Abstract
Anomia is a frequent and persistent symptom of poststroke aphasia, resulting from damage to areas of the brain involved in language production. Cortical neuroplasticity plays a significant role in language recovery following stroke and can be facilitated by behavioral speech and language therapy. Recent research suggests that complementing therapy with neurostimulation techniques may enhance functional gains, even amongst those with chronic aphasia. The current review focuses on the use of transcranial Direct Current Stimulation (tDCS) as an adjunct to naming therapy for individuals with chronic poststroke aphasia. Our survey of the literature indicates that combining therapy with anodal (excitatory) stimulation to the left hemisphere and/or cathodal (inhibitory) stimulation to the right hemisphere can increase both naming accuracy and speed when compared to the effects of therapy alone. However, the benefits of tDCS as a complement to therapy have not been yet systematically investigated with respect to site and polarity of stimulation. Recommendations for future research to help determine optimal protocols for combined therapy and tDCS are outlined.
Highlights
Aphasia is an acquired disorder that affects the way in which an individual produces and/or understands language [1]
Voxel-based lesion-symptom mapping (VLSM) studies have revealed that lesions to the left orbital IFG (BA47) and posterior middle temporal gyrus (MTG) are significantly correlated with impaired picture naming [27] and, correspondingly, that lack of damage to the left midposterior MTG and underlying white matter tracts is critical for successful oral picture naming [28]
Long-term recovery from poststroke anomia is facilitated by a number of cortical mechanisms and, in particular, by spontaneous and/or therapy-induced relateralization of language skills to the left hemisphere
Summary
Aphasia is an acquired disorder that affects the way in which an individual produces and/or understands language [1]. It is perhaps unsurprising that anomia, or word finding difficulty, is the most common and persistent symptom across all types of aphasia [4]. The typical approach to the treatment of anomia is impairmentbased behavioral speech and language therapy, which focuses on helping the patient to “relearn” words they are unable to retrieve or produce. This type of therapy can improve both object naming [6] and everyday communicative abilities [7, 8]. In contrast to previous reviews on this topic (e.g., [9,10,11,12,13,14]), the present review will focus on studies that have examined the effects of tDCS on confrontation naming of noun and verb pictures in chronic aphasia via a range of research designs, with reference to current neuroscientific models of speech processing and aphasia recovery
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