Stilling, Joan

Background and Objectives: Stroke is a leading cause of disability worldwide. Recent studies have suggested the feasibility and potential utility of remotely supervised transcranial direct current stimulation (RS-tDCS) to improve different types of impairments in various neurological conditions. This scoping review provides a critical appraisal of RS-tDCS as an adjunct therapy to enhance recovery after stroke. Materials and Methods: A comprehensive literature review was systematically conducted using PubMed through Nested Knowledge software. A supplementary search was conducted in Google Scholar. Two independent authors screened and identified related studies investigating RS-tDCS in patients with stroke from inception to February 2025. Results: Studies showed that RS-tDCS was safe, with only mild side effects. Additionally, it was feasible, with high adherence rates likely due to ease of use. Regarding efficacy, RS-tDCS preliminarily yielded improvements in upper- and lower-limb motor functions and increased language and cognitive performance. However, the studies were underpowered and heterogeneous, limiting generalization of findings. Conclusions: RS-tDCS is safe and feasible, affording beneficial effects in the motor, language, and cognitive functions of patients with post-stroke impairments. RS-tDCS has the potential to improve access and reduce disparities for post-stroke experimental treatments. However, adequately powered randomized trials are needed to further investigate the efficacy.

Introduction: The influence of the cerebellum in poststroke aphasia recovery is poorly understood. Despite the right cerebellum being identified as a critical region involved in both language and cognitive functions, little is known about functional connections between the cerebellum and bilateral cortical hemispheres following stroke. This study investigated the relationship between chronic poststroke naming deficits and cerebello-cerebral resting-state functional connectivity (FC). Methods: Twenty-five cognitively normal participants and 42 participants with chronic poststroke aphasia underwent resting-state functional magnetic resonance imaging. Participants with aphasia also underwent language assessment. We conducted regions of interest (ROI)-to-ROI analyses to investigate the FC between the right cerebellar Crus I/II (seed ROI; Cereb1r/Cereb2r) and bilateral cortical language regions and compared these results to cognitively normal controls. Single-subject connectivity parameters were extracted and used as independent variables in a stepwise multiple linear regression model associating Boston Naming Test (BNT) score with FC measures. Results: FC analyses demonstrated correlations between the right cerebellar Crus I/II and both left and right cortical regions for both cognitively normal controls and stroke participants. Additionally, aphasia severity and lesion load had an effect on the cerebello-cerebral network connectivity in participants with aphasia. In a stepwise multiple linear regression, controlling for aphasia severity, time poststroke and lesion load, FC between the right Cereb2–left Cereb1 (standardized beta [std B]= −0.255, p < 0.004), right Cereb2–right anterior MTG (std B = 0.259, p < 0.004), and the right Cereb2–left anterior STG (std B = −0.208, p < 0.018) were significant predictors of BNT score. The overall model fit was R 2 = 0.786 ( p = 0.001). Conclusion: Functional connections between the right cerebellum and residual bilateral cerebral hemisphere regions may play a role in predicting naming ability in poststroke aphasia.