Improving Aphasia Outcomes through tDCS-Mediated Attention Management

项目摘要 已经提出经颅直流电刺激（tDCS）作为增强治疗的方法， 失语症，但大多是在与语言功能相关的备用大脑区域进行测试。虽然这 这种方法在很大程度上是成功的，在典型的临床环境中为失语症患者提供tDCS的可行性 由于识别功能性大脑所需的功能性神经成像的费用和不可用性， 病变周围的区域。我们提出了一种替代方法，其目的是将注意力作为一种手段 来提高语言学习。研究表明，应用于背外侧前额叶皮层的阳极tDCS （DLPFC）可以改善中风后的注意力。然而，仍不清楚DLPFC给予tDCS是否会 改善失语症患者的注意力、语言恢复或语言学习。的长期目标 我们提出的研究是为了提高现有的语音和语言的效率和功效， 失语症的治疗拟议的项目将是实现这一目标的第一步， 研究tDCS介导的语言特异性注意力训练对注意力测量的影响， 失语症患者的语言。该项目将通过推进以下研究来推进NIDCD的使命： 中风和失语症康复。对于本临床试验，我们将追求以下具体目标： tDCS应用于DLPFC对（目标1a）领域一般注意技能，（目标1b）复杂语言的影响 理解，和（目标1c）人工语法规则学习。参加者将参加10个会议， 结合特定语言的注意力和人工语法训练，而积极或假tDCS是 同时给予左侧DLPFC。我们将在三个时间点（基线，术后， 训练，一个月的随访）在两个领域的一般注意力任务，句子理解任务，和 人工语法学习的两种方法。我们将通过比较以下方面的表现来实现我们的研究目标： 这些任务跨越活动和假tDCS条件。在这项临床试验结束时，我们希望 提供证据表明，积极的阳极tDCS到DLPFC可以提高注意能力，复杂句 理解和人工语法学习。该项目的成功完成将提供必要的 初步数据，使后续的大规模研究调查的影响，tDCS介导的注意力 失语症患者语言恢复训练。

PROJECT SUMMARY Transcranial direct current stimulation (tDCS) has been proposed as a method of enhancing treatment for aphasia but has mostly been tested on spared brain regions associated with language function. Although this approach has been largely successful, feasibility of providing tDCS to aphasia clients in a typical clinical setting is limited given the expense and unavailability of functional neuroimaging required to identify functional brain areas surrounding the lesion. We propose an alternative approach, which aims to target attention as a means to improve language learning. Studies have shown that anodal tDCS applied to dorsolateral prefrontal cortex (DLPFC) can improve attention after stroke. However, it remains unknown if tDCS administered to DLPFC will improve attention, language recovery, or language learning in persons with aphasia. The long-term objective of our proposed research is to is to increase the efficiency and efficacy of existing speech and language treatments for aphasia. The proposed project will be a first step toward achieving this objective, specifically investigating effects of tDCS-mediated language-specific attention training on measures of attention and language in persons with aphasia. This project will advance the NIDCD’s mission by advancing research for stroke and aphasia rehabilitation. For this clinical trial, we will pursue the following specific aim: Determine the impact of tDCS applied to DLPFC on (Aim 1a) domain-general attention skills, (Aim 1b) complex language comprehension, and (Aim 1c) artificial grammar rule learning. Participants will undergo 10 sessions of combined language-specific attention and artificial grammar training while active or sham tDCS is simultaneously administered to left DLPFC. We will measure performance at three time points (baseline, post- training, one-month follow-up) on two domain-general attention tasks, a sentence comprehension task, and two measures of artificial grammar learning. We will address our study aims by comparing performance on these tasks across active and sham tDCS conditions. At the conclusion of this clinical trial, we expect to provide evidence that active anodal tDCS to DLPFC can enhance attention ability, complex sentence comprehension, and artificial grammar learning. Successful completion of this project will provide essential preliminary data to enable subsequent large-scale studies investigating the effects of tDCS-mediated attention training on language recovery in persons with aphasia.