title: Transcranial direct current stimulation in post-stroke sub-acute aphasia: study protocol for a randomized controlled trial.
abstract: Transcranial direct current stimulation (tDCS) is a promising new technique to optimize the effect of regular Speech and Language Therapy (SLT) in the context of aphasia rehabilitation. The present study focuses on the effect of tDCS provided during SLT in the sub-acute stage after stroke. The primary aim is to evaluate the potential effect of tDCS on language functioning, specifically on word-finding, as well as generalization effects to verbal communication. The secondary aim is to evaluate its effect on social participation and quality of life, and its cost-effectiveness.
  
  
  
  We strive to include 58 stroke patients with aphasia, enrolled in an inpatient or outpatient stroke rehabilitation program, in a multicenter, double-blind, randomized controlled trial with two parallel groups and 6 months' follow-up. Patients will participate in two separate intervention weeks, with a pause of 2 weeks in between, in the context of their regular aphasia rehabilitation program. The two intervention weeks comprise daily 45-minute sessions of word-finding therapy, combined with either anodal tDCS over the left inferior frontal gyrus (1 mA, 20 minutes; experimental condition) or sham-tDCS over the same region (control condition). The primary outcome measure is word-finding. Secondary outcome measures are verbal communication, social participation, quality of life, and cost-effectiveness of the intervention.
  
  
  
  Our results will contribute to the discussion on whether tDCS should be implemented in regular aphasia rehabilitation programs for the sub-acute post-stroke population in terms of (cost-)effectiveness.
  
  
  
  Nederlands Trail Register: NTR4364 . Registered on 21 February 2014.
authors.affiliation: Rijndam Rehabilitation Institute, PO Box 23181, 3001, KD, Rotterdam, The Netherlands. kspielmann@rijndam.nl.|Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. kspielmann@rijndam.nl.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Spielmann
authors.affiliation: Rijndam Rehabilitation Institute, PO Box 23181, 3001, KD, Rotterdam, The Netherlands.|Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
authors.forename: W Mieke E
authors.initials: WM
authors.lastname: van de Sandt-Koenderman
authors.affiliation: Rijndam Rehabilitation Institute, PO Box 23181, 3001, KD, Rotterdam, The Netherlands.
authors.forename: Majanka H
authors.initials: MH
authors.lastname: Heijenbrok-Kal
authors.affiliation: Rijndam Rehabilitation Institute, PO Box 23181, 3001, KD, Rotterdam, The Netherlands.|Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
authors.forename: Gerard M
authors.initials: GM
authors.lastname: Ribbers
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D020127:Recovery of Function; D012107:Research Design; D058992:Social Participation; D013066:Speech-Language Pathology / Q000191:economics / Q000379:methods*; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D013997:Time Factors; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects / Q000191:economics; D016896:Treatment Outcome; D014705:Verbal Behavior; D055815:Young Adult
keywords: Aphasia; Stroke; Sub-acute; Transcranial direct current stimulation