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

ABSTRACT

Background

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.

Aims

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.

Methods & Procedures

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.

Outcomes & Results

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.

Conclusions

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.

KEYWORDS:

• aphasia
• primary progressive aphasia
• tDCS
• telerehabilitation
• brain stimulation

Acknowledgements

The authors would like to express our gratitude to the participants and the study personnel who helped us to learn more about the feasibility of RS-tDCS in people with aphasia.

Disclosure Statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Research by JDR was supported by an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant number P20GM109089.