Thursday, November 21, 2024 11/21/2024

Effects of Transcranial Direct Current Stimulation (tDCS) on Spaced Discourse Treatment for Chronic Post-Stroke Aphasia

Award Number: R21DC018364
ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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PROJECT SUMMARY/ABSTRACT Aphasia is a brain disorder, most commonly occurring following stroke, that affects multimodal language abilities. Humans are socially embedded creatures, and thus deficits in communication have dramatic effects on occupational potential and quality of life. Despite the unequivocal and quantifiable benefits of behavioral speech-language therapy, they continue to fall short of a cure, or even desired levels of recovery. One way to increase the benefits of such therapies is to combine them with transcranial direct current stimulation (tDCS). Although this approach has been shown to improve naming, there is limited knowledge of the extent to which this neuromodulatory intervention can complement behavioral treatment to benefit discourse skills and functional communication. This is particularly true for treatment provided on a clinically-feasible schedule (i.e., spaced rather than massed practice). In this project, we take an innovative approach to investigate the effects of tDCS on discourse production in a pilot study of participants with aphasia. We pair active or sham tDCS with Verb Network Strengthening Treatment (VNeST), a behavioral therapy that has demonstrated significant discourse improvement using a spaced treatment schedule. Further, we use a tDCS protocol that has demonstrated benefit with spaced treatment in our preliminary work. AIM 1 determines behavioral effects of pairing active tDCS with spaced discourse treatment, in comparison to a group receiving identical therapy with sham stimulation. An additional goal of this project is to acquire neuroimaging data to inform mechanisms of tDCS effects by identifying graph theoretic network properties related to behavioral change; we use functional magnetic resonance imaging (fMRI) to identify each individual's language network using an adaptive semantic paradigm. In AIM 2A, we examine imaging measures as potential predictors of tDCS effect by calculating two key features of complex networks (integration and segregation) for both task and resting state fMRI. We then analyze the relationship between these variables at baseline and discourse changes measured post-therapy. We anticipate that pre-therapy organization more similar to that of a matched control group will predict greater benefit from treatment, particularly for active stimulation. In AIM 2B, we assess post-therapy changes in the language network, including changes in functional connectivity for the region targeted by tDCS (inferior frontal gyrus; IFG). We predict that the betweenness centrality of IFG within this network will increase significantly during both task and rest for the active stimulation group compared to sham (approaching that of controls), and this increase will be associated with discourse improvement. Our findings will increase understanding of (i) tDCS effects on an evidence-based aphasia treatment provided on a spaced schedule, (ii) language network properties associated with therapy benefit, and (iii) how targeted stimulation changes this network. Thus, we will provide insight into how tDCS might be combined with current clinical practice, as well as the mechanisms through which it induces adaptive neuroplasticity to produce meaningful functional outcomes in aphasia.!


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2022	RESEARCH FOUNDATION OF THE CITY UNIVERSITY OF NEW YORK	365 5TH AVE STE 8113	NEW YORK	NY	10016	NEW YORK	USA	Research Related to Deafness and Communication Disorders	003	4	10/24/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$216,878
2025	2022	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	002	3	10/24/2024	NON-COMPETING CONTINUATION	-$35,740
2025	2021	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	001	2	10/24/2024	NON-COMPETING CONTINUATION	-$145,398
2025	2020	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	000	1	10/24/2024	NEW	-$35,740
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $4,445 )
2024	2022	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	000	3	8/30/2024	NON-COMPETING CONTINUATION	-$109,658
2024	2022	RESEARCH FOUNDATION OF THE CITY UNIVERSITY OF NEW YORK	365 5TH AVE STE 8113	NEW YORK	NY	10016	NEW YORK	USA	Research Related to Deafness and Communication Disorders	001	4	8/30/2024	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$114,103
														Subtotal = $4,445

Issue Date FY: 2022 ( Subtotal = $145,398 )
2022	2022	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	000	3	8/22/2022	NON-COMPETING CONTINUATION	$145,398
														Subtotal = $145,398

Issue Date FY: 2021 ( Subtotal = $145,398 )
2021	2021	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	000	2	8/10/2021	NON-COMPETING CONTINUATION	$145,398
														Subtotal = $145,398

Issue Date FY: 2020 ( Subtotal = $145,398 )
2020	2020	LOUISIANA STATE UNIVERSITY	202 HIMES HALL	BATON ROUGE	LA	70803	EAST BATON ROUGE	USA	Research Related to Deafness and Communication Disorders	000	1	7/6/2020	NEW	$145,398
														Subtotal = $145,398

Grand Total All Awards = $440,639

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Effects of Transcranial Direct Current Stimulation (tDCS) on Spaced Discourse Treatment for Chronic Post-Stroke Aphasia

Award Number: R21DC018364

ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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