Abstract

The learning of writing skills involves the re-engagement of previously established independent procedures. Indeed, the writing deficit an adult may acquire after left hemispheric brain injury is caused by either an impairment to the lexical route, which processes words as a whole, to the sublexical procedure based on phoneme-to-grapheme conversion rules, or to both procedures. To date, several approaches have been proposed for writing disorders, among which, interventions aimed at restoring the sub-lexical procedure were successful in cases of severe agraphia. In a randomized double-blind crossover design, fourteen chronic Italian post-stroke aphasics underwent dual transcranial direct current stimulation (tDCS) (20 min, 2 mA) with anodal and cathodal current simultaneously placed over the left and right temporo-parietal cortex, respectively. Two different conditions were considered: (1) real, and (2) sham, while performing a writing task. Each experimental condition was performed for ten workdays over two weeks. After real stimulation, a greater amelioration in writing with respect to the sham was found. Relevantly, these effects generalized to different language tasks not directly treated. This evidence suggests, for the first time, that dual tDCS associated with training is efficacious for severe agraphia. Our results confirm the critical role of the temporo-parietal cortex in writing skills.

Highlights

  • IntroductionAphasia is an acquired language impairment following left-hemisphere brain injury [1]

  • Accepted: 12 April 2021Aphasia is an acquired language impairment following left-hemisphere brain injury [1]

  • The aim of the present study was to explore whether dual-transcranial direct current stimulation (tDCS) combined with a language treatment would improve writing skills in fourteen chronic patients with severe agraphia

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Summary

Introduction

Aphasia is an acquired language impairment following left-hemisphere brain injury [1]. The aphasic symptoms vary in terms of severity and degree of involvement across the different language modalities, such as oral expression, comprehension, reading, and writing. Despite the fact that clinicians and therapists are generally more attentive to spoken than written language disorders, persons with aphasia (PWA) show severe difficulties in writing [2,3], which interferes with everyday activities (e.g., to take notes; to make a shopping list). One of the major models proposed for writing is the dual-route model (DRM). A dual-route model accounts for how a literate person can write both regular, irregular words and legal nonwords

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