Combining Intermittent Theta Burst Stimulation (iTBS) With Computerized Working Memory Training to Improve Language Abilities in Chronic Aphasia: A Pilot Case Study

Kranou-Economidou, Despina; Kambanaros, Maria

doi:10.1080/02687038.2020.1852165

Cited by 6 publications

(11 citation statements)

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“…In line with previous studies, findings from this investigation ( Table 7 ) lend support to the evidence that (i) WM interacts with language abilities and deficits in WM influence language performance [ 10 , 61 ], (ii) applying iTBS to the LDLPFC results in improved WM performance [ 10 , 62 , 63 ], (iii) computerized WM training can have positive outcomes on WM tasks [ 64 ], and (iv) aphasia has a negative effect on QoL [ 65 ].…”

Section: Discussionsupporting

confidence: 91%

“…These findings are consistent with research showing that significant improvements in Gf resulting from cognitive intervention combined with different transcranial electrical brain stimulation protocols [ 70 ]. Our findings support the notion that Gf can be improved with DLPFC stimulation [ 70 ] and WM training [ 10 , 71 – 73 ]. Considering the fact that a combination of treatments was used and it is still controversial whether WM training leads to Gf improvement [ 74 ], the findings are inconclusive as to whether improvement was due to the treatment combination or to the DLPFC stimulation.…”

Section: Discussionsupporting

confidence: 89%

“…The main objective was to explore the potential domains of transfer effects after stimulating the left DLPFC combined with WM training and also to measure how this affected the quality of life of the participant. In a previous pilot study [ 10 ], we found evidence signifying the possible improvement that could specifically yield from noninvasive brain stimulation programs using iTBS combined with the RehaCom WM training program in PWA. Studies performed on healthy aging which are usually focused on prevention, consider the use of rTMS as a tool for cognitive enhancement of the elderly with mild cognitive impairments (MCI), aimed at reversing or compensating for the cognitive deficits [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 87%

“…WM, the ability to temporarily store and manipulate information in the provision of ongoing tasks, is based on the belief that a dedicated system maintains and stores information in the short term and that this system underlies human thought processes [ 3 ]. While a range of cognitive abilities has been associated with WM, including reading comprehension, logical thinking, general intelligence, learning ability, and fluid reasoning [ 4 – 8 ], recent investigations explore how cognitive enhancement can support improvements in other areas (i.e., language) in people with neurological impairments [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Aphasia has traditionally been defined as a language impairment due to the disruption of the blood flow to the brain, which can result in reduced ability to comprehend and/or express oral and/or written language. Lately, research studies investigate whether aphasia is the result of a cognitive process disruption, specifically the disruption of the WM neural network [ 10 ]. In the recent past, aphasia was also defined as a cognitive disorder with major linguistic deficits, as opposed to a specific language disturbance [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Transcranial Magnetic Stimulation and Working Memory Training to Address Language Impairments in Aphasia: A Case Study

Kranou-Economidou

Kambanaros

2021

Behavioural Neurology

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Background. Traditionally, people with aphasia (PWA) are treated with impairment-based language therapy to improve receptive and expressive language skills. In addition to language deficits, PWA are often affected by some level of working memory (WM) impairments. Both language and working memory impairments combined have a negative impact on PWA’s quality of life. The aim of this study was to investigate whether the application of intermittent theta-burst stimulation (iTBS) combined with computerized WM training will result in near-ransfer effects (i.e., trained WM) and far-transfer effects (i.e., untrained language tasks) and have a positive effect on the quality of life of PWA. Methods. The participant was a 63-year-old Greek-Cypriot male who presented with mild receptive aphasia and short-term memory difficulties. Treatment was carried out using a multiple baseline (MB) design composed of a pretherapy or baseline testing phase, a therapy phase, and a posttherapy/follow-up phase. The treatment program involved iTBS application to the left dorsolateral prefrontal cortex (DLPFC), an area responsible for WM, for 10 consecutive sessions. The participant received a 3-minute iTBS application followed by 30-minute computer-assisted WM training. Outcome measures included a WM screening test, a standardized aphasia test, a nonverbal intelligence test, story-telling speech samples, a procedural discourse task, and a questionnaire addressing quality of life. These measures were performed three times before the treatment, immediately upon completion of the treatment, and once during follow-up testing at 3 months posttreatment. Results. We found a beneficial effect of iTBS and WM training on naming, reading, WM, reasoning, narrative, communication efficiency, and quality of life (QoL). Implications for Rehabilitation. Noninvasive brain stimulation combined with computerized WM training may be used in aphasia rehabilitation to improve WM and generalize to language improvement.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Transcranial Magnetic Stimulation and Working Memory Training to Address Language Impairments in Aphasia: A Case Study

Kranou-Economidou

Kambanaros

2021

Behavioural Neurology

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Investigating NIBS for language rehabilitation in aphasia

et al. 2022

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Purpose: The purpose of this scoping review was to identify and synthesize research on interventions in which noninvasive brain stimulation (NIBS) was used to improve linguistic abilities in individuals with aphasia. NIBS comprising transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are emerging technologies with potential to improve the underlying neurobiology of language in brains with stroke-induced lesions.Methods: The results of a systematic search of electronic literature databases were reviewed in CADIMA software by two authors yielding 57 studies published between 2015 and 2022. Selected articles were reviewed for study characteristics, participant characteristics, intervention details, and outcome measures.Results: NIBS is largely used for non-fluent aphasia during the chronic phase of recovery for improving naming and comprehension using picture naming and auditory comprehension of words, commands, and small paragraphs. Standardized test materials are used to measure treatment efficiency, with neuroimaging gradually emerging as an added measure to assess the neurobiological changes arising as a result of treatment induced linguistic recovery. Conclusion:The findings from this scoping review describe the design and delivery of NIBS treatment from subacute to chronic stages of recovery in aphasia. Positive results from heterogenous studies show the potential of NIBS in improving linguistic outcomes for people with aphasia. Large scale clinical trials and systematic reviews should further substantiate our findings of NIBS efficiency for specific language skills (e.g., naming accuracy, sentence production, discourse comprehension).

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Non-invasive brain stimulation in the treatment of post-stroke aphasia: a scoping review

Williams,

Sghirripa,

Rogasch

et al. 2023

Disability and Rehabilitation

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Combining Intermittent Theta Burst Stimulation (iTBS) With Computerized Working Memory Training to Improve Language Abilities in Chronic Aphasia: A Pilot Case Study

Cited by 6 publications

References 73 publications

Transcranial Magnetic Stimulation and Working Memory Training to Address Language Impairments in Aphasia: A Case Study

Transcranial Magnetic Stimulation and Working Memory Training to Address Language Impairments in Aphasia: A Case Study

Investigating NIBS for language rehabilitation in aphasia

Non-invasive brain stimulation in the treatment of post-stroke aphasia: a scoping review

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