Improving self-awareness (Pettemeridou et al., 2025)
Purpose: This pilot study aimed to evaluate the feasibility of an integrated rehabilitation intervention combining the social cognitive-communication (SocCom) training with transcranial direct current stimulation (tDCS) for individuals with chronic moderate–severe acquired brain injury (MS-ABI), focusing on enhancing self-awareness and executive functions in an outpatient setting.
Method: Twenty-five individuals with MS-ABI (Mage = 39.64, SD = 14.78; Mdntimesinceinjury = 6.00 years). Participants were randomly assigned to either the combined intervention (n = 12) or the SocCom group (n = 13). The intervention was delivered over an 11-week period. A comprehensive neuropsychological and psychosocial assessment, along with functional near-infrared spectroscopy (fNIRS), were conducted pre and post intervention implementation to assess its impact on self-awareness, executive functions, and quality of life. Nonparametric tests were conducted to examine within- and between-group differences.
Results: Participants of both groups showed significant within-group improvements (p < .05) in memory, executive functions, semantic knowledge, and quality of life, demonstrating the interventions’ broad impact. Furthermore, neurophysiological changes measured via the fNIRS indicated significant brain function alterations (p < .05) in the combined intervention group, suggesting a synergistic effect of SocCom and tDCS. Between-groups comparisons revealed superior improvements in the combined intervention group in tasks requiring visual memory, executive function, and processing speed, underscoring the added value of tDCS in cognitive rehabilitation outcomes for individuals with chronic MS-ABI.
Conclusion: The integrated SocCom and tDCS intervention offers a promising strategy for enhancing cognitive and psychosocial outcomes in individuals with chronic MS-ABI, suggesting a valuable addition to existing rehabilitation efforts and supporting a more personalized, holistic approach to recovery.
Supplemental Material S1. The inclusion/exclusion criteria for TBI and stroke.
Supplemental Material S2. Description of the SocCom intervention protocol.
Pettemeridou, E., Lofitou, K., Solomou, I., Charalambous, M., Ioannou, M., Lori, A., Papacostas, S. S., Pantzaris, M., & Constantinidou, F. (2025). Improving self-awareness in chronic moderate–severe acquired brain injury: The social cognitive communication intervention combined with transcranial direct current stimulation. American Journal of Speech-Language Pathology, 34(4), 2228–2243. https://doi.org/10.1044/2025_AJSLP-24-00326
Funding
This work was supported by the Research and Innovation Foundation of Cyprus and co-funded by the Republic of Cyprus and the European Regional Development Fund under the Framework Program “RESTART 2016–2020/EXCELLENCE HUBS: PILLAR II” for Research, Technological Development, and Innovation (EXCELLENCE/0918/0117 and EXCELLENCE/1216/0411; awarded to Principal Investigator: Fofi Constantinidou, Center for Applied Neuroscience, University of Cyprus).
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