The Clinical Outcome of Concurrent Speech Therapy and Transcranial Direct Current Stimulation in Dysarthria and Palilalia Following Traumatic Brain Injury: A Case Study
Introduction: Dysarthria, a neurological motor speech disorder, is regarded as a common sequala of traumatic brain injury (TBI). Palilalia is a speech disorder characterized by involuntary repetition of words, phrases, or sentences. Based on the evidence supporting the effectiveness of transcranial direct current stimulation (tDCS) in some speech disorders, we hypothesized that using tDCS would enhance the expected speech therapy outcome in a case of TBI with dysarthria and palilalia. Method: The “Be Clear” protocol, a relatively new approach in speech therapy in dysarthria, together with tDCS were employed in this single case investigation. With respect to the tDCS montage, regions of interest (ROIs) were identified based on the comparative analysis of resting-state vs. speech task-concurrent qEEG results. Results: Measures of intelligibility, an important index in the assessment of dysarthria, were superior to the primary protocol results immediately and 4 months after intervention. We did not find any factor other than the use of tDCS to justify this superiority. Palilalia showed a remarkable improvement immediately after intervention but fell somewhat after 4 months. This might have been justified owing to the subcortical origin of palilalia. Conclusion: Our present findings suggested that applying tDCS together with speech therapy might be more effective in similar case profiles as compared to traditional speech therapy. This notion needs to be systematically investigated in well-designed parallel arm clinical trials.
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