BDNF genotype and tDCS interaction in aphasia treatment

Julius Fridriksson, Jordan Elm, Brielle C Stark, Alexandra Basilakos, Chris Rorden, Souvik Sen, Mark S George, Michelle Gottfried, Leonardo Bonilha, Julius Fridriksson, Jordan Elm, Brielle C Stark, Alexandra Basilakos, Chris Rorden, Souvik Sen, Mark S George, Michelle Gottfried, Leonardo Bonilha

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; Aphasia treatment; Electrical brain stimulation; Rehabilitation; Stroke; tDCS.

Conflict of interest statement

Conflicts of interest

The authors report no conflicts of interest with this work.

Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1.
Fig. 1.
Distribution of participants across genotype and tDCS conditions. Frequency for each sub-group is shown in the box within each quadrant of the pie chart.
Fig. 2.
Fig. 2.
Mean proportional improvement (y-axis) at 1 week, 4 weeks, and 24 weeks (x-axis) after treatment completion for subgroups who had typical or atypical BDNF genotype and received either A-tDCS or S-tDCS. Means are adjusted for WAB-R AQ at baseline, lesion size, time, BDNF, tDCS, BDNF x time, tDCS x time and BDNF x time x tDCS. The error bars denote standard error of the adjusted means. Asterisks indicate statistically significant difference (p

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Source: PubMed

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