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Abstract
Objective To explore whether transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) can improve language capacities in patients with progressive supranuclear palsy (PSP).
Methods We used a sham-controlled double-blind crossover design to assess the efficiency of tDCS over the DLPFC in a cohort of 12 patients with PSP. In 3 separate sessions, we evaluated the ability to boost the left DLPFC via left-anodal (excitatory) and right-cathodal (inhibitory) tDCS, while comparing them to sham tDCS. Tasks assessing lexical access (letter fluency task) and semantic access (category judgment task) were applied immediately before and after the tDCS sessions to provide a marker of potential language modulation.
Results The comparison with healthy controls showed that patients with PSP were impaired on both tasks at baseline. Contrasting poststimulation vs prestimulation performance across tDCS conditions revealed language improvement in the category judgment task following right-cathodal tDCS, and in the letter fluency task following left-anodal tDCS. A computational finite element model of current distribution corroborated the intended effect of left-anodal and right-cathodal tDCS on the targeted DLPFC.
Conclusions Our results demonstrate tDCS-driven language improvement in PSP. They provide proof-of-concept for the use of tDCS in PSP and set the stage for future multiday stimulation regimens, which might lead to longer-lasting therapeutic effects promoted by neuroplasticity.
Classification of evidence This study provides Class III evidence that for patients with PSP, tDCS over the DLPFC improves performance in some language tasks.
Glossary
- ANOVA=
- analysis of variance;
- CI=
- confidence interval;
- DLPFC=
- dorsolateral prefrontal cortex;
- FAB=
- Frontal Assessment Battery;
- MADRS=
- Montgomery-Åsberg Depression Rating Scale;
- MMSE=
- Mini-Mental State Examination;
- MNI=
- Montreal Neurological Institute;
- PPA=
- primary progressive aphasia;
- PSP=
- progressive supranuclear palsy;
- tDCS=
- transcranial direct current stimulation;
- TMS=
- transcranial magnetic stimulation
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
Editorial, page 235
Class of Evidence: NPub.org/coe
- Received October 17, 2018.
- Accepted in final form March 22, 2019.
- © 2019 American Academy of Neurology
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