Improvement in naming with tDCS and alteration of functional connectivity in post-stroke aphasia: A randomized controlled trial

Improvement in naming with tDCS and alteration of functional connectivity in post-stroke aphasia: A randomized controlled trial | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Improvement in naming with tDCS and alteration of functional connectivity in post-stroke aphasia: A randomized controlled trial Jiayi Zhao, Jin Guo, Yuanyuan Li, Xu Zhang, Ying Yuan, Yinan Cheng, and 8 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8606611/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 11 You are reading this latest preprint version Abstract Background This study aimed to investigate the effects of anodal transcranial direct current stimulation (A-tDCS) over the left Sylvian parietal temporal region (SPT) on picture naming and changes in brain functional connectivity in post-stroke aphasic patients. Methods This is a double-blind, sham-controlled, randomized controlled study. Sixty aphasic patients were randomly assigned to receive either active or sham tDCS over the SPT as well as speech-language therapy for four weeks. Standardized aphasia assessments and electroencephalogram (EEG) examinations were conducted before and after the treatment. The EEG nonlinear index of cross approximate entropy (C-ApEn) was used to assess brain functional connectivity. Results The tDCS group demonstrated significantly greater improvements than the control group in both picture naming and auditory word-picture identification scores ( p < 0.001). Regression analysis revealed that the group (tDCS/control) was the primary factor associated with improving picture naming. The functional connectivity of F3-P3, F7-P3, T3-T5, T5-P3, T5-C3, C3-P3, T4-T6, T3-T4, and T5-T6 significantly increased following tDCS. Conclusions A-tDCS targeting the left SPT region can improve picture naming in patients with subacute post-stroke aphasia. Both direct and indirect connections within language networks in the left hemisphere were partially elevated, and functional connectivity between the executive control network and the language network was enhanced. Additionally, activation was observed in some connections within the right hemisphere and between the bilateral hemispheres. The analysis of brain functional connectivity provides neural network evidence for the effect of tDCS in enhancing naming abilities in stroke patients with aphasia. Clinical trial registry number: ChiCTR-TRC-14005072 aphasia electroencephalogram functional connectivity picture naming transcranial direct current stimulation Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Transcranial direct current stimulation (tDCS), a non-invasive technique, has been shown to enhance language performance. Improvements in picture naming have been observed following anodal tDCS (A-tDCS) over the left frontal cortex ( 1 ), Broca's area ( 2 ), and cathodal tDCS over the right Broca's homologue area ( 3 ). Benefits have also been reported from tDCS applied to temporal regions, such as the left temporal cortex ( 4 ) and Wernicke's area ( 5 – 7 ). One study comparing the effects of four tDCS configurations on picture naming improvement in patients with non-fluent aphasia found that 64% of patients benefited from tDCS over the superior temporal gyrus (STG), while 18% benefited from tDCS over the inferior frontal gyrus (IFG) ( 8 ). Increasing attention is being directed toward the role of tDCS over temporal lobe regions, including Wernicke's area, in improving naming abilities in aphasia. Our previous study ( 9 ) demonstrated that A-tDCS over Wernicke's area not only enhances auditory comprehension but also significantly improves picture naming abilities in post-stroke aphasia patients. However, existing studies often involve small sample sizes (e.g., 8 subjects ( 7 ), 3 subjects ( 5 ), 7 subjects ( 6 ), 16 subjects ( 8 )) and typically include patients with only one type of aphasia (either fluent aphasia ( 7 ) or nonfluent aphasia ( 5 , 6 , 8 )). Additionally, few studies have reported functional connectivity changes in the brain network following tDCS over Wernicke's area or the Sylvian parietal temporal region (SPT). The organization of language processing in the brain exhibits a dual network comprising dorsal and ventral streams ( 10 – 12 ). The dorsal stream connects the temporo-parietal regions to the frontal premotor areas via the superior longitudinal fasciculus (SLF) and the arcuate fasciculus (AF), integrating sensory-motor processing to support speech production. Major nodes in the dorsal stream include the Sylvian parietal temporal (SPT) area, the inferior parietal lobule (IPL), the premotor cortex (PMC), the primary motor cortex (M1), and the inferior frontal gyrus (IFG, Broca's area). The ventral stream connects the middle and posterior temporal lobe, the inferior parietal lobe, and the occipital lobe to the anterior temporal lobe and IFG through the inferior fronto-occipital fasciculus (IFOF), the inferior longitudinal fasciculus (ILF), the middle longitudinal fasciculus (MLF), and the uncinate fasciculus (UF), mediating semantic comprehension ( 13 ). The SPT area is the posterior confluence/divergence point of the dorsal and ventral streams ( 10 ), while the IFG serves as the anterior confluence point. The white matter fiber tracts of the dorsal and ventral streams provide the anatomical foundation for functional connectivity during language tasks and serve as the basis for network-based therapeutic interventions for aphasia. However, the functional distinction between the ventral and dorsal streams is not absolute. Research supports the notion that successful speech processing relies on the functional interactions between these dual streams ( 10 , 14 , 15 ). A voxelwise lesion-behavior mapping study showed significant damage to both tracts in cases of repetition and comprehension impairments, indicating that both pathways contribute to speech production and comprehension ( 14 ). Evidence suggests that damage to the posterior temporal lobe results in speech production deficits ( 16 , 17 ). High scores on tests of naming, verb generation, and sentence organization rely more on lexical, syntactic, or semantic processes rather than motor-speech planning and control, reflecting the significant involvement of the ventral stream in speech production tasks ( 10 ). This suggests that tDCS targeting the SPT region, the posterior confluence/divergence point of the ventral and dorsal streams, could potentially enhance both streams and lead to better language outcomes. Our previous study ( 9 ) demonstrated that A-tDCS over Wernicke's area not only increases cortical excitability within the targeted region but also in remote, non-stimulated areas. This suggests that functionally related brain regions might be activated through cortico-cortical connections. To the best of our knowledge, there are few studies examining changes in functional connectivity within the language network following tDCS targeting the SPT area in individuals with post-stroke aphasia. The aim of the present study is to investigate alterations in functional connectivity induced by tDCS over the SPT. Electroencephalogram (EEG) captures the electrical activity evoked by cortical functional activity in a direct and dynamic manner. Nonlinear dynamics analysis (NDA) characterizes the dynamics of neural networks underlying the EEG, offering a robust tool for examining dynamic changes and extracting correlative information from cortical networks ( 18 ). Cross-approximate entropy (C-ApEn) is used to assess the degree of coupling between two signals ( 19 ). In our previous research, we applied C-ApEn analysis to study brain functional connectivity in disorders of consciousness to predict prognosis ( 20 ) and to analyze changes in network functional connectivity in patients with apraxia of speech after tDCS treatment ( 21 ). In this study, the EEG index of C-ApEn was used to investigate functional network connectivity. We hypothesized that tDCS targeting the SPT could improve naming abilities in patients with aphasia, and that the elevated functional connectivity between SPT and adjacent regions as well as remote regions in language networks might be the underlying mechanism. To test these hypotheses, A-tDCS and sham tDCS were randomly administered over the left SPT, and the EEG nonlinear index of C-ApEn was calculated to assess functional network connectivity. Methods Participants Participants were recruited from the Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China. Written informed consent was obtained from all participants or their legal guardians. The study was approved by The Ethics Committees of Wangjing Hospital of China Academy of Chinese Medical Sciences (WJEC-KT-2017-004-P002). Clinical trial registry number: ChiCTR-TRC-14005072. Inclusion criteria were: ( 1 ) 3–6 months post-stroke onset, ( 2 ) no previous brain injury, and ( 3 ) right-handed and native Mandarin Chinese speakers. Exclusion criteria included: ( 1 ) severely impaired auditory verbal comprehension (auditory word-picture identification score < 6/60), ( 2 ) inability to repeat three-syllable words, ( 3 ) history of seizures in the past 12 months, ( 4 ) presence of implanted metal objects, ( 5 ) history of other neurological conditions, and ( 6 ) history of psychiatric disorders or dementia. A total of 60 patients were ultimately included in the study. The flowchart outlining the study process is presented in Fig. 1 . Procedures This was a double-blind, sham-controlled, randomized controlled study. Patients were randomly assigned to one of the two groups: the tDCS group (active tDCS over the SPT) and the control group (sham tDCS). Both groups received active/sham tDCS and speech-language therapy (SLT) twice daily, five days a week, for four consecutive weeks (40 sessions). Before and after the treatment, the aphasia assessments and the EEG were assessed. Blinding Randomization was performed using a computer-generated randomization sequence. The assigned random number was input into the tDCS device, which automatically generated an active or sham stimulation. The researcher responsible for randomization randomization was not involved in subsequent study procedures. The tDCS administration, clinical assessments, and SLT were conducted by three different language therapists with at least ten years of experience. Both participants and language therapists remained blinded to the group assignment throughout the study. Aphasia assessment and Speech-language therapy Aphasia type and severity were assessed using the Boston Diagnostic Aphasia Examination-Chinese version. Additionally, all subjects underwent evaluations involving picture naming and auditory word identification, following the protocols of the Psycholinguistic Assessment in Chinese Aphasia (PACA). Four lists, each containing 60 test items, were used randomly across each assessment. The reaction time for each item was limited to 20 seconds, and no cues were provided if the patient failed to respond correctly. Speech-language therapy was conducted using a computer system in two 30-minute sessions each day. Further details on these procedures are available in previously published work ( 9 ). tDCS A portable battery-driven device (IS200, Chengdu, China) delivered a constant current of 1.2 mA (approximately 0.05 mA/cm²) for 20 minutes to the left SPT using a pair of saline-soaked surface sponge electrodes (4.5 cm × 5.5 cm). The location of the SPT was identified by referencing the "left Wernicke’s point (LWP)," defined as the intersection of the T3-P3 and C3-T5 lines in the posterior temporal region according to Friederici’s method ( 22 ). The cathodal electrode was positioned over the right shoulder. For sham tDCS, the device automatically powered off after 30 seconds. In both active and sham tDCS conditions, the current intensity was gradually increased and decreased. EEG recording A wireless digital EEG system (ZN16E, Chengdu, China) was used for EEG recording, with a bandwidth of 0.3–100 Hz and a sampling rate of 500 Hz. Sixteen EEG electrodes were positioned according to the international 10–20 or 10–10 system. Notably, the F7 electrode was placed on the left IFG, defined as the intersection of the T3-Fz and F7-Cz lines ( 22 ), and the F8 electrode was placed on the right IFG. The cortical regions corresponding to the electrode placements were as follows: dorsolateral prefrontal cortex (DLPFC) at F3/F4, IFG at F7/F8, M1 at C3/C4, SPT at T5/T6, middle temporal lobe (MTL) at T3/T4, and IPL at P3/P4 ( 23 , 24 ). Reference electrodes were positioned on the earlobes. The procedures for EEG recording, including methods to mitigate electromyography artifacts and eliminate electrical noise, followed those detailed in previously published studies ( 25 , 26 ). EEG was recorded under two conditions: with the eyes closed for approximately 5 minutes, followed by eyes-closed repetition of a three-syllable word list. Non-linear Index: Cross Approximate Entropy (C-ApEn) Cross approximate entropy (C-ApEn) was used to analyse two related time series and measure their degree of asynchrony by comparing sequences from one series to those of the second series to reflect the spatial decorrelation of cortical potentials from two remote sites ( 19 ). Higher values of C-ApEn indicated higher degrees of inter-cortical communication or information flow ( 27 ). The expression formula and parameters for C-ApEn have been previously detailed in our earlier studies ( 25 , 26 ). In this study, specific EEG sites within the speech and language network were selected, including DLPFC (F3/F4), IFG (F7/F8), M1 (C3/C4), IPL (P3/P4), SPT (T5/T6), and MTL (T3/T4). C-ApEn for these sites, encompassing intrahemispheric C-ApEn within the left and right hemispheres and interhemispheric C-ApEn, were calculated to elucidate functional connectivity within the network. Statistical Analysis SPSS 22.0 (IBM, Armonk, NY, USA) was used for data analysis. The Pearson chi-square test was used to determine the difference between the two groups for categorical variables. For continuous variables, the independent t-test (normal distribution) or Mann-Whitney U-test (non-normal distribution) was applied to test the difference between the two groups. Paired t-test or paired Wilcoxson signed-rank test was adopted for comparing baseline and post-treatment for each group. Univariate and multivariate linear regression analyses were used to investigate the relevant factors for improving picture naming. The group and baseline characteristics were included as independent variables in the model. The multivariate linear regression analysis included variables with p < 0.3 in the univariate linear regression analysis. Two-tailed p values < 0.05 were considered statistically significant. Results Baseline The study included a total of 60 patients. The treatment of tDCS was well-tolerated by all participants, with no adverse effects observed. The demographics and stroke characteristics of the participants are presented in Table 1 . No significant differences were observed between groups for age, sex, education, stroke etiology, lesion site, and post-stroke onset. The speech assessments at baseline, including types of aphasia, aphasia severity, baseline score of picture naming and auditory word-picture identification, were similar between groups. Table 1 The demographics and stroke characteristics of the participants. tDCS group(n = 30) Control group(n = 30) p Age(years) 49.7 ± 21.0 49.4 ± 16.2 0.941 Sex(male) 23(76.7%) 24(80.0%) 0.754 Education(years) 12.4 ± 4.9 13.3 ± 4.0 0.628 Stroke etiology Thrombosis MCA 20(66.7%) 19(63.3%) 0.787 Hemorrhage MCA 10(33.3%) 11(36.7%) Lesion site Frontal cortex 26(86.7%) 26(86.7%) 1.000 Temporal cortex 24(80.0%) 25(83.3%) 0.739 Parietal cortex 24(80.0%) 23(76.7%) 0.754 Basal ganglia 10(33.3%) 16(53.3%) 0.118 Poststroke onset(months) 4.3 ± 1.5 4.3 ± 1.4 0.909 Aphasia type* Broca’s 26(86.7%) 21(70.0%) 0.341 Wernicke 0(0.0%) 1(3.3%) Conductive 0(0.0%) 1(3.3%) Mixed 4(13.3%) 7(23.3%) Aphasia severity* 0 4(13.3%) 6(20.0%) 0.857 1 9(30.0%) 7(23.3%) 2 9(30.0%) 10(33.3%) 3 8(26.7%) 7(23.3%) * Aphasia type and aphasia severity were evaluated using the Boston Diagnostic Aphasia Examination-Chinese Version. MCA: middle cerebral artery. Values are mean ± SD or number (percentage). Speech-language assessments Following the 4-week intervention, both groups showed significant improvement from baseline in picture naming and auditory word-picture identification scores (both p < 0.001), showed in Table 2 and Fig. 2 . The tDCS group demonstrated significantly greater improvements than the control group, a difference that was statistically confirmed when comparing the changes (pre-post difference scores) between the two groups( p < 0.001). Results were listed in Fig. 3 . Univariate and multivariate linear regression analyses were used to investigate the relevant factors for improving picture naming (Table 3 ). The group assignment and baseline characteristics were included in the model as independent variables. The multivariate regression analyses showed that assignment to the tDCS group was significantly associated with greater improvement ( p < 0.001). Table 2 Speech-language assessments of each group at baseline and post-treatment (Post-T). tDCS group Control group Baseline Post-T z p Baseline Post-T z p Picture naming (0–60) 18.2 ± 14.2 27.7 ± 17.5 -4.786 < 0.001 18.8 ± 16.0 20.3 ± 16.4 -3.401 < 0.001 Auditory word-picture identification (0–60) 42.0 ± 10.5 49.8 ± 10.3 -4.797 < 0.001 42.8 ± 13.4 44.6 ± 13.0 -3.837 < 0.001 Values are mean ± SD. Table 3 Linear regression analysis of the relevant factors for the improvement of picture naming. Univariate Multivariate Characteristics(ref) Unstandardized coefficient Standardized coefficient t p R 2 Unstandardized coefficient Standardized coefficient t p B standard error b B standard error b Group(control) 7.933 1.089 0.691 7.288 < 0.001 0.477 7.811 1.068 0.681 7.317 < 0.001 Age 0.02 0.041 0.063 0.479 0.634 0.004 Sex(male) -0.638 1.827 -0.046 -0.349 0.728 0.002 Education -0.002 0.169 -0.001 -0.01 0.992 0.000 Stroke etiology -2.234 1.552 -0.186 -1.44 0.155 0.034 -1.779 1.126 -0.148 -1.579 0.120 Post-stroke onset -0.219 0.535 -0.054 -0.41 0.684 0.003 Aphasia type -0.546 0.639 -0.112 -0.855 0.396 0.013 Aphasia severity 0.919 0.721 0.165 1.274 0.208 0.027 0.633 0.522 0.114 1.213 0.230 Multivariate regression analysis: R 2 0.517, adjust R 2 0.491 EEG C-ApEn analysis C-ApEn difference values under eyes-closed and repetition task conditions at baseline and post-treatment are presented in Table 4 . Within the tDCS group, post-treatment values were significantly higher than baseline in multiple connections: F3-P3(left DLPFC-left IPL), F7-P3(left IFG- left IPL), T3-T5(left MTL- left SPT), T5-P3(left SPT-left IPL), T5-C3(left SPT-left M1), C3-P3(left M1-left IPL), T4-T6(right MTL-right SPT), T3-T4(bilateral MTL), and T5-T6(bilateral SPT). Between-group comparisons of the change in C-ApEn difference values (Table 5 ) revealed that the tDCS group exhibited overall greater increases in the left hemisphere. Significant between-group differences were found in the same connections listed above. Table 4 The difference value of the cross approximate entropy (C-ApEn) under the eye-closed condition and repetition task before and after the treatment. tDCS group Control group Baseline Post-T p Baseline Post-T p F3-F7 0.01 ± 0.02 0.03 ± 0.03 0.056 0.01 ± 0.02 0.01 ± 0.03 0.442 F3-P3 0.01 ± 0.02 0.04 ± 0.04 < 0.001 0.01 ± 0.03 0.01 ± 0.03 0.810 F7-C3 0.02 ± 0.01 0.03 ± 0.03 0.065 0.01 ± 0.03 0.02 ± 0.02 0.201 F7-T3 0.01 ± 0.02 0.02 ± 0.03 0.136 0 ± 0.04 0 ± 0.04 0.100 F7-T5 0.02 ± 0.02 0.03 ± 0.03 0.072 0.02 ± 0.04 0.02 ± 0.03 0.476 F7-P3 0.01 ± 0.02 0.03 ± 0.03 0.001 0.01 ± 0.02 0.01 ± 0.02 0.873 T3-T5 0.01 ± 0.02 0.04 ± 0.03 < 0.001 0.02 ± 0.04 0.01 ± 0.03 0.125 T5-P3 0.02 ± 0.02 0.05 ± 0.04 < 0.001 0.02 ± 0.03 0.02 ± 0.03 0.738 T5-C3 0.02 ± 0.01 0.04 ± 0.04 0.009 0.02 ± 0.03 0.02 ± 0.03 0.722 C3-P3 0.02 ± 0.02 0.04 ± 0.04 0.003 0.02 ± 0.03 0.02 ± 0.02 0.271 F4-F8 0.01 ± 0.01 0 ± 0.02 0.229 0 ± 0.03 0 ± 0.03 0.556 F4-P4 0.01 ± 0.02 0.02 ± 0.03 0.075 0.02 ± 0.03 0.01 ± 0.03 0.177 F8-C4 0.01 ± 0.02 0.01 ± 0.03 0.613 0.01 ± 0.03 0.01 ± 0.03 0.613 F8-T4 0.01 ± 0.02 0.01 ± 0.03 1.000 0 ± 0.04 -0.01 ± 0.04 0.674 F8-T6 0.01 ± 0.02 0.02 ± 0.03 0.125 0.01 ± 0.03 0 ± 0.03 0.601 F8-P4 0.01 ± 0.01 0.02 ± 0.03 0.100 0.01 ± 0.03 0 ± 0.03 0.142 T4-T6 0 ± 0.01 0.03 ± 0.03 < 0.001 0 ± 0.04 0 ± 0.03 0.321 T6-P4 0.01 ± 0.01 0.02 ± 0.03 0.089 0.02 ± 0.04 0.01 ± 0.04 0.167 T6-C4 0.02 ± 0.02 0.03 ± 0.04 0.142 0.02 ± 0.03 0.01 ± 0.04 0.512 C4-P4 0.02 ± 0.02 0.03 ± 0.03 0.222 0.02 ± 0.03 0.02 ± 0.03 0.446 F3-F4 0.02 ± 0.03 0.02 ± 0.02 0.482 0.01 ± 0.03 0.01 ± 0.03 0.553 F7-F8 0.01 ± 0.02 0.02 ± 0.03 0.177 -0.01 ± 0.03 0 ± 0.03 0.354 C3-C4 0.02 ± 0.01 0.02 ± 0.03 0.886 0.01 ± 0.03 0.02 ± 0.02 0.079 T3-T4 0.00 ± 0.01 0.02 ± 0.03 0.034 0 ± 0.03 -0.01 ± 0.03 0.014 T5-T6 0.01 ± 0.01 0.04 ± 0.02 < 0.001 0.02 ± 0.03 0.01 ± 0.03 0.039 P3-P4 0.01 ± 0.02 0.03 ± 0.04 0.084 0.02 ± 0.03 0.02 ± 0.03 0.495 Values are mean ± SD. Table 5 The comparison of changes of the difference value of the cross approximate entropy (C-ApEn) between two groups. tDCS group Control group p F3-F7 0.02 ± 0.04 0.00 ± 0.02 0.065 F3-P3 0.03 ± 0.04 0.00 ± 0.02 0.006 F7-C3 0.01 ± 0.03 0.00 ± 0.02 0.053 F7-T3 0.01 ± 0.04 0.00 ± 0.02 0.059 F7-T5 0.01 ± 0.03 0.00 ± 0.02 0.068 F7-P3 0.02 ± 0.03 0.00 ± 0.01 < 0.001 T3-T5 0.03 ± 0.04 -0.01 ± 0.02 < 0.001 T5-P3 0.04 ± 0.04 0.00 ± 0.02 0.001 T5-C3 0.02 ± 0.04 0.00 ± 0.02 < 0.001 C3-P3 0.02 ± 0.03 0.00 ± 0.02 0.049 F4-F8 -0.01 ± 0.03 0.00 ± 0.02 0.086 F4-P4 0.01 ± 0.04 0.00 ± 0.02 0.135 F8-C4 0.00 ± 0.03 0.00 ± 0.02 0.567 F8-T4 0.00 ± 0.03 0.00 ± 0.02 0.479 F8-T6 0.01 ± 0.03 0.00 ± 0.03 0.069 F8-P4 0.01 ± 0.03 -0.01 ± 0.02 0.080 T4-T6 0.03 ± 0.03 -0.01 ± 0.03 < 0.001 T6-P4 0.01 ± 0.04 -0.01 ± 0.02 0.053 T6-C4 0.01 ± 0.04 0.00 ± 0.02 0.141 C4-P4 0.01 ± 0.04 0.00 ± 0.02 0.095 F3-F4 0.01 ± 0.04 0.00 ± 0.02 0.502 F7-F8 0.01 ± 0.02 0.00 ± 0.02 0.328 C3-C4 0.00 ± 0.03 0.00 ± 0.01 0.173 T3-T4 0.02 ± 0.03 0.00 ± 0.01 < 0.001 T5-T6 0.03 ± 0.02 -0.01 ± 0.02 < 0.001 P3-P4 0.02 ± 0.04 0.00 ± 0.02 0.071 Values are mean ± SD. Discussion To the best of our knowledge, this study is the first to investigate alterations in functional connectivity after A-tDCS over the left SPT. The combination of A-tDCS over the left SPT with speech-language therapy improved picture naming and auditory word-picture identification performance in patients with subacute post-stroke aphasia, showing significant improvement compared to speech therapy alone. EEG C-ApEn analysis revealed significant elevation of the functional connectivity in F3-P3, F7-P3, T3-T5, T5-P3, T5-C3, C3-P3, T4-T6, T3-T4, and T5-T6, indicating partial elevation of both direct and indirect connections within the ventral and dorsal language networks and enhanced functional connectivity between the executive control network and the language network. These results confirm our hypotheses. In this study, the EEG index of C-ApEn was used to investigate functional connectivity during a repetition task. The ventral pathway for picture naming projects from the occipital lobe and the visual object-form area to the frontal regions via the IFOF, ILF, and UF ( 28 , 29 ). The dorsal pathway for picture naming significantly overlaps with brain regions engaged during word repetition: the SPT is involved in translating and integrating sensory codes with the motor system ( 30 ); the IPL is a key area where multiple sensory inputs converge, playing a role in motor program selection ( 31 ) and motor learning ( 32 ); the left IFG (Broca’s area) is closely linked to word retrieval and speech motor programming ( 33 ); and the left PMC and left M1 function as a sequentially organized common final pathway for producing specific movement commands, following projections of information from other cortical and subcortical areas ( 34 ). The elevation of direct connections with the stimulation site SPT after tDCS Among all the direct connections with the stimulation site SPT, A-tDCS enhanced the direct connections between the left SPT and the left MTL, left IPL (T5-T3, T5-P3), as well as the right SPT (T5-T6). However, the direct connection between the left SPT and the left IFG (T5-F7) was not elevated. Both direct and indirect connections within the dual-streams are partially elevated after tDCS In the dual-stream model of language processing, the dorsal stream links the temporo-parietal regions to the frontal premotor areas via the SLF and the AF. This includes the “long segment” as the “direct” pathway, projecting from the posterior STG to the IFG, and two “indirect” pathways: a fronto-inferior parietal–posterior temporal segment as the anterior part ( 35 ) and a posterior temporal–inferior parietal segment as the posterior part. In the ventral stream, the IFOF serves as the main “direct” pathway essential for semantic processing, projecting from the temporo-occipital area and the parietal lobe to the IFG, orbital frontal cortex, and the frontal pole ( 36 ). Additionally, there are two “indirect” pathways: the ILF, which connects the occipital lobe to the temporal lobe, and the UF, which connects the temporal lobe to the prefrontal cortex ( 13 ). In this study, we found that in the dorsal stream, the “long segment” between the tDCS stimulation site SPT and the IFG (T5-F7), which serves as the “direct” pathway, did not fully recover, whereas the multi-step “indirect” pathway SPT-IPL-IFG (T5-P3-F7) did recover. Within the multi-step “indirect” pathway SPT-IPL-M1-IFG, the connection between M1 and IFG (C3-F7) did not recover. In the ventral stream, the main “direct” pathway SPT-IFG did not completely recover. The “indirect” pathway SPT-MTL (T5-T3) recovered, but the MTL-IFG connection (T3-F7) did not. A graphical summary of these results is illustrated in Fig. 4 . The functional connectivity between the executive control network and the language network is enhanced In the EEG examination, we also monitored the DLPFC (F3) and IPL (P3), which are key nodes of the executive control network (ECN), to observe the role of the ECN in language processing. The ECN, a domain-general network, supports various cognitive processes, including working memory, cognitive control, attention, and executive functions, providing flexible resources for initiating and maintaining cognitive control. Key brain regions of the ECN were found to remain elevated in post-stroke aphasia patients ( 37 ). Successful language recovery aligned with the recovery of domain-general networks, particularly the modular brain networks of attention and spatial memory ( 38 ). In this study, EEG functional connectivity results showed that the connection between the IFG and the IPL (F7-P3) recovered, as did the fronto-parietal connection between the DLPFC and IPL (F3-P3), but the connection between the IFG and DLPFC (F7-F3) did not recover. It remains unclear whether this lack of recovery is due to insufficient activation of the IFG or because the repetition task is relatively simple, requiring less semantic activation and lexical retrieval involving the ECN. The results also revealed that multiple pathways directly connected to the IPL were elevated, possibly indicating that the IPL, adjacent to the SPT, compensated for the function of the SPT when it was damaged. The activation of the IPL might play a crucial role in the improvement of naming and repetition tasks. The elevation of connections in the right hemisphere This study also found that tDCS over the left SPT could elevate its interhemispheric connections with the right SPT (T5-T6), as well as the direct interhemispheric connection of the bilateral MTL (T3-T4) and the direct connection between the right SPT and the right MTL (T6-T4). This suggests partial involvement of the right hemisphere in aphasia recovery. Given that the ventral stream exists in both hemispheres, this elevation may be related to the bilateral STG and MTL being engaged by auditory speech. Further Research Implications We found that the non-elevated functional connections were all related to the IFG, including: the M1-IFG (C3-F7) in the dorsal stream, the “long-segment” pathway SPT-IFG (T5-F7), the IFG-DLPFC (F7-F3) in the executive control network, and the MTL-IFG (T3-F7) in the ventral stream. This suggests that for aphasia patients with severe lesions spanning temporal, parietal, and frontal lobes (17/30 cases in this study), tDCS targeting only the SPT region may be insufficient to restore the IFG's direct connections with the dual streams, or the complete multi-step indirect connections. The SPT is the posterior confluence/divergence point of the dual streams, while the IFG is the anterior confluence point. Future research should investigate whether dual-target tDCS involving both the left IFG and left SPT can further promote changes in the functional connectivity of the dual-stream and the executive control network, thereby improving the picture-naming ability of aphasia patients. Limitations Limitations of this study include: ( 1 ) Our findings do not allow us to conclude whether the activation of long direct pathways confers a recovery benefit superior to that achieved through the activation of multi-step indirect pathways. ( 2 ) The localization of brain regions was conducted using the EEG international 10–20 system, which has relatively low spatial resolution compared to fMRI. Conclusions A-tDCS targeting the left SPT region, combined with speech-language therapy, can improve picture naming and auditory comprehension in patients with subacute post-stroke aphasia. Both direct and indirect connections within the ventral and dorsal language networks in the left hemisphere were partially elevated, and functional connectivity between the executive control network and the language network was enhanced. Additionally, the elevation was observed in some connections within the right hemisphere and between the bilateral hemispheres. Abbreviations AF arcuate fasciculus A-tDCS anodal transcranial direct current stimulation C-ApEn cross approximate entropy DLPFC dorsolateral prefrontal cortex ECN executive control network EEG electroencephalogram IFG inferior frontal gyrus IFOF inferior fronto-occipital fasciculus ILF inferior longitudinal fasciculus IPL inferior parietal lobule LWP left Wernicke’s point MLF middle longitudinal fasciculus MTL middle temporal lobe NDA Nonlinear dynamics analysis PACA Psycholinguistic Assessment in Chinese Aphasia PMC premotor cortex RCT randomized controlled trial SLF superior longitudinal fasciculus SLT speech-language therapy SPT Sylvian parietal temporal region STG superior temporal gyrus UF uncinate fasciculus Declarations Ethics approval and consent to participate The studies involving human participants were reviewed and approved by The Ethics Committees of Wangjing Hospital of China Academy of Chinese Medical Sciences and. The patients/participants provided their written informed consent to participate in this study. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests. Funding This work was supported by National Natural Science Foundation of China (grant numbers 81171011 and 81572220), the Scientific and technological innovation project of China Academy of Chinese Medical Sciences (CI2021A01410) and Project of Wangjing Hospital of China Academy of Chinese Medical Sciences (grant numbers WJYY-XZKT-2023-26, WJCXTD-2024-02, WJYY-ZZXT-2023-06 and WJYY-ZZXT-2025-06). Author Contribution JZ and JG have contributed equally to the data analysis and drafting the manuscript. YL, XZ, YY, YC, GD, BL, QW, YJ and QG participated in the conduction of the study including patients’ enrollment, treatment and assessments. DW, JW and CX designed and supervised the study, and critically revised the manuscript. 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1","display":"","copyAsset":false,"role":"figure","size":228123,"visible":true,"origin":"","legend":"\u003cp\u003eThe flowchart of this study.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8606611/v1/e8c32b28679b7061f9226c25.png"},{"id":100855753,"identity":"e5db5899-4cbf-4e06-a2d5-74d2492fbc1b","added_by":"auto","created_at":"2026-01-22 06:56:58","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":66426,"visible":true,"origin":"","legend":"\u003cp\u003eDifferences of scores between baseline and post-treatment in both groups.\u003c/p\u003e\n\u003cp\u003e**\u003cem\u003ep\u003c/em\u003e\u003cstrong\u003e\u0026lt;\u003c/strong\u003e0.001\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8606611/v1/36fbf6dc4e2da5f9ddbc4e9c.png"},{"id":100855395,"identity":"e010f7a1-120e-4fda-8f52-6aedddad3f9f","added_by":"auto","created_at":"2026-01-22 06:56:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":129339,"visible":true,"origin":"","legend":"\u003cp\u003eThe comparisons of changes (pre-post difference scores) between the tDCS and control groups.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8606611/v1/5a287fa2a9b177055c36597d.png"},{"id":100855851,"identity":"bbff256e-5a4a-4b61-95ab-111469bd6872","added_by":"auto","created_at":"2026-01-22 06:57:16","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":2441940,"visible":true,"origin":"","legend":"\u003cp\u003eAlterations in functional connectivity after tDCS.\u003c/p\u003e\n\u003cp\u003eDLPFC: dorsolateral prefrontal cortex; IPL: inferior parietal lobule; MTL: middle temporal lobe; SPT: Sylvian parietal temporal region\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8606611/v1/4680190063678b5151337680.png"},{"id":100859987,"identity":"08f70309-d7d2-42ba-914c-2ab4be849867","added_by":"auto","created_at":"2026-01-22 07:35:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3426252,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8606611/v1/5cf46f47-77e5-4f5d-9904-65eb6149971f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Improvement in naming with tDCS and alteration of functional connectivity in post-stroke aphasia: A randomized controlled trial","fulltext":[{"header":"Background","content":"\u003cp\u003eTranscranial direct current stimulation (tDCS), a non-invasive technique, has been shown to enhance language performance. Improvements in picture naming have been observed following anodal tDCS (A-tDCS) over the left frontal cortex (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e), Broca's area (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e), and cathodal tDCS over the right Broca's homologue area (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Benefits have also been reported from tDCS applied to temporal regions, such as the left temporal cortex (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) and Wernicke's area (\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). One study comparing the effects of four tDCS configurations on picture naming improvement in patients with non-fluent aphasia found that 64% of patients benefited from tDCS over the superior temporal gyrus (STG), while 18% benefited from tDCS over the inferior frontal gyrus (IFG) (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Increasing attention is being directed toward the role of tDCS over temporal lobe regions, including Wernicke's area, in improving naming abilities in aphasia. Our previous study (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) demonstrated that A-tDCS over Wernicke's area not only enhances auditory comprehension but also significantly improves picture naming abilities in post-stroke aphasia patients. However, existing studies often involve small sample sizes (e.g., 8 subjects (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e), 3 subjects (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e), 7 subjects (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e), 16 subjects (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)) and typically include patients with only one type of aphasia (either fluent aphasia (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) or nonfluent aphasia (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)). Additionally, few studies have reported functional connectivity changes in the brain network following tDCS over Wernicke's area or the Sylvian parietal temporal region (SPT).\u003c/p\u003e \u003cp\u003eThe organization of language processing in the brain exhibits a dual network comprising dorsal and ventral streams (\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The dorsal stream connects the temporo-parietal regions to the frontal premotor areas via the superior longitudinal fasciculus (SLF) and the arcuate fasciculus (AF), integrating sensory-motor processing to support speech production. Major nodes in the dorsal stream include the Sylvian parietal temporal (SPT) area, the inferior parietal lobule (IPL), the premotor cortex (PMC), the primary motor cortex (M1), and the inferior frontal gyrus (IFG, Broca's area). The ventral stream connects the middle and posterior temporal lobe, the inferior parietal lobe, and the occipital lobe to the anterior temporal lobe and IFG through the inferior fronto-occipital fasciculus (IFOF), the inferior longitudinal fasciculus (ILF), the middle longitudinal fasciculus (MLF), and the uncinate fasciculus (UF), mediating semantic comprehension (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The SPT area is the posterior confluence/divergence point of the dorsal and ventral streams (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e), while the IFG serves as the anterior confluence point. The white matter fiber tracts of the dorsal and ventral streams provide the anatomical foundation for functional connectivity during language tasks and serve as the basis for network-based therapeutic interventions for aphasia.\u003c/p\u003e \u003cp\u003eHowever, the functional distinction between the ventral and dorsal streams is not absolute. Research supports the notion that successful speech processing relies on the functional interactions between these dual streams (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). A voxelwise lesion-behavior mapping study showed significant damage to both tracts in cases of repetition and comprehension impairments, indicating that both pathways contribute to speech production and comprehension (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Evidence suggests that damage to the posterior temporal lobe results in speech production deficits (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). High scores on tests of naming, verb generation, and sentence organization rely more on lexical, syntactic, or semantic processes rather than motor-speech planning and control, reflecting the significant involvement of the ventral stream in speech production tasks (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). This suggests that tDCS targeting the SPT region, the posterior confluence/divergence point of the ventral and dorsal streams, could potentially enhance both streams and lead to better language outcomes.\u003c/p\u003e \u003cp\u003eOur previous study (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) demonstrated that A-tDCS over Wernicke's area not only increases cortical excitability within the targeted region but also in remote, non-stimulated areas. This suggests that functionally related brain regions might be activated through cortico-cortical connections. To the best of our knowledge, there are few studies examining changes in functional connectivity within the language network following tDCS targeting the SPT area in individuals with post-stroke aphasia. The aim of the present study is to investigate alterations in functional connectivity induced by tDCS over the SPT.\u003c/p\u003e \u003cp\u003eElectroencephalogram (EEG) captures the electrical activity evoked by cortical functional activity in a direct and dynamic manner. Nonlinear dynamics analysis (NDA) characterizes the dynamics of neural networks underlying the EEG, offering a robust tool for examining dynamic changes and extracting correlative information from cortical networks (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Cross-approximate entropy (C-ApEn) is used to assess the degree of coupling between two signals (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn our previous research, we applied C-ApEn analysis to study brain functional connectivity in disorders of consciousness to predict prognosis (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e) and to analyze changes in network functional connectivity in patients with apraxia of speech after tDCS treatment (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). In this study, the EEG index of C-ApEn was used to investigate functional network connectivity.\u003c/p\u003e \u003cp\u003eWe hypothesized that tDCS targeting the SPT could improve naming abilities in patients with aphasia, and that the elevated functional connectivity between SPT and adjacent regions as well as remote regions in language networks might be the underlying mechanism. To test these hypotheses, A-tDCS and sham tDCS were randomly administered over the left SPT, and the EEG nonlinear index of C-ApEn was calculated to assess functional network connectivity.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003e Participants were recruited from the Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China. Written informed consent was obtained from all participants or their legal guardians. The study was approved by The Ethics Committees of Wangjing Hospital of China Academy of Chinese Medical Sciences (WJEC-KT-2017-004-P002). Clinical trial registry number: ChiCTR-TRC-14005072.\u003c/p\u003e \u003cp\u003eInclusion criteria were: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) 3\u0026ndash;6 months post-stroke onset, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) no previous brain injury, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) right-handed and native Mandarin Chinese speakers. Exclusion criteria included: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) severely impaired auditory verbal comprehension (auditory word-picture identification score\u0026thinsp;\u0026lt;\u0026thinsp;6/60), (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) inability to repeat three-syllable words, (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) history of seizures in the past 12 months, (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) presence of implanted metal objects, (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) history of other neurological conditions, and (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) history of psychiatric disorders or dementia.\u003c/p\u003e \u003cp\u003eA total of 60 patients were ultimately included in the study. The flowchart outlining the study process is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eProcedures\u003c/h3\u003e\n\u003cp\u003eThis was a double-blind, sham-controlled, randomized controlled study. Patients were randomly assigned to one of the two groups: the tDCS group (active tDCS over the SPT) and the control group (sham tDCS). Both groups received active/sham tDCS and speech-language therapy (SLT) twice daily, five days a week, for four consecutive weeks (40 sessions). Before and after the treatment, the aphasia assessments and the EEG were assessed.\u003c/p\u003e\n\u003ch3\u003eBlinding\u003c/h3\u003e\n\u003cp\u003eRandomization was performed using a computer-generated randomization sequence. The assigned random number was input into the tDCS device, which automatically generated an active or sham stimulation. The researcher responsible for randomization randomization was not involved in subsequent study procedures. The tDCS administration, clinical assessments, and SLT were conducted by three different language therapists with at least ten years of experience. Both participants and language therapists remained blinded to the group assignment throughout the study.\u003c/p\u003e\n\u003ch3\u003eAphasia assessment and Speech-language therapy\u003c/h3\u003e\n\u003cp\u003eAphasia type and severity were assessed using the Boston Diagnostic Aphasia Examination-Chinese version. Additionally, all subjects underwent evaluations involving picture naming and auditory word identification, following the protocols of the Psycholinguistic Assessment in Chinese Aphasia (PACA). Four lists, each containing 60 test items, were used randomly across each assessment. The reaction time for each item was limited to 20 seconds, and no cues were provided if the patient failed to respond correctly. Speech-language therapy was conducted using a computer system in two 30-minute sessions each day. Further details on these procedures are available in previously published work (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003etDCS\u003c/h3\u003e\n\u003cp\u003eA portable battery-driven device (IS200, Chengdu, China) delivered a constant current of 1.2 mA (approximately 0.05 mA/cm\u0026sup2;) for 20 minutes to the left SPT using a pair of saline-soaked surface sponge electrodes (4.5 cm \u0026times; 5.5 cm). The location of the SPT was identified by referencing the \"left Wernicke\u0026rsquo;s point (LWP),\" defined as the intersection of the T3-P3 and C3-T5 lines in the posterior temporal region according to Friederici\u0026rsquo;s method (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The cathodal electrode was positioned over the right shoulder. For sham tDCS, the device automatically powered off after 30 seconds. In both active and sham tDCS conditions, the current intensity was gradually increased and decreased.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEEG recording\u003c/h2\u003e \u003cp\u003eA wireless digital EEG system (ZN16E, Chengdu, China) was used for EEG recording, with a bandwidth of 0.3\u0026ndash;100 Hz and a sampling rate of 500 Hz. Sixteen EEG electrodes were positioned according to the international 10\u0026ndash;20 or 10\u0026ndash;10 system. Notably, the F7 electrode was placed on the left IFG, defined as the intersection of the T3-Fz and F7-Cz lines (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e), and the F8 electrode was placed on the right IFG. The cortical regions corresponding to the electrode placements were as follows: dorsolateral prefrontal cortex (DLPFC) at F3/F4, IFG at F7/F8, M1 at C3/C4, SPT at T5/T6, middle temporal lobe (MTL) at T3/T4, and IPL at P3/P4 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Reference electrodes were positioned on the earlobes. The procedures for EEG recording, including methods to mitigate electromyography artifacts and eliminate electrical noise, followed those detailed in previously published studies (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). EEG was recorded under two conditions: with the eyes closed for approximately 5 minutes, followed by eyes-closed repetition of a three-syllable word list.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eNon-linear Index: Cross Approximate Entropy (C-ApEn)\u003c/h3\u003e\n\u003cp\u003eCross approximate entropy (C-ApEn) was used to analyse two related time series and measure their degree of asynchrony by comparing sequences from one series to those of the second series to reflect the spatial decorrelation of cortical potentials from two remote sites (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Higher values of C-ApEn indicated higher degrees of inter-cortical communication or information flow (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The expression formula and parameters for C-ApEn have been previously detailed in our earlier studies (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In this study, specific EEG sites within the speech and language network were selected, including DLPFC (F3/F4), IFG (F7/F8), M1 (C3/C4), IPL (P3/P4), SPT (T5/T6), and MTL (T3/T4). C-ApEn for these sites, encompassing intrahemispheric C-ApEn within the left and right hemispheres and interhemispheric C-ApEn, were calculated to elucidate functional connectivity within the network.\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eSPSS 22.0 (IBM, Armonk, NY, USA) was used for data analysis. The Pearson chi-square test was used to determine the difference between the two groups for categorical variables. For continuous variables, the independent t-test (normal distribution) or Mann-Whitney U-test (non-normal distribution) was applied to test the difference between the two groups. Paired t-test or paired Wilcoxson signed-rank test was adopted for comparing baseline and post-treatment for each group. Univariate and multivariate linear regression analyses were used to investigate the relevant factors for improving picture naming. The group and baseline characteristics were included as independent variables in the model. The multivariate linear regression analysis included variables with \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.3 in the univariate linear regression analysis. Two-tailed \u003cem\u003ep\u003c/em\u003e values\u0026thinsp;\u0026lt;\u0026thinsp;0.05 were considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eBaseline\u003c/h2\u003e \u003cp\u003eThe study included a total of 60 patients. The treatment of tDCS was well-tolerated by all participants, with no adverse effects observed. The demographics and stroke characteristics of the participants are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. No significant differences were observed between groups for age, sex, education, stroke etiology, lesion site, and post-stroke onset. The speech assessments at baseline, including types of aphasia, aphasia severity, baseline score of picture naming and auditory word-picture identification, were similar between groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe demographics and stroke characteristics of the participants.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003etDCS group(n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group(n\u0026thinsp;=\u0026thinsp;30)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49.7\u0026thinsp;\u0026plusmn;\u0026thinsp;21.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.4\u0026thinsp;\u0026plusmn;\u0026thinsp;16.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.941\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex(male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23(76.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.754\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation(years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.4\u0026thinsp;\u0026plusmn;\u0026thinsp;4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.628\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke etiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThrombosis MCA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20(66.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(63.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.787\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemorrhage MCA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(36.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLesion site\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrontal cortex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(86.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(86.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTemporal cortex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24(80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(83.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.739\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParietal cortex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24(80.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(76.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.754\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBasal ganglia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(33.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16(53.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.118\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoststroke onset(months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.909\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAphasia type*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBroca\u0026rsquo;s\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(86.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21(70.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.341\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWernicke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(3.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConductive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0(0.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(3.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMixed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(23.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAphasia severity*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(13.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(20.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.857\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9(30.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(23.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9(30.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(33.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(26.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(23.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003e* Aphasia type and aphasia severity were evaluated using the Boston Diagnostic Aphasia Examination-Chinese Version.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eMCA: middle cerebral artery.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD or number (percentage).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSpeech-language assessments\u003c/h2\u003e \u003cp\u003eFollowing the 4-week intervention, both groups showed significant improvement from baseline in picture naming and auditory word-picture identification scores (both \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), showed in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The tDCS group demonstrated significantly greater improvements than the control group, a difference that was statistically confirmed when comparing the changes (pre-post difference scores) between the two groups(\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Results were listed in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Univariate and multivariate linear regression analyses were used to investigate the relevant factors for improving picture naming (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The group assignment and baseline characteristics were included in the model as independent variables. The multivariate regression analyses showed that assignment to the tDCS group was significantly associated with greater improvement (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSpeech-language assessments of each group at baseline and post-treatment (Post-T).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003etDCS group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c10\" namest=\"c7\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePost-T\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ez\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003ePost-T\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ez\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePicture naming (0\u0026ndash;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e18.2\u0026thinsp;\u0026plusmn;\u0026thinsp;14.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e27.7\u0026thinsp;\u0026plusmn;\u0026thinsp;17.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-4.786\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e18.8\u0026thinsp;\u0026plusmn;\u0026thinsp;16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c8\"\u003e \u003cp\u003e20.3\u0026thinsp;\u0026plusmn;\u0026thinsp;16.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-3.401\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAuditory word-picture identification (0\u0026ndash;60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e42.0\u0026thinsp;\u0026plusmn;\u0026thinsp;10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e \u003cp\u003e49.8\u0026thinsp;\u0026plusmn;\u0026thinsp;10.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-4.797\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c7\"\u003e \u003cp\u003e42.8\u0026thinsp;\u0026plusmn;\u0026thinsp;13.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c8\"\u003e \u003cp\u003e44.6\u0026thinsp;\u0026plusmn;\u0026thinsp;13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e-3.837\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLinear regression analysis of the relevant factors for the improvement of picture naming.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eUnivariate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c14\" namest=\"c10\"\u003e \u003cp\u003eMultivariate\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics(ref)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eUnstandardized coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandardized coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c8\" namest=\"c7\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003eUnstandardized coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003eStandardized coefficient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003estandard error\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eb\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003estandard error\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cem\u003eb\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGroup(control)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.933\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.288\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.477\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7.811\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.068\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.681\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e7.317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.063\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.479\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.634\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex(male)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.638\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.827\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.046\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.349\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.728\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.992\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStroke etiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-2.234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.155\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1.779\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1.126\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-0.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-1.579\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.120\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePost-stroke onset\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.684\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAphasia type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.546\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.639\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-0.855\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.396\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAphasia severity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.919\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.721\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.208\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.633\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e0.522\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e1.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e0.230\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"14\"\u003eMultivariate regression analysis: R\u003csup\u003e2\u003c/sup\u003e 0.517, adjust R\u003csup\u003e2\u003c/sup\u003e 0.491\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eEEG C-ApEn analysis\u003c/h2\u003e \u003cp\u003eC-ApEn difference values under eyes-closed and repetition task conditions at baseline and post-treatment are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Within the tDCS group, post-treatment values were significantly higher than baseline in multiple connections: F3-P3(left DLPFC-left IPL), F7-P3(left IFG- left IPL), T3-T5(left MTL- left SPT), T5-P3(left SPT-left IPL), T5-C3(left SPT-left M1), C3-P3(left M1-left IPL), T4-T6(right MTL-right SPT), T3-T4(bilateral MTL), and T5-T6(bilateral SPT). Between-group comparisons of the change in C-ApEn difference values (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e) revealed that the tDCS group exhibited overall greater increases in the left hemisphere. Significant between-group differences were found in the same connections listed above.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe difference value of the cross approximate entropy (C-ApEn) under the eye-closed condition and repetition task before and after the treatment.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003etDCS group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c8\" namest=\"c6\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePost-T\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eBaseline\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ePost-T\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF3-F7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.442\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF3-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.810\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-C3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-T3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-T5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.072\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.476\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.873\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT3-T5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT5-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.05\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.738\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT5-C3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.009\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.722\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC3-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.271\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF4-F8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.556\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF4-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-C4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.613\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-T4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-T6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.601\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.100\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.142\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT4-T6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.321\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT6-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.167\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT6-C4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.512\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC4-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.446\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF3-F4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.482\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.553\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-F8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.354\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC3-C4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.886\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT3-T4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.034\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT5-T6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP3-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.495\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe comparison of changes of the difference value of the cross approximate entropy (C-ApEn) between two groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003etDCS group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF3-F7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF3-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-C3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-T3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.059\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-T5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT3-T5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT5-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT5-C3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC3-P3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.049\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF4-F8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF4-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-C4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-T4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.479\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-T6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.069\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF8-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.080\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT4-T6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT6-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT6-C4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.141\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC4-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.095\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF3-F4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.502\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eF7-F8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.328\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC3-C4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.173\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT3-T4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eT5-T6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.03\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-0.01\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eP3-P4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.02\u0026thinsp;\u0026plusmn;\u0026thinsp;0.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.00\u0026thinsp;\u0026plusmn;\u0026thinsp;0.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.071\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo the best of our knowledge, this study is the first to investigate alterations in functional connectivity after A-tDCS over the left SPT. The combination of A-tDCS over the left SPT with speech-language therapy improved picture naming and auditory word-picture identification performance in patients with subacute post-stroke aphasia, showing significant improvement compared to speech therapy alone. EEG C-ApEn analysis revealed significant elevation of the functional connectivity in F3-P3, F7-P3, T3-T5, T5-P3, T5-C3, C3-P3, T4-T6, T3-T4, and T5-T6, indicating partial elevation of both direct and indirect connections within the ventral and dorsal language networks and enhanced functional connectivity between the executive control network and the language network. These results confirm our hypotheses.\u003c/p\u003e \u003cp\u003eIn this study, the EEG index of C-ApEn was used to investigate functional connectivity during a repetition task. The ventral pathway for picture naming projects from the occipital lobe and the visual object-form area to the frontal regions via the IFOF, ILF, and UF (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The dorsal pathway for picture naming significantly overlaps with brain regions engaged during word repetition: the SPT is involved in translating and integrating sensory codes with the motor system (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e); the IPL is a key area where multiple sensory inputs converge, playing a role in motor program selection (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e) and motor learning (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e); the left IFG (Broca\u0026rsquo;s area) is closely linked to word retrieval and speech motor programming (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e); and the left PMC and left M1 function as a sequentially organized common final pathway for producing specific movement commands, following projections of information from other cortical and subcortical areas (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eThe elevation of direct connections with the stimulation site SPT after tDCS\u003c/h2\u003e \u003cp\u003eAmong all the direct connections with the stimulation site SPT, A-tDCS enhanced the direct connections between the left SPT and the left MTL, left IPL (T5-T3, T5-P3), as well as the right SPT (T5-T6). However, the direct connection between the left SPT and the left IFG (T5-F7) was not elevated.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eBoth direct and indirect connections within the dual-streams are partially elevated after tDCS\u003c/h2\u003e \u003cp\u003eIn the dual-stream model of language processing, the dorsal stream links the temporo-parietal regions to the frontal premotor areas via the SLF and the AF. This includes the \u0026ldquo;long segment\u0026rdquo; as the \u0026ldquo;direct\u0026rdquo; pathway, projecting from the posterior STG to the IFG, and two \u0026ldquo;indirect\u0026rdquo; pathways: a fronto-inferior parietal\u0026ndash;posterior temporal segment as the anterior part (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e) and a posterior temporal\u0026ndash;inferior parietal segment as the posterior part. In the ventral stream, the IFOF serves as the main \u0026ldquo;direct\u0026rdquo; pathway essential for semantic processing, projecting from the temporo-occipital area and the parietal lobe to the IFG, orbital frontal cortex, and the frontal pole (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). Additionally, there are two \u0026ldquo;indirect\u0026rdquo; pathways: the ILF, which connects the occipital lobe to the temporal lobe, and the UF, which connects the temporal lobe to the prefrontal cortex (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In this study, we found that in the dorsal stream, the \u0026ldquo;long segment\u0026rdquo; between the tDCS stimulation site SPT and the IFG (T5-F7), which serves as the \u0026ldquo;direct\u0026rdquo; pathway, did not fully recover, whereas the multi-step \u0026ldquo;indirect\u0026rdquo; pathway SPT-IPL-IFG (T5-P3-F7) did recover. Within the multi-step \u0026ldquo;indirect\u0026rdquo; pathway SPT-IPL-M1-IFG, the connection between M1 and IFG (C3-F7) did not recover. In the ventral stream, the main \u0026ldquo;direct\u0026rdquo; pathway SPT-IFG did not completely recover. The \u0026ldquo;indirect\u0026rdquo; pathway SPT-MTL (T5-T3) recovered, but the MTL-IFG connection (T3-F7) did not. A graphical summary of these results is illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eThe functional connectivity between the executive control network and the language network is enhanced\u003c/h2\u003e \u003cp\u003eIn the EEG examination, we also monitored the DLPFC (F3) and IPL (P3), which are key nodes of the executive control network (ECN), to observe the role of the ECN in language processing. The ECN, a domain-general network, supports various cognitive processes, including working memory, cognitive control, attention, and executive functions, providing flexible resources for initiating and maintaining cognitive control. Key brain regions of the ECN were found to remain elevated in post-stroke aphasia patients (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Successful language recovery aligned with the recovery of domain-general networks, particularly the modular brain networks of attention and spatial memory (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). In this study, EEG functional connectivity results showed that the connection between the IFG and the IPL (F7-P3) recovered, as did the fronto-parietal connection between the DLPFC and IPL (F3-P3), but the connection between the IFG and DLPFC (F7-F3) did not recover. It remains unclear whether this lack of recovery is due to insufficient activation of the IFG or because the repetition task is relatively simple, requiring less semantic activation and lexical retrieval involving the ECN. The results also revealed that multiple pathways directly connected to the IPL were elevated, possibly indicating that the IPL, adjacent to the SPT, compensated for the function of the SPT when it was damaged. The activation of the IPL might play a crucial role in the improvement of naming and repetition tasks.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eThe elevation of connections in the right hemisphere\u003c/h2\u003e \u003cp\u003eThis study also found that tDCS over the left SPT could elevate its interhemispheric connections with the right SPT (T5-T6), as well as the direct interhemispheric connection of the bilateral MTL (T3-T4) and the direct connection between the right SPT and the right MTL (T6-T4). This suggests partial involvement of the right hemisphere in aphasia recovery. Given that the ventral stream exists in both hemispheres, this elevation may be related to the bilateral STG and MTL being engaged by auditory speech.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eFurther Research Implications\u003c/h2\u003e \u003cp\u003eWe found that the non-elevated functional connections were all related to the IFG, including: the M1-IFG (C3-F7) in the dorsal stream, the \u0026ldquo;long-segment\u0026rdquo; pathway SPT-IFG (T5-F7), the IFG-DLPFC (F7-F3) in the executive control network, and the MTL-IFG (T3-F7) in the ventral stream. This suggests that for aphasia patients with severe lesions spanning temporal, parietal, and frontal lobes (17/30 cases in this study), tDCS targeting only the SPT region may be insufficient to restore the IFG's direct connections with the dual streams, or the complete multi-step indirect connections. The SPT is the posterior confluence/divergence point of the dual streams, while the IFG is the anterior confluence point. Future research should investigate whether dual-target tDCS involving both the left IFG and left SPT can further promote changes in the functional connectivity of the dual-stream and the executive control network, thereby improving the picture-naming ability of aphasia patients.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec21\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eLimitations of this study include: (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) Our findings do not allow us to conclude whether the activation of long direct pathways confers a recovery benefit superior to that achieved through the activation of multi-step indirect pathways. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) The localization of brain regions was conducted using the EEG international 10\u0026ndash;20 system, which has relatively low spatial resolution compared to fMRI.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eA-tDCS targeting the left SPT region, combined with speech-language therapy, can improve picture naming and auditory comprehension in patients with subacute post-stroke aphasia. Both direct and indirect connections within the ventral and dorsal language networks in the left hemisphere were partially elevated, and functional connectivity between the executive control network and the language network was enhanced. Additionally, the elevation was observed in some connections within the right hemisphere and between the bilateral hemispheres.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003earcuate fasciculus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eA-tDCS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eanodal transcranial direct current stimulation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eC-ApEn\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ecross approximate entropy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDLPFC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003edorsolateral prefrontal cortex\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eECN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eexecutive control network\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEEG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eelectroencephalogram\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIFG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003einferior frontal gyrus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIFOF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003einferior fronto-occipital fasciculus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eILF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003einferior longitudinal fasciculus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIPL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003einferior parietal lobule\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLWP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eleft Wernicke\u0026rsquo;s point\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMLF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emiddle longitudinal fasciculus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMTL\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emiddle temporal lobe\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNDA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNonlinear dynamics analysis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePACA\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePsycholinguistic Assessment in Chinese Aphasia\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePMC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003epremotor cortex\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eRCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003erandomized controlled trial\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esuperior longitudinal fasciculus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003espeech-language therapy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eSylvian parietal temporal region\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSTG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esuperior temporal gyrus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eUF\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003euncinate fasciculus\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003e The studies involving human participants were reviewed and approved by The Ethics Committees of Wangjing Hospital of China Academy of Chinese Medical Sciences and. The patients/participants provided their written informed consent to participate in this study.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis work was supported by National Natural Science Foundation of China (grant numbers 81171011 and 81572220), the Scientific and technological innovation project of China Academy of Chinese Medical Sciences (CI2021A01410) and Project of Wangjing Hospital of China Academy of Chinese Medical Sciences (grant numbers WJYY-XZKT-2023-26, WJCXTD-2024-02, WJYY-ZZXT-2023-06 and WJYY-ZZXT-2025-06).\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJZ and JG have contributed equally to the data analysis and drafting the manuscript. YL, XZ, YY, YC, GD, BL, QW, YJ and QG participated in the conduction of the study including patients\u0026rsquo; enrollment, treatment and assessments. DW, JW and CX designed and supervised the study, and critically revised the manuscript. All authors reviewed and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBaker JM, Rorden C, Fridriksson J. Using transcranial direct-current stimulation to treat stroke patients with aphasia. Stroke. 2010;41(6):1229\u0026ndash;36.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePolanowska KE, Leśniak MM, Seni\u0026oacute;w JB, Czepiel W, Członkowska A. 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Cortex. 2018;101:44\u0026ndash;59.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-neuroengineering-and-rehabilitation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jner","sideBox":"Learn more about [Journal of NeuroEngineering and Rehabilitation](http://jneuroengrehab.biomedcentral.com/)","snPcode":"12984","submissionUrl":"https://submission.nature.com/new-submission/12984/3","title":"Journal of NeuroEngineering and Rehabilitation","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"aphasia, electroencephalogram, functional connectivity, picture naming, transcranial direct current stimulation","lastPublishedDoi":"10.21203/rs.3.rs-8606611/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8606611/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study aimed to investigate the effects of anodal transcranial direct current stimulation (A-tDCS) over the left Sylvian parietal temporal region (SPT) on picture naming and changes in brain functional connectivity in post-stroke aphasic patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is a double-blind, sham-controlled, randomized controlled study. Sixty aphasic patients were randomly assigned to receive either active or sham tDCS over the SPT as well as speech-language therapy for four weeks. Standardized aphasia assessments and electroencephalogram (EEG) examinations were conducted before and after the treatment. The EEG nonlinear index of cross approximate entropy (C-ApEn) was used to assess brain functional connectivity.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe tDCS group demonstrated significantly greater improvements than the control group in both picture naming and auditory word-picture identification scores (\u003cem\u003ep\u003c/em\u003e \u0026lt; 0.001). Regression analysis revealed that the group (tDCS/control) was the primary factor associated with improving picture naming. The functional connectivity of F3-P3, F7-P3, T3-T5, T5-P3, T5-C3, C3-P3, T4-T6, T3-T4, and T5-T6 significantly increased following tDCS.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA-tDCS targeting the left SPT region can improve picture naming in patients with subacute post-stroke aphasia. Both direct and indirect connections within language networks in the left hemisphere were partially elevated, and functional connectivity between the executive control network and the language network was enhanced. Additionally, activation was observed in some connections within the right hemisphere and between the bilateral hemispheres. The analysis of brain functional connectivity provides neural network evidence for the effect of tDCS in enhancing naming abilities in stroke patients with aphasia.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial registry number: \u003c/strong\u003eChiCTR-TRC-14005072\u003c/p\u003e","manuscriptTitle":"Improvement in naming with tDCS and alteration of functional connectivity in post-stroke aphasia: A randomized controlled trial","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-22 06:53:41","doi":"10.21203/rs.3.rs-8606611/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-03-24T03:07:56+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-23T15:04:38+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-12T11:43:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"88777475700118692057163050947631050170","date":"2026-02-16T13:11:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"35910095699854081202466821302527344279","date":"2026-02-12T07:14:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"291385213297853686771373225108540083458","date":"2026-02-10T08:24:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"339027365316218152654182840366313642035","date":"2026-01-19T05:26:26+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-19T02:13:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-15T08:33:08+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-15T08:31:03+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of NeuroEngineering and Rehabilitation","date":"2026-01-15T03:40:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-neuroengineering-and-rehabilitation","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"jner","sideBox":"Learn more about [Journal of NeuroEngineering and Rehabilitation](http://jneuroengrehab.biomedcentral.com/)","snPcode":"12984","submissionUrl":"https://submission.nature.com/new-submission/12984/3","title":"Journal of NeuroEngineering and Rehabilitation","twitterHandle":"@BioMedCentral","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0fef4f41-d807-4ebd-a5f4-fbc0fe55e295","owner":[],"postedDate":"January 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-03-24T03:23:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-22 06:53:41","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8606611","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8606611","identity":"rs-8606611","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}