Effects of different frequencies of repetitive transcranial magnetic stimulation in stroke patients with non-fluent aphasia: a randomized, sham-controlled study

Hu, Xueyan; Zhang, Tong; Rajah, Gary; Stone, Christopher; Liu, Lixu; He, Jing-Jie; Shan, Lei; Yang, Lingyu; Liu, Ping; Gao, Fei; Yang, Yuqi; Wu, Xiaoli; Ye, Changqing; Chen, Yudong

doi:10.1080/01616412.2018.1453980

Cited by 68 publications

(77 citation statements)

References 41 publications

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“…We also found that the application of LF-rTMS to the right pIFG displayed apparently beneficial changes in WAB-AQ, spontaneous speech, and repetition. This result is consistent with previous studies that showed that LF-rTMS over the right prIFG exhibited superior performance in spontaneous speech, comprehension, repetition, naming, and AQ in nonfluent aphasia [3, 8, 22, 23]. However, in our study, only small changes were observed in the recovery of naming ability between pre- and posttreatment with rTMS for global aphasia.…”

Section: Discussionsupporting

confidence: 93%

“…Mounting studies have demonstrated that inhibitory low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) (≤1 Hz) over the unaffected hemisphere can improve language function in poststroke aphasic patients with left-hemispheric lesions [3–6]. Language functional recovery occurs because of compensatory facilitation of the left hemisphere following the reduction of interhemispheric inhibition by suppressive LF-rTMS.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of rTMS over the Different Targets on Language Recovery in Stroke Patients with Global Aphasia: A Randomized Sham-Controlled Study

Ren

Zhang

et al. 2019

BioMed Research International

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Objective.To evaluate and compare the effects of repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis of the posterior inferior frontal gyrus (pIFG) and the right posterior superior temporal gyrus (pSMG) in global aphasia following subacute stroke.Methods.Fifty-four patients with subacute poststroke global aphasia were randomized to 15-day protocols of 20-minute inhibitory 1 Hz rTMS over either the right triangular part of the pIFG (the rTMS-b group) or the right pSTG (the rTMS-w group) or to sham stimulation, followed by 30 minutes of speech and language therapy. Language outcomes were assessed by aphasia quotient (AQ) scores obtained from the Chinese version of the Western Aphasia Battery (WAB) at baseline and immediately after 3 weeks (15 days) of experimental treatment.Results.Forty-five patients completed the entire study. The primary outcome measures include the changes in WAB-AQ score, spontaneous speech, auditory comprehension, and repetition. These measures indicated significant main effect between the baseline of the rTMS-w, rTMS-b, and sham groups and immediately after stimulation (P<0.05). Compared with the sham group, the increases were significant for auditory comprehension, repetition, and AQ in the rTMS-w group (P<0.05), whereas the changes in repetition, spontaneous speech, and AQ tended to be higher in the rTMS-b group (P<0.05).Conclusions.Inhibitory rTMS targeting the right pIFG and pSTG can be an effective treatment for subacute stroke patients with global aphasia. The effect of rTMS may depend on the stimulation site. Low-frequency rTMS inhibited the right pSTG and significantly improved language recovery in terms of auditory comprehension and repetition, whereas LF-rTMS inhibited the right pIFG, leading to apparent changes in spontaneous speech and repetition.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The Effect of rTMS over the Different Targets on Language Recovery in Stroke Patients with Global Aphasia: A Randomized Sham-Controlled Study

Ren

Zhang

et al. 2019

BioMed Research International

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“…Also included in the motor relearning interventions were the 208 trials on Activities of Daily Living (ADL), 108 and 51 trials on gait and mobility, respectively. These neurorehabilitation techniques include innovatively high technology interventions such as robotic therapy ( 11 – 50 ), transcranial direct current stimulation ( 16 , 29 , 51 – 64 , 344 ), transcranial magnetic stimulation ( 66 – 94 ), functional electrical stimulation ( 95 – 112 ), virtual reality ( 113 – 129 ), and video game ( 130 – 132 ). Many of these trials reported “within-group” improvement in motor functioning outcomes in both intervention and control groups (usually conventional therapy) with no “between-group differences” in these outcomes.…”

Section: Resultsmentioning

confidence: 99%

Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

et al. 2020

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Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6 min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.

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“…[5–8] In addition, most survivors suffer from server impairments, such as limbs paralysis or weakness, depression, bladder or bowel disorders, and aphasia. [9–20] Therefore, timely and effective managements are very important for the CH survivors.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of rehabilitation training combined with acupuncture on aphasia after cerebral hemorrhage

Xiao¹,

Song²,

et al. 2019

Medicine

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Background: This study aims to systematically evaluate the effectiveness of rehabilitation training (RT) combined with acupuncture on aphasia after cerebral hemorrhage (CH). Methods: PUBMED, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, Ovid, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be searched to identify any potential studies from inception to March 1, 2019, without language restrictions. All randomized controlled trials and case-controlled studies assessing the effectiveness of RT combined with acupuncture for the treatment of aphasia following CH will be included in this study. Cochrane risk of bias tool will be used to determine the methodological quality for included studies. RevMan 5.3 software (Cochrane Community, London, UK) will be utilized to perform statistical analysis. Results: This study will systematically evaluate the effectiveness of RT and acupuncture for aphasia post CH. Primary outcome includes aphasia, which can be measured by Aachener Aphasia Test or Communicative Activity Log or other related scales. Secondary outcomes consist of speech performance, as assessed by Western Aphasia Battery-Revised; measure of skill in Supported Conversation scales; measure of Participation in Conversation scales; types of strategies used in conversation; occurrence and repair of conversation breakdowns; as well as any adverse events. Conclusion: The results of this study will provide present evidence on assessing effectiveness of RT and acupuncture after CH. Dissemination and ethics: The findings of this study are expected to be published in peer-reviewed journals. It does not require ethical approval, because no individual data will be utilized in this study. Systematic review registration: PROSPERO CRD42019131587.

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Effects of different frequencies of repetitive transcranial magnetic stimulation in stroke patients with non-fluent aphasia: a randomized, sham-controlled study

Cited by 68 publications

References 41 publications

The Effect of rTMS over the Different Targets on Language Recovery in Stroke Patients with Global Aphasia: A Randomized Sham-Controlled Study

The Effect of rTMS over the Different Targets on Language Recovery in Stroke Patients with Global Aphasia: A Randomized Sham-Controlled Study

Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries—A Systematic Review

Effectiveness of rehabilitation training combined with acupuncture on aphasia after cerebral hemorrhage

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