Feasibility of Remotely Supervised Transcranial Direct Current Stimulation (RS-tDCS) for People with Stroke-Induced and Progressive Aphasia

• Published in: Aphasiology Vol. 37; no. 7; pp. 1039 - 1063
• Main Authors: Richardson, Jessica D., Galletta, Elizabeth E., Charvet, Leigh, Shaw, Michael
• Format: Journal Article
• Language: English
• Published: Abingdon Routledge 03.07.2023; Taylor & Francis Ltd
• Subjects: Acceptability; Aphasia; Brain diseases; brain stimulation; Clinical trials; Electrical stimulation of the brain; ESB; Feasibility studies; Language; Neurological diseases; primary progressive aphasia; Simulation; Speech; Speech-language pathologists; Stimulation; Stroke; tDCS; Telemedicine; telerehabilitation; Transcranial direct current stimulation; Typology; Video conferencing
• ISSN: 0268-7038; 1464-5041
• DOI: 10.1080/02687038.2022.2076279

Remotely-supervised transcranial direct current stimulation (RS-tDCS) is a telerehabilitation protocol that provides access to tDCS treatment to participants with aphasia in their homes using real-time monitoring via videoconference and overcomes barriers associated with in-person tDCS treatment of neurological disease. Two feasibility studies for participants with aphasia are presented herein that investigate (1) RS-tDCS procedural implementation, acceptability, and demand, and (2) acceptability of ten repeated consecutive RS-tDCS sessions. Thirteen participants with aphasia were enrolled in Study 1: (1) seven participants with stroke-induced latent aphasia, (2) four participants with stroke-induced clinically diagnosed aphasia, and (3) two participants with logopenic variant primary progressive aphasia (lvPPA). Four supervisors (1 certified speech-language pathologist [SLP], 3 graduate SLPs-in-training) were trained to supervise RS-tDCS and also provided survey responses. All participants participated in RS-tDCS training and a virtual simulation of home delivery. Two participants with stroke-induced aphasia (1 latent aphasia, 1 clinically diagnosed aphasia) were enrolled in 10 consecutive sessions of RS-tDCS alongside computerized treatment in their home for Study 2. This work provides preliminary evidence for the feasibility of RS-tDCS for people with stable and progressive aphasia of varying severity and typology and includes both participant and clinician perspectives. Importantly, no major barriers to use of RS-tDCS were revealed for people with aphasia, though eHelpers were required for two participants. This work confirms that remotely supervised at-home tDCS studies can be used to enable much-needed efficacy trials, with sufficient sample size, power, and dosing considerations, that will determine the clinical efficacy of tDCS as a treatment adjuvant to aphasia treatment.