Transcranial direct current stimulation in post-stroke aphasia rehabilitation: A systematic review - 11/02/19

Doi : 10.1016/j.rehab.2019.01.003

Elisa Biou ^a,^b, Hélène Cassoudesalle ^a,^c, Mélanie Cogné ^a,^c, Igor Sibon ^d,^e, Isabelle De Gabory ^e, Patrick Dehail ^a,^b,^c, Jerome Aupy ^f, Bertrand Glize ^a,^b,^c,^f,^⁎
^a EA4136 handicap activity cognition health, university of Bordeaux, 33000 Bordeaux, France
^b Institut universitaire des sciences de la réadaptation, university of Bordeaux, 33000 Bordeaux, France
^c Department of physical medicine and rehabilitation, CHU de Bordeaux, 33000 Bordeaux, France
^d INCIA, CNRS UMR5287, university of Bordeaux, 33400 Talence, France
^e Stroke unit, clinical neurosciences department, CHU de Bordeaux, 33076 Bordeaux, France
^f Institute of neurodegenerative diseases, CNRS UMR 5293, University of Bordeaux, 33000 Bordeaux, France

^⁎Corresponding author at: Service MPR, place Amélie-Raba-Léon, 33076 Bordeaux, France.Service MPRplace Amélie-Raba-LéonBordeaux33076France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Monday 11 February 2019
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Abstract

Background

Transcranial direct current stimulation (tDCS) is a non-invasive tool that induces neuromodulation in the brain. Several studies have shown the effectiveness of tDCS in improving language recovery in post-stroke aphasia. However, this innovative technique is not currently used in routine speech and language therapy (SLT) practice.

Objective

This systematic review aimed to summarise the role of tDCS in aphasia rehabilitation.

Methods

We searched MEDLINE via PubMed and Scopus on October 5, 2018 for English articles published from 1996 to 2018. Eligible studies involved post-stroke aphasia rehabilitation with tDCS combined or not with SLT.

Results

We retained 5 meta-analyses and 48 studies. Among the 48 studies, 39 were randomised controlled trials (558 patients), 2 prospective studies (56 patients), and 5 case studies (5 patients). Two articles were sub-analyses of a randomised clinical trial. Methods used in these studies were heterogeneous. Only 6 studies did not find a significant effect of tDCS on language performance. As compared with earlier meta-analyses, the 2 latest found significant effects.

Conclusion

Evidence from published peer reviewed literature is effective for post-stroke aphasia rehabilitation at the chronic stages. tDCS devices are easy to use, safe and inexpensive. They can be used in routine clinical practice by speech therapists for aphasia rehabilitation. However, further studies should investigate the effectiveness in the subacute post-stroke phase and determine the effect of the lesion for precisely identifying the targeted brain areas. We discuss crucial challenges for future studies.

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Keywords : Aphasia, TDCS, Rehabilitation, Speech therapy