{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:14:16Z","timestamp":1783602856129,"version":"3.55.0"},"reference-count":80,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: While a growing number of studies have demonstrated positive effects of adjuvant anodal transcranial direct current stimulation (tDCS) on linguistic performance in aphasia, evidence for corresponding effects on verbal and\u2014in particular\u2014nonverbal functional communication remains absent. This is a critical gap, given that restoring everyday communicative competence is the ultimate goal of speech and language therapy (SLT). In the present observational study, we investigated the add-on effect of anodal tDCS over language-relevant left-hemispheric areas on verbal and nonverbal functional communication in n = 34 individuals with subacute aphasia and examined the relationship between communicative and linguistic change. Methods: Participants underwent two consecutive two-week therapy phases (P1, P2), each consisting of 10 SLT sessions. Severity-specific linguistic and communicative assessments were administered before, between, and after both phases: the Aachen Aphasia Test (AAT; n = 26) combined with the Amsterdam\u2013Nijmegen Everyday Language Test (ANELT, A-scale), and the Bielefeld Aphasia Screening Rehabilitation (BIAS-R; n = 8) combined with the Scenario Test. During P2, SLT was supplemented by online anodal tDCS. Results: Overall test performance improved significantly more in tDCS-supported P2 compared to P1 (AAT profile level, p &lt; 0.001; BIAS-R mean percentage value (MPW), p = 0.027; ANELT A-scale raw score Version 1, p = 0.081, and version 2, p = 0.038; and Scenario Test total score, p = 0.003). Significant correlations between AAT profile level and ANELT total scores were found across all time points. Between the MPV and subtests of the BIAS-R and the Scenario total score, there was a tendency toward decreasing correlation levels from T1 to T3. Conclusions: To our knowledge, this is the first study demonstrating that adjuvant tDCS in subacute aphasia enhances not only linguistic performance but also verbal and nonverbal functional communication beyond SLT alone\u2014assessed with standardized, performance-based, ecologically valid instruments.<\/jats:p>","DOI":"10.3390\/brainsci16070727","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:55:32Z","timestamp":1783598132000},"page":"727","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of Anodal tDCS on Verbal and Nonverbal Functional Communication in Subacute Aphasia\u2014An Observational Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9775-3812","authenticated-orcid":false,"given":"Ilona","family":"Rubi-Fessen","sequence":"first","affiliation":[{"name":"Neurological Rehabilitation Hospital, RehaNova K\u00f6ln, 51109 Cologne, Germany"},{"name":"Department of Rehabilitation and Special Education, Faculty of Human Sciences, University of Cologne, 50931 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"Gerbershagen","sequence":"additional","affiliation":[{"name":"Neurological Rehabilitation Hospital, RehaNova K\u00f6ln, 51109 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisca","family":"Stenneken","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Special Education, Faculty of Human Sciences, University of Cologne, 50931 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9012-0553","authenticated-orcid":false,"given":"Klaus","family":"Willmes","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty, RWTH Aachen University, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1080\/02687038.2020.1759772","article-title":"Prevalence of aphasia and dysarthria among inpatient stroke survivors: Describing the population, therapy provision and outcomes on discharge","volume":"35","author":"Mitchell","year":"2021","journal-title":"Aphasiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1161\/01.STR.0000221815.64093.8c","article-title":"Epidemiology of aphasia attributable to first ischemic stroke: Incidence, severity, fluency, etiology, and thrombolysis","volume":"37","author":"Engelter","year":"2006","journal-title":"Stroke"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2165\/00002512-200522020-00006","article-title":"Poststroke aphasia: Epidemiology, pathophysiology and treatment","volume":"22","author":"Berthier","year":"2005","journal-title":"Drugs Aging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3003","DOI":"10.1080\/09638288.2020.1722264","article-title":"Aphasia disrupts usual care: The stroke team\u2019s perceptions of delivering healthcare to patients with aphasia","volume":"43","author":"Carragher","year":"2021","journal-title":"Disabil. 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