Brescia, Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Borroni
mesh_terms: D000368:Aged; D018888:Aphasia, Primary Progressive / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007808:Language Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Aphasia; frontotemporal dementia; non-invasive brain stimulation; rehabilitation