Johanna Chang MS, CCC-SLP, Clinical Research Coordinator at Department of Functional Neuroanatomy of Feinstein Institute of Medical Research, tells us about noninvasive brain stimluation and robotic therapy.
Participating in clinical research can be a great opportunity for individuals with aphasia and post-stroke hemiparesis (arm or leg weakness) to receive intensive, innovative therapy, usually at no cost to the participant. In the US, the average inpatient rehab stay ranges from 2 weeks to 1 month, with subsequent outpatient services lasting generally between 3-12 months. This means that for most individuals, steady rehab services will be cut by 1 year after the stroke. Rehabilitation research allows us to better understand neurological recovery and discover more efficient and effective therapeutic interventions. It also provides participants with an opportunity to receive investigational and often cutting edge services when conventional insurance coverage runs out.
Noninvasive brain stimluation is a technique that has been around for over thirty years, and has become very hot in the field of neurorehabiliitation in the past 5-10 years. There are several types of non-invasive brain stimluation, namely, TMS (transcranial magnetic stimulation) and tDCS (transcranial direct current stimulation). Both types of stimulation work by producing a transient electrical current within the brain, which depending on the parameters of the stimluation, can increase or decrease excitability in a targeted area of the cortex (e.g. make neurons more or less likely to fire). The goal of neurorehabiliation after stroke is to make the injured brain rewire. TDCS and TMS can increase the excitation of damaged neural networks, and potentially facilitate better recovery by priming the brain for better rewiring and learning during therapy.
In this clip, you saw a patient participating in one of our research studies combining tDCS and intensive robotic arm therapy. This study is investigating whether the addition of tDCS to robotic arm therapy improves arm function better than robotic arm therapy alone. More recently, we have also added a study combining tDCS and aphasia therapy. Several new publications in aphasia research using tDCS have reported that participants had significant improvements in naming, verbal fluency, and repetition. We are excited to embark on this new study, as this could be a potential new therapy for the treatment of aphasia.
If you are interested in learning more about clinical research trials in your area, visit www.clinicaltrials.gov, and search the name of your state and “aphasia” or “tDCS stroke rehabiliation.”
Johanna Chang MS, CCC-SLP, Clinical Research Coordinator
Department of Functional Neuroanatomy. Feinstein Institute of Medical Research