, 2011; Marangolo et al, 2011, 2013) through additional

, 2011; Marangolo et al., 2011, 2013) through additional

modulation of interhemispheric interactions via cathodic stimulation to the homologue contralesional area (Jung et al., 2011; Kang et al., 2011; You et al., 2011). Indeed, only after the real stimulation condition, articulatory errors significantly decreased and all patients were faster in repeating the stimuli compared to the sham condition. Most importantly, significant changes after therapy persisted at F/U and generalised to other tasks. Accordingly, most of the patients showed a significant improvement in different oral language tasks (picture description, noun and verb naming, word repetition and reading) administered before and after the treatment, an improvement which was still present 1 week after the therapy (see Table 2). This improvement revealed Inhibitor Library concentration CT99021 that the language treatment resulted in a positive effect on the production of stimuli not only treated but also belonging to other tasks. Indeed, after tDCS stimulation most patients were able to correctly produce the whole word and they showed

a reduction in phonological errors, the reduction being due to improvement in speech praxis. This is consistent with previous transcranial direct current stimulation–tDCS literature showing longer-term changes (at 1 month or more) in word retrieval and other language measures (Naeser et al., 2010, 2011; Marangolo et al., 2011, 2013). As far as

we know, this is the first study which has investigated the effects of bihemispheric stimulation on the recovery of language. As stated in the Introduction, several studies have already stressed the importance of associating specific language training with anodic unihemispheric tDCS stimulation over the perilesional language areas (Baker et al., 2010; Fiori et al., 2011; Fridriksson et al., 2011; Marangolo et al., 2013). This was based on the assumption that, in chronic patients, language recovery may be associated with the reactivation FAD of left-hemispheric perilesional structures (Warburton et al., 1999; Saur et al., 2006; Winhuisen et al., 2007). Although it is often assumed that the right homologue of Broca’s area takes over the function of the left if it is infarcted, the evidence for this is slender. Recent studies have stressed the importance of the left Broca’s area or adjacent tissue in the natural recovery from post-stroke aphasia (Saur et al., 2006, 2008). Coherently with this assumption, some studies have also shown that the suppression of the right homologue language areas through repetitive transcranial magnetic stimulation (Naeser et al., 2005, 2010, 2011) or unihemispheric cathodic tDCS (Jung et al., 2011; Kang et al., 2011; You et al., 2011), reducing the inhibition on the ipsilesional cortex exerted by the unaffected hemisphere via the transcallosal pathway, determines significant changes in language recovery.

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