# Exploring the Effects of a Computerized Naming Intervention Combined with Cerebellar tDCS in Cantonese-Speaking Individuals with Aphasia

## TL;DR

This study explores how combining a computerized naming therapy with cerebellar tDCS affects language recovery in Cantonese-speaking stroke patients with aphasia.

## Contribution

The study introduces a novel combination of computerized naming therapy and cerebellar tDCS for Cantonese-speaking individuals with aphasia.

## Key findings

- Sham tDCS paired with therapy significantly improved verb naming, while anodal tDCS did not.
- Reaction times decreased post-treatment across all groups, but no significant differences were found between tDCS conditions.
- Individual variability in response to neuromodulation and treatment outcomes was observed.

## Abstract

Background/Objectives: This study examined the effects of a computerized naming intervention combined with either cerebellar anodal transcranial direct-current stimulation (A-tDCS) or sham (S-tDCS) on noun and verb naming in Cantonese-speaking persons with chronic stroke-related aphasia (PWA). Methods: A double-blind, randomized, crossover, sham-controlled clinical trial was conducted with six Cantonese-speaking PWA following stroke. Participants received a 60 min computerized naming intervention incorporating audio–visual speech perception cues over five consecutive days, paired with concurrent 20 min of either 2 mA cerebellar A-tDCS or S-tDCS. Generalized linear mixed-effects models (GLMM) and linear mixed-effects models (LME) were used to evaluate naming accuracy and reaction time (RT). Individual variability was further explored through single-case analyses of naming accuracy changes across conditions and grammatical categories. Results: The GLMM showed a significant three-way interaction of condition, grammatical category, and time (p < 0.05). Specifically, the intervention paired with S-tDCS significantly improved verb naming, whereas A-tDCS did not induce significant improvements at the group level, effectively showing significantly smaller gains regarding verb naming compared to S-tDCS. Overall, RT decreased post-treatment across groups, but no significant differences emerged by the tDCS condition. The results support the promising efficacy of the Cantonese computerized audio–visual noun and verb naming therapy. Single-case analyses revealed high inter-individual variability in response to neuromodulation effects on naming and behavioral treatment outcomes. Conclusions: This study contributes to the emerging literature on cerebellar neuromodulation in post-stroke aphasia and underscores the need for larger trials examining grammar-specific (particularly verb-related) effects and polarity-dependent outcomes. It also highlights the value of developing personalized neuromodulation protocols to optimize the efficacy of behavioral language interventions in people with aphasia.