P050 Does rTMS and/or tDCS improve the outcome of behavioral aphasia therapy in subacute aphasia?

Introduction For several years non invasive brain stimulation (NIBS) techniques like rTMS and tDCS were used in combination with speech and language therapy. There is evidence that both techniques are able to enhance behavioral treatment effects by inhibiting right Broca’s area and thereby facilitating reintegration of perilesional activation. However, to date, there is a lack of systematic randomized trials comparing the effectiveness of the two techniques. Question Does additive, inhibitory rTMS or tDCS over right Broca’s area for two weeks enhance behavioral treatment effects in patients with subacute poststroke aphasia? Method Protocol and participants: In a multicenter, multilingual (German, English, French) clinical trial 90 right-handed participants with subacute aphasia after ischemic stroke in the left MCA territory are randomly assigned to: rTMS-group, tDCS-group, or Sham-group. Participants receive 10 sessions of 45 min speech and language therapy after/during rTMS, tDCS or sham stimulation over two weeks. Stimulation protocol: Inhibitory (1 Hz) rTMS or cathodal tDCS over right pars triangularis (BA 44/45). Outcome measures: Primary multilingual outcome measures are the Boston Naming Test (BNT), a verbal fluency test, and the Token Test. Secondary outcome measures are the Aachen Aphasia Test (German), the Western Aphasia Battery (English) and the Montreal-Toulouse Language Assessment Battery for Aphasia (French). Outcome measures are assessed the day before and the day after the treatment period and after a 30 days follow-up time. Summary This study will be the first multilingual, multinational randomized trial comparing the additive effects of two NIBS techniques on the outcome of aphasia therapy in patients with subacute aphasia. Literature Thiel et al. (2015) Non-invasive repeated therapeutic stimulation for aphasia recovery: A multilingual, multicenter aphasia trial. J Stroke Cerebrovasc , 24 (4): 751–758. Rubi-Fessen et al. (2015) Add-on effects of rTMS on subacute aphasia therapy: Enhanced improvement of functional communication and basic linguistic skills. A randomized controlled study. Arch Phys Med Rehab , 96: 1935–1944. Thiel et al. (2013) Effects of noninvasive brain stimulation on language networks and recovery in early poststroke aphasia. Stroke , 44: 2240–2246.