P 102. Transcranial direct current stimulation for improving aphasia after stroke. First results of a systematic Cochrane Review

Abstract

Background Transcranial Direct Current Stimulation (tDCS) is a non-invasive approach to alter brain excitability. Recent studies suggest that tDCS might improve aphasia after stroke. However, it lacks on a comprehensive systematic review with meta-analysis of the effectiveness of the intervention. Methods We included only randomised controlled trials (RCTs) or randomised cross-over trials, which investigated tDCS either with conventional speech and language therapy (SLT) or no intervention versus sham-tDCS and/or conventional SLT or no intervention in people with aphasia due to stroke according to the criteria of the World Health Organization (WHO). We searched the following databases: The Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, latest issue), MEDLINE (from 1948), EMBASE (from 1980), CINAHL (from 1982), AMED (from1985), Science Citation Index (from 1899), the Physiotherapy Evidence Database (PEDro, http://www.pedro.org.au/ ), Rehabdata (from 1956) and the Engineering databases Compendex and Inspec (from 1969). Two review authors independently used the Cochrane Risk of bias tool in order to assess the methodological quality of the included trials. We quantified heterogeneity across the included studies by using I2 statistics. For all statistic comparisons we used the current version of the Cochrane Review Manager Software, RevMan 5.1. Results We included 5 RCTs and Randomised Cross-over Trials in the analysis. tDCS might be a promising adjunct to neurorehabilitation after stroke to improve language function, particularly word naming. However, any of the included studies have measured functional communication, i.e. real life communication. At least a more detailed review will be published and updated in the Cochrane Database of Systematic Reviews. Conclusion Our review showed that in some studies tDCS might facilitate word retrieval after stroke and hence might improve aphasia. However, it is still unclear if tDCS could improve functional communication. Thus further research seems to be needed.