title: Cerebellar tDCS: A Novel Approach to Augment Language Treatment Post-stroke.
abstract: People with post-stroke aphasia may have some degree of chronic deficit for which current rehabilitative treatments are variably effective. Accumulating evidence suggests that transcranial direct current stimulation (tDCS) may be useful for enhancing the effects of behavioral aphasia treatment. However, it remains unclear which brain regions should be stimulated to optimize effects on language recovery. Here, we report on the therapeutic potential of right cerebellar tDCS in augmenting language recovery in SMY, who sustained bilateral MCA infarct resulting in aphasia and anarthria. We investigated the effects of 15 sessions of anodal cerebellar tDCS coupled with spelling therapy using a randomized, double-blind, sham controlled within-subject crossover trial. We also investigated changes in functional connectivity using resting state functional magnetic resonance imaging before and 2 months post-treatment. Both anodal and sham treatments resulted in improved spelling to dictation for trained and untrained words immediately after and 2 months post-treatment. However, there was greater improvement with tDCS than with sham, especially for untrained words. Further, generalization to written picture naming was only noted during tDCS but not with sham. The resting state functional connectivity data indicate that improvement in spelling was accompanied by an increase in cerebro-cerebellar network connectivity. These results highlight the therapeutic potential of right cerebellar tDCS to augment spelling therapy in an individual with large bilateral chronic strokes.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Rajani
authors.initials: R
authors.lastname: Sebastian
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Sadhvi
authors.initials: S
authors.lastname: Saxena
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Kyrana
authors.initials: K
authors.lastname: Tsapkini
authors.affiliation: Department of Radiology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Andreia V
authors.initials: AV
authors.lastname: Faria
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Charltien
authors.initials: C
authors.lastname: Long
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Wright
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA.
authors.forename: Cameron
authors.initials: C
authors.lastname: Davis
authors.affiliation: Department of Neurology, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of MedicineBaltimore, MD, USA.
authors.forename: Donna C
authors.initials: DC
authors.lastname: Tippett
authors.affiliation: Department of Biomedical Engineering, The City College of New York of CUNY New York, NY, USA.
authors.forename: Antonios P
authors.initials: AP
authors.lastname: Mourdoukoutas
authors.affiliation: Department of Biomedical Engineering, The City College of New York of CUNY New York, NY, USA.
authors.forename: Marom
authors.initials: M
authors.lastname: Bikson
authors.affiliation: Department of Neurology, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Neuroscience, Johns Hopkins University School of MedicineBaltimore, MD, USA.
authors.forename: Pablo
authors.initials: P
authors.lastname: Celnik
authors.affiliation: Department of Neurology, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of MedicineBaltimore, MD, USA; Department of Cognitive Science, Johns Hopkins UniversityBaltimore, MD, USA.
authors.forename: Argye E
authors.initials: AE
authors.lastname: Hillis
keywords: aphasia; cerebellar tDCS; resting state fMRI; spelling therapy; stroke