CN-NINM Intervention For The Neurorehabilitation Of Disordered Speech And Emotion

Abstract

BACKGROUND: CN-NINM intervention combines the use of targeted exercise and non-invasive neurostimulation—delivered transcutaneously to the tongue—to enhance natural recovery mechanisms. In a case of chronic stroke, CN-NINM intervention successfully recovered speech and reversed symptoms of depression. PURPOSE: To evaluate the efficiency of CN-NINM intervention, using translingual neurostimulation (TLNS), in stroke patient populations. METHOD: The patient completed a thirteen-month intervention that consists of three components; (1) TLNS, (2) physical exercises for balance, posture and gait, and (3) speech training. For the first 6 months of the intervention this individual practiced all three components for one hour, twice daily. After 6 months of intervention, there was a 30-day withdrawal period, followed by an additional 6 months resuming the exercises, training, and device use. Improvements in speech and emotion were measured using the Dysarthria Impact Profile (DIP), the Quick Inventory of Depressive Symptoms (QIDS), and the Stroke Impact Scale (SIS). RESULTS: All measures demonstrated substantial improvement from baseline to end of intervention. Speech recovered by 49 percent. Depression score decreased by 10 points—a clinically significant improvement—from moderate depression to complete remission of depression. SIS scores for communication and emotion also improved by 13 and 20 percent, respectively. CONCLUSION: CN-NINM intervention can be used to recover and improve disordered emotion and speech in individuals with chronic stroke. These findings present a new non-invasive brain stimulation technique with applications in rehabilitative neurosciences. Additional research is necessary to understand the potential mechanisms of this phenomenon and optimize efficiency of the intervention.