The effect of tDCS in improving speech problems caused by stroke
tDCS electrical brain stimulation is an emerging approach to improve speech problems after stroke. However, it is not clear which type of stimulation is most effective. The aim of this article was to provide an overview of the evidence for the efficacy and safety of tDCS and to estimate the effectiveness of different types of stimulation.
Among the various studies from the CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, Web of Science databases, 25 studies with 471 participants were reviewed, which included types of anodic, cathodic and simultaneous stimulation. There was no difference in the level of safety between the types of tDCS methods and the interventions of the control group.
After comparing various protocols, the results showed that tDCS does not improve functional communication, but anodic stimulation, especially in the area of the inferior frontal gyrus, which has improved naming, is the most promising method of stimulation in improving speech problems caused by stroke.
This article has been published in Journal of NeuroEngineering and Rehabilitation with an impact factor (IF) of 5.
Transcranial direct current stimulation (tDCS) for improving aphasia after stroke: a systematic review with network meta-analysis of randomized controlled trials
Background
Transcranial Direct Current Stimulation (tDCS) is an emerging approach for improving aphasia after stroke. However, it remains unclear what type of tDCS stimulation is most effective. Our aim was to give an overview of the evidence network regarding the efficacy and safety of tDCS and to estimate the effectiveness of the different stimulation types.
Methods
This is a systematic review of randomized controlled trials with network meta-analysis (NMA). We searched the following databases until 4 February 2020: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, AMED, Web of Science, and four other databases. We included studies with adult people with stroke. We compared any kind of active tDCS (anodal, cathodal, or dual, that is applying anodal and cathodal tDCS concurrently) regarding improvement of our primary outcome of functional communication, versus control, after stroke. PROSPERO ID: CRD42019135696.
Results
We included 25 studies with 471 participants. Our NMA showed that tDCS did not improve our primary outcome, that of functional communication. There was evidence of an effect of anodal tDCS, particularly over the left inferior frontal gyrus, in improving our secondary outcome, that of performance in naming nouns (SMD = 0.51; 95% CI 0.11 to 0.90). There was no difference in safety between tDCS and its control interventions, measured by the number of dropouts and adverse events.
Conclusion
Comparing different application/protocols of tDCS shows that the anodal application, particularly over the left inferior frontal gyrus, seems to be the most promising tDCS treatment option to improve performance in naming in people with stroke.
