Early transcranial direct current stimulation for aphasia after acute ischemic stroke: a preliminary randomized controlled trial
10.3760/cma.j.issn.1673-4165.2024.03.003
- VernacularTitle:早期经颅直流电刺激治疗急性缺血性卒中后失语：初步随机对照试验
- Author:
Siqi SUN
1
;
Bin DONG
Author Information
1. 安徽医科大学第三附属医院滨湖院区神经内科，合肥 230000
- Keywords:
Ischemic stroke;
Aphasia;
Transcranial direct current stimulation;
Treatment outcome
- From:
International Journal of Cerebrovascular Diseases
2024;32(3):172-179
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the therapeutic effect of transcranial direct current stimulation (tDCS) for post-stroke aphasia (PSA) in acute phase.Methods:Patients with acute ischemic stroke who met the PSA diagnostic criteria and admitted to the Department of Neurology, the Third Affiliated Hospital of Anhui Medical University from June 2022 to November 2023 were prospectively included. They were randomly divided into a tDCS group and a control group using a random number table method. All patients received routine speech and language therapy, and the tDCS group received tDCS on this basis. The anode was the left Broca area, with a stimulation current intensity of 1.5 mA, 20 min per session, once a day, for 7 consecutive days. Before and after treatment, the Western Aphasia Battery (WAB) was used to assess spontaneous speech, comprehension, repetition and naming ability, and to calculate the Aphasia Quotient (AQ). National Institutes of Health Stroke Scale (NIHSS) was used to assess the severity of neurological deficits. The effectiveness of treatment was evaluated based on changes in various speech function scores, and improvements in AQ and Boston Diagnostic Aphasia Examination (BDAE) severity grading scale scores.Results:A total of 56 patients with PSA were included, of which 42 (75.00%) were male and aged 66.95±11.07 years. The median baseline NIHSS score was 4.00 (interquartile range, 2.00-7.00). The median WAB-AQ score was 64.30 (interquartile range, 50.60-73.05). Thirty-one patients (55.36%) were mild aphasia, 20 (35.71%) were moderate aphasia, and 5 (8.92%) were severe aphasia. There were 28 patients in the tDCS group and 28 in the control group. There were no statistically significant differences in baseline data between the two groups. After treatment, spontaneous speech, comprehension, repetition and naming ability were significantly improved in both groups compared with before treatment (all P<0.001). The repetition ability score in the tDCS group was significantly higher than that in the control group after treatment ( P=0.049). In addition, the differences in spontaneous speech, comprehension, repetition and naming ability scores before and after treatment in the tDCS group were significantly higher than those in the control group (all P<0.05), with the most significant differences in spontaneous speech and naming ability scores before and after treatment (all P<0.05). However, there was no statistically significant difference in the effectiveness of AQ and BDAE grading improvement between the two groups, and the difference in NIHSS scores before and after treatment were also no statistically significance. Conclusion:tDCS has an improvement effect on the spontaneous speech, comprehension, repetition and naming ability in patients with PSA in acute phase, but the degree of improvement is relatively weaker.
