Non-invasive brain stimulation in the treatment of post-stroke aphasia: a scoping review

Ellen E R Williams; Sabrina Sghirripa; Nigel C Rogasch; Brenton Hordacre; Stacie Attrill

doi:10.1080/09638288.2023.2259299

Non-invasive brain stimulation in the treatment of post-stroke aphasia: a scoping review

Disabil Rehabil. 2023 Oct 13:1-22. doi: 10.1080/09638288.2023.2259299. Online ahead of print.

Authors

Ellen E R Williams^{1

2}, Sabrina Sghirripa^{1

2}, Nigel C Rogasch^{1

2

3}, Brenton Hordacre⁴, Stacie Attrill⁵

Affiliations

¹ School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia.
² Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
³ Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.
⁴ Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, The University of South Australia, Adelaide, Australia.
⁵ Speech Pathology, School of Allied Health Science and Practice, The University of Adelaide, Adelaide, Australia.

PMID: 37828899
DOI: 10.1080/09638288.2023.2259299

Abstract

Purpose: Aphasia is an acquired language impairment that commonly results from stroke. Non-invasive brain stimulation (NIBS) might accelerate aphasia recovery trajectories and has seen mounting popularity in recent aphasia rehabilitation research. The present review aimed to: (1) summarise all existing literature on NIBS as a post-stroke aphasia treatment; and (2) provide recommendations for future NIBS-aphasia research.

Materials and methods: Databases for published and grey literature were searched using scoping review methodology. 278 journal articles, conference abstracts/posters, and books, and 38 items of grey literature, were included for analysis.

Results: Quantitative analysis revealed that ipsilesional anodal transcranial direct current stimulation and contralesional 1-Hz repetitive transcranial magnetic stimulation were the most widely used forms of NIBS, while qualitative analysis identified four key themes including: the roles of the hemispheres in aphasia recovery and their relationship with NIBS; heterogeneity of individuals but homogeneity of subpopulations; individualisation of stimulation parameters; and much remains under-explored in the NIBS-aphasia literature.

Conclusions: Taken together, these results highlighted systemic challenges across the field such as small sample sizes, inter-individual variability, lack of protocol optimisation/standardisation, and inadequate focus on aphasiology. Four key recommendations are outlined herein to guide future research and refine NIBS methods for post-stroke aphasia treatment.

Keywords: Aphasia; non-invasive brain stimulation; rehabilitation; repetitive transcranial magnetic stimulation; stroke; transcranial direct current stimulation; transcranial magnetic stimulation.

Plain language summary

A comprehensive review of non-invasive brain stimulation (NIBS) post-stroke aphasia literature, including all study designs, was required.Review of this literature revealed that anodal transcranial direct current stimulation is the mostly commonly used type of NIBS in aphasia treatment research.Systemic challenges across the field hinder prospective translation of NIBS into aphasia practice.Aphasia rehabilitation professionals should note that further research is required before NIBS is suitable for translation into clinical practice.

Publication types

Review