Cerebellar Transcranial Direct Current Stimulation to Augment Chronic Aphasia Treatment

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Project Summary Aphasia is one of the leading causes of disability following stroke. Individuals with post-stroke aphasia are left with some degree of chronic deficit for which current rehabilitative treatments are variably effective. A small growing body of evidence suggests that transcranial direct current stimulation (tDCS) may be useful for enhancing the effects of behavioral aphasia treatment. The candidate proposes a comprehensive training plan that seeks to expand her understanding of brain plasticity associated with tDCS aphasia treatment by providing extensive training in neuromodulatory technique, structure–function relationships in chronic aphasia, behavioral aphasia treatment, cerebellar mechanisms of cognitive functions, and advanced neuroimaging techniques. This research proposal will permit the candidate to apply these skills in understanding language recovery and treatment of naming deficits in chronic stroke survivors with aphasia with large lesions. Specifically, this proposal aims to study the effects of right cerebellar tDCS on naming and functional connectivity changes of the language network in chronic stroke survivors with aphasia. During the mentored phase, the candidate will evaluate the benefits of tDCS + computerized naming therapy compared to computerized naming therapy alone on trained and untrained items immediately after intervention and through 2 months post-therapy. This will allow us to evaluate the potential benefits and sustainability of cerebellar tDCS in stroke survivors with large lesions and the generalization of trained items to untrained items. During the independent phase, the candidate will examine the topography of network modulation by right cerebellar tDCS in individuals with chronic aphasia by using resting-state fMRI. This will enable us to evaluate the polarity- specific changes in brain network dynamics induced by cerebellar tDCS to provide a plausible mechanistic account of neuroplasticity and explain behavioral changes that are modulated by cerebellar tDCS in aphasia.