Transcutaneous auricular vagus nerve stimulation (taVNS) is an emerging non-invasive neuromodulation therapy. This study aimed to explore the therapeutic use of taVNS, optimal stimulation parameters, effective sham protocols, and safety. A scoping review was conducted. Five databases and grey literature were searched. The data extracted included stimulation parameters, adverse events (AEs), and therapeutic effects on clinical outcomes. 109 studies were included. taVNS was used across 21 different clinical populations, most commonly in psychiatric, cardiac, and neurological disorders. Overall, 2,214 adults received active taVNS and 1,017 received sham taVNS. Reporting of stimulation parameters was limited and inconsistent. taVNS appeared to have a favourable therapeutic effect across a wide range of clinical populations with varied parameters. Three sham protocols were reported but their effectiveness was documented in only two of the 54 sham-controlled studies. Most reported adverse events were localised to stimulation site. There is growing evidence for taVNS therapeutic effect. taVNS appears safe and tolerable. Sham protocols need evaluation. Standardised and comprehensive reporting of both stimulation parameters and adverse events is required. Two different questionnaires have been proposed to evaluate adverse events and the effectiveness of sham methods in blinding participants.

Aphasia is an acquired language impairment that commonly results from stroke. Non-invasive brain stimulation (NIBS) might accelerate aphasia recovery trajectories and has seen mounting popularity in recent aphasia rehabilitation research. The present review aimed to: (1) summarise all existing literature on NIBS as a post-stroke aphasia treatment; and (2) provide recommendations for future NIBS-aphasia research. Databases for published and grey literature were searched using scoping review methodology. 278 journal articles, conference abstracts/posters, and books, and 38 items of grey literature, were included for analysis. Quantitative analysis revealed that ipsilesional anodal transcranial direct current stimulation and contralesional 1-Hz repetitive transcranial magnetic stimulation were the most widely used forms of NIBS, while qualitative analysis identified four key themes including: the roles of the hemispheres in aphasia recovery and their relationship with NIBS; heterogeneity of individuals but homogeneity of subpopulations; individualisation of stimulation parameters; and much remains under-explored in the NIBS-aphasia literature. Taken together, these results highlighted systemic challenges across the field such as small sample sizes, inter-individual variability, lack of protocol optimisation/standardisation, and inadequate focus on aphasiology. Four key recommendations are outlined herein to guide future research and refine NIBS methods for post-stroke aphasia treatment.

Background: Technologies such as videofluoroscopy, therapy applications, and telehealth have been translated into the clinical toolkit of many speech–language pathologists (SLPs). Transcranial magnetic stimulation (TMS) is an emerging technology that shows therapeutic promise for communication and swallowing disorders and, once suitable for clinical use, SLPs will likely be responsible for delivering this treatment. As such, it is critical that SLP opinions and attitudes towards TMS, as well as broader translation issues facing the profession, are considered early in the TMS research and translation process.Aims: (1) To explore in‐depth the determinants of SLP behaviour that could influence translation of TMS into speech–language pathology practice; and (2) to examine these behavioural determinants within the context of profession‐wide research‐to‐practice gaps.Methods and Procedures: Semi‐structured interviews were conducted with 10 SLPs, who were classified into novice, intermediate, or expert TMS knowledge/experience levels. Reflexive thematic analysis conventions were used to inductively and deductively code interview data. The refined Theoretical Domains Framework (rTDF) informed study design, analysis, interpretation, and reporting, and served as a theoretical lens through which recommendations were developed.Outcomes and Results: Four main themes were derived from interview data, representing four overarching determinants of SLP behaviour: actual knowledge/experience; perceptions of professional role and capabilities; optimism/pessimism mindset and emotions; and environmental factors. Results within each theme were categorised as TMS‐specific (aim 1) or profession‐wide (aim 2).Conclusions and Implications: Many TMS‐specific behavioural determinants could impact the translation of TMS into speech–language pathology, however these exist against the backdrop of larger, profession‐wide translation issues. A taxonomy of nine recommendations for bridging technology translation gaps in speech–language pathology is provided, with a view to facilitating future implementation of TMS and other technologies.WHAT THIS PAPER ADDS: What is already known on the subject Transcranial magnetic stimulation (TMS) might one day be used as a treatment for communication and swallowing disorders, and speech–language pathologists (SLPs) will likely be responsible for delivering this treatment. Previous research has investigated SLPs’ opinions and attitudes towards TMS to identify determinants of SLP behaviour that could impact translation of TMS into practice. However, more in‐depth investigation is required within the context of profession‐wide translation issues. What this paper adds to the existing knowledge The present study highlights behavioural determinants that could impact translation of TMS, as well as profession‐wide research‐to‐practice gaps. We suggest important strategies and lines of enquiry to bridge translation gaps for use of technologies in speech–language pathology, which are summarised as a taxonomy of nine recommendations. What are the potential or actual clinical implications of this work? Results from this study may help SLPs to acknowledge and characterise translation issues in their own practice and across the broader profession. Our taxonomy of recommendations can be used in clinical, research, and implementation science settings to address technology translation issues in speech–language pathology, facilitating future integration of TMS and other technologies into practice.

To identify determinants of speech-language pathologist (SLP) behaviour that might influence future implementation of transcranial magnetic stimulation (TMS) treatments for communication and swallowing. A cross-sectional, international, online survey of 96 SLPs collected quantitative and qualitative data in a convergent parallel design. The refined Theoretical Domains Framework (rTDF) guided survey design, analysis, interpretation, and reporting. Respondents had limited familiarity and experience with TMS (rTDF domains of knowledge and skills). Approximately half did not believe TMS would fit within their current role (social/professional role and identity). Few perceived themselves capable of administering TMS at the time of the survey, however 66.7% believed they would be capable following standard training (beliefs about capabilities). Many were optimistic about TMS (optimism), while others described potential consequences (beliefs about consequences). Respondents perceived environmental barriers such as cost and training requirements/availability (environmental context and resources). As a next step, education should be provided to SLPs to increase awareness of TMS and to address beliefs about TMS in relation to role and identity, capabilities, optimism, and consequences. This study is an example of how new technologies are perceived by SLPs. Further research into broader technology translation issues facing the profession is warranted.

Objective: Repetitive transcranial magnetic stimulation (rTMS) shows promise as an aphasia treatment, however its physiological mechanisms in people with aphasia (PWA) remain largely unclear. Electroencephalography (EEG) could be used to explore rTMS mechanisms. The present study investigated the acute effects of rTMS in PWA on: 1) an EEG measure of language (N400 event-related potential); and 2) picture naming. Methods: Eleven people with chronic non-fluent or anomic aphasia (64 ± 10.13 years old; 8 males; 37.27 ± 20.64 months since stroke) received one session of 1-Hz rTMS and one session of sham to the right pars triangularis at 80% resting motor threshold (RMT). N400 mean amplitude and picture naming accuracy were compared before and after each session. Results: No acute changes were observed in N400 mean amplitude or picture naming accuracy as compared to sham (p > 0.05; BF₁₀ < 0.33). Conclusions: Results suggest that language networks underlying the N400 are not altered following one session of 1-Hz rTMS in PWA. Significance: Although EEG could be useful for assessing physiological mechanisms of rTMS in PWA, the N400 does not appear to be a viable measure of acute 1-Hz rTMS effects, at least when delivered at 80% RMT in a single session.