Transcranial direct current stimulation improves post-stroke aphasia — individual dosing based on neuroimaging predicts response
Summary
A 120-patient RCT of anodal tDCS over left inferior frontal gyrus combined with speech therapy in post-stroke aphasia found 29% greater naming improvement in the tDCS group. Critically, response was predicted by pre-treatment DTI measures of arcuate fasciculus integrity — patients with >30% DTI connectivity showed 2.4x greater benefit than those with lower connectivity. Individualized dosing based on skull-brain distance modeling further improved response prediction.
Why it matters
The DTI response predictor for aphasia tDCS is clinically immediately deployable — arcuate fasciculus tractography is routine in many stroke centers. Personalizing tDCS for aphasia based on white matter integrity moves this from a generic enhancement intervention to a precision rehabilitation tool.
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