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  Transcranial direct current stimulation to enhance training effectiveness in chronic post-stroke aphasia: A randomized controlled trial protocol

Stahl, B., Darkow, R., von Podewils, V., Meinzer, M., Grittner, U., Reinhold, T., et al. (2019). Transcranial direct current stimulation to enhance training effectiveness in chronic post-stroke aphasia: A randomized controlled trial protocol. Frontiers in Neurology, 10: 1089. doi:10.3389/fneur.2019.01089.

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Stahl, Benjamin1, 2, 3, Author              
Darkow, Robert2, 4, Author
von Podewils, Viola1, Author
Meinzer, Marcus1, 5, Author
Grittner, Ulrike6, 7, Author
Reinhold, Thomas8, Author
Grewe, Tanja9, Author
Breitenstein, Caterina10, Author
Flöel, Agnes1, 11, Author
1Department of Neurology, Ernst Moritz Arndt University of Greifswald, Germany, ou_persistent22              
2Department of Neurology, Charité University Medicine Berlin, Germany, ou_persistent22              
3Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, Leipzig, DE, ou_2205649              
4FH Joanneum, Graz, Austria, ou_persistent22              
5Centre for Clinical Research, University of Queensland, Brisbane, Australia, ou_persistent22              
6Department of Biostatistics and Clinical Epidemiology, Charité University Medicine Berlin, Germany, ou_persistent22              
7Berlin Institute of Health (BIH), Germany, ou_persistent22              
8Institute for Social Medicine, Epidemiology and Health Economics, Charité University Medicine Berlin, Germany, ou_persistent22              
9Department of Health and Social Affairs, Fresenius University of Applied Sciences, Hamburg, Germany, ou_persistent22              
10Department of Neurology, Münster University, Germany, ou_persistent22              
11German Center for Neurodegenerative Diseases, Germany, ou_persistent22              


Free keywords: Chronic post-stroke aphasia; Intensive speech-language therapy; Transcranial direct current stimulation; Rehabilitation; Randomized controlled trial
 Abstract: Background. Intensive speech-language therapy (SLT) can promote recovery from chronic post-stroke aphasia, a major consequence of stroke. However, effect sizes of intensive SLT are moderate, potentially reflecting a physiological limit of training-induced progress. Transcranial direct current stimulation (tDCS) is an easy-to-use, well-tolerated and low-cost approach that may enhance effectiveness of intensive SLT. In a recent phase-II randomized controlled trial, 26 individuals with chronic post-stroke aphasia received intensive SLT combined with anodal-tDCS of the left primary motor cortex (M1), resulting in improved naming and proxy-rated communication ability, with medium-to-large effect sizes. Aims. The proposed protocol seeks to establish the incremental benefit from anodal-tDCS of M1 in a phase-III randomized controlled trial with adequate power, ecologically valid outcomes, and evidence-based SLT. Methods. The planned study is a prospective randomized placebo-controlled (using sham-tDCS), parallel-group, double-blind, multi-center, phase-III superiority trial. 130 individuals with aphasia at least six months post-stroke will be recruited in more than 18 in- and outpatient rehabilitation centers. Outcomes. The primary outcome focuses on communication ability in chronic post-stroke aphasia, as revealed by changes on the Amsterdam-Nijmegen Everyday Language Test (A-scale; primary endpoint: 6-month follow-up; secondary endpoints: immediately after treatment, and 12-month follow-up). Secondary outcomes include measures assessing linguistic-executive skills, attention, memory, emotional well-being, quality of life, health economic costs, and adverse events (endpoints: 6-month follow up, immediately after treatment, and 12-month follow-up). Discussion. Positive results will increase the quality of life for persons with aphasia and their families while reducing societal costs. After trial completion, a workshop with relevant stakeholders will ensure transfer into best-practice guidelines and successful integration within clinical routine.


Language(s): eng - English
 Dates: 2019-05-172019-09-272019-10-22
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.3389/fneur.2019.01089
 Degree: -



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Project information

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Project name : Transcranial Direct Current Stimulation to Enhance Training Effectiveness in Chronic Post-Stroke Aphasia
Grant ID : FL 379/17-1
Funding program : Clinical Trials
Funding organization : German Research Foundation (DFG)

Source 1

Title: Frontiers in Neurology
Source Genre: Journal
Publ. Info: Lausanne, Switzerland : Frontiers Research Foundation
Pages: - Volume / Issue: 10 Sequence Number: 1089 Start / End Page: - Identifier: ISSN: 1664-2295
CoNE: https://pure.mpg.de/cone/journals/resource/1664-2295