Abstract WP194: Influence of Selective Seratonin Reuptake Inhibitors on Aphasia Recovery: Preliminary Data From a Clinical Trial

Abstract

Background: In an ongoing trial on the effects of transcranial direct current stimulation (tDCS vs sham) plus language therapy on aphasia recovery in subacute stroke, we are evaluating the effects of SSRI use (with or without tDCS) on aphasia recovery. Hypothesis: Mean change in correct Content Units (CU) produced in a picture description (primary outcome variable) is influenced by SSRI use, independently of depression, age, and sex. Methods: We analyzed data from 17 participants (with aphasia within 3 months of single left hemisphere ischemic stroke) who have completed 2-month post-treatment follow-up. We expect to have data on 30 by February, 2019. Participants described a picture (scored for CU), and were administered the Philadelphia Naming Test (PNT), Hopkins Assessment of Naming Actions (HANA), and retold the Cinderella Story (scored for CU per minute) before treatment and 2 months post-treatment. They were also administered the Patient Health Questionnaire-9 at each time point to evaluate depression. Treatment was a computer-delivered naming treatment plus either tDCS (1 mA, for first 30 minutes) or sham (randomly assigned), for 15 sessions. SSRI use depended on physician’s discretion. We remain blinded to treatment group; but we analyzed effects of SSRI (independent of depression, age, and sex) on achieving highest quartile change in CU using logistic regression. We compared mean change in each test in SSRI users vs nonusers with Wilcoxon Rank Sum tests. Results: Five participants took daily SSRI. There were no significant differences between SSRI users and nonusers in age, education, or any test at baseline. Together, SSRI use, PHQ9, age, and education predicted highest quartile of change in CU; pseudo r2 = 0.62 (p=0.016). SSRI users were more likely to achieve the highest quartile in CU (OR: 50.9; 95%CI: 0.15-16975), compared to nonusers. Although there were no significant differences between SSRI users and nonusers in change on any of the tests (likely due to low power), SSRI users showed higher mean improvements on all tests compared to nonusers; CU: 6.5 vs 1.7; PNT: 68.6 vs 50.9; HANA: 7.4 vs 1.8; Cinderella Story: 12.1 vs 10.9. Conclusions: Preliminary data indicate that daily SSRI may positively affect language gains with subacute aphasia treatment.