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BDNF genotype and tDCS interaction in aphasia treatment
Authors:Julius Fridriksson  Jordan Elm  Brielle C. Stark  Alexandra Basilakos  Chris Rorden  Souvik Sen  Mark S. George  Michelle Gottfried  Leonardo Bonilha
Affiliation:1. Department of Communication Sciences & Disorders, University of South Carolina, USA;2. Department of Public Health Sciences, Medical University of South Carolina, USA;3. Department of Psychology, University of South Carolina, USA;4. Department of Neurology, University of South Carolina, USA;5. Department of Psychiatry, Medical University of South Carolina, USA;6. Department of Neurology, Medical University of South Carolina, USA;7. Ralph H. Johnson VA Medical Center, Charleston, USA
Abstract:

Background

Several studies, including a randomized controlled trial by our group, support applying anodal tDCS (A-tDCS) to the left hemisphere during behavioral aphasia treatment to improve outcomes. A clear mechanism explaining A-tDCS's efficacy has not been established, but modulation of neuroplasticity may be involved.

Objective/hypothesis

The brain-derived neurotrophic factor (BDNF) gene influences neuroplasticity and may modulate the effects of tDCS. Utilizing data from our recently completed trial, we conducted a planned test of whether aphasia treatment outcome is influenced by interaction between A-tDCS and a single-nucleotide polymorphism of the BDNF gene, rs6265.

Methods

Seventy-four individuals with chronic stroke-induced aphasia completed 15 language therapy sessions and were randomized to receive 1?mA A-tDCS or sham tDCS (S-tDCS) to the intact left temporoparietal region for the first 20?min of each session. BDNF genotype was available for 67 participants: 37 participants had the typical val/val genotype. The remaining 30 participants had atypical BDNF genotype (Met allele carriers). The primary outcome factor was improvement in object naming at 1 week after treatment completion. Maintenance of treatment effects was evaluated at 4 and 24 weeks.

Results

An interaction was revealed between tDCS condition and genotype for treatment-related naming improvement (F?=?4.97, p?=?0.03). Participants with val/val genotype who received A-tDCS showed greater response to aphasia treatment than val/val participants who received S-tDCS, as well as the Met allele carriers, regardless of tDCS condition.

Conclusion

Individuals with the val/val BDNF genotype are more likely to benefit from A-tDCS during aphasia treatment.
Keywords:Aphasia  Stroke  tDCS  Electrical brain stimulation  Rehabilitation  Aphasia treatment
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