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Transcranial Direct Current Stimulation (tDCS) and Language/Speech: Can Patients Benefit from a Combined Therapeutic Approach?

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Translational Neuroscience of Speech and Language Disorders

Part of the book series: Contemporary Clinical Neuroscience ((CCNE))

Abstract

The modulation of cognitive functions by noninvasive stimulation of the human brain has gained increasing attention over the last few decades. Transcranial direct current stimulation (tDCS) is an easy-to-use, painless, and affordable modulatory technique with no or minimal side effects. However, studies show no consistency in outcome measures due to high variability in terms of the methodological approach. This review starts with an enumeration and critical discussion of all the influencing parameters regarding (1) the tDCS protocol itself, (2) the targeted behavioral task, (3) the characteristics of the study group, and (4) the outcome measures used. First, the use of different settings with different combinations of parameters that might co-interfere hampers the comparability between studies. A focus on within instead of between subjects can give a better insight in which parameters to use in which conditions. Second, the area of stimulation has to depend on the used behavioral task and may crucially influence the therapeutic outcome and thereby its efficiency. Different brain networks play a role in language and motor speech, such as the prefrontal cortex, the inferior frontal gyrus, and the superior temporal gyrus. That means that therapists need to know which functional network is addressed by a given behavioral task and how this network can be targeted the most efficiently with tDCS taking into account the sustained neural damage. Third, different tasks might be differentially sensitive to performance changes induced by tDCS, depending on, e.g., task complexity. Finally, speech-language therapy is a type of neurorehabilitation that focuses not only on the rehabilitation of an impairment but also searches for compensating strategies aiming to improve functional communication. Therefore, this chapter also provides a road map summing up all the variables and linking them in a patient-centered virtuous circle, since speech-language therapy should be an iterative process where the clinician is in constant dialogue with the patient.

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Abbreviations

AoS:

Apraxia of speech

atDCS:

Anodal transcranial direct current stimulation

BA:

Brodmann area

ctDCS:

Cathodal transcranial direct current stimulation

DLPFC:

Dorsolateral prefrontal cortex

F:

Female

h:

Hours

HD tDCS:

High-density transcranial direct current stimulation

IFG:

Inferior frontal gyrus

ITG:

Inferior temporal gyrus

LTD:

Long-term depression

LTP:

Long-term potentiation

M:

Male

M1:

Primary motor cortex

min:

Minutes

MTG:

Middle temporal gyrus

NMDA:

N-Methyl-d-aspartate

PFC:

Prefrontal cortex

PML:

Principles of motor learning

pSTG:

Posterior superior temporal gyrus

STG:

Superior temporal gyrus

tDCS:

Transcranial direct current stimulation

TMS:

Transcranial magnetic stimulation

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  • Sandars, M., Cloutman, L., & Woollams, A. M. (2016). Taking sides: An integrative review of the impact of laterality and polarity on efficacy of therapeutic transcranial direct current stimulation for anomia in chronic poststroke aphasia. Neural Plasticity, 2016(8428256). https://doi.org/10.1155/2016/8428256

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Authors and Affiliations

  1. Speech and Language Therapy, Thomas More University of Applied Sciences, Antwerp, Belgium

    Dorien Vandenborre & Ineke Wilssens

  2. Rehabilitation Research Center REVAL, Hasselt University, Diepenbeek, Belgium

    Kim van Dun

  3. Unité d’Etude du Mouvement (UEM), FNRS, ULB-Erasme, Bruxelles, Belgium

    Mario Manto

  4. Service des Neurosciences, University of Mons, Mons, Belgium

    Mario Manto

  5. Department of Neurology, Centre Hospitalier Universitaire (CHU) de Charleroi, Charleroi, Belgium

    Mario Manto

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  1. Dorien Vandenborre
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  2. Ineke Wilssens
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  3. Kim van Dun
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  4. Mario Manto
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  1. Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital University of Oxford, Oxford, UK

    Georgios P. D. Argyropoulos

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Vandenborre, D., Wilssens, I., van Dun, K., Manto, M. (2020). Transcranial Direct Current Stimulation (tDCS) and Language/Speech: Can Patients Benefit from a Combined Therapeutic Approach?. In: Argyropoulos, G.P.D. (eds) Translational Neuroscience of Speech and Language Disorders. Contemporary Clinical Neuroscience. Springer, Cham. https://doi.org/10.1007/978-3-030-35687-3_6

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