Improved language performance subsequent to low-frequency rTMS in patients with chronic non-fluent aphasia post-stroke

Barwood, Caroline H S; Murdoch, Bruce E.; Whelan, Brooke‐Mai; Lloyd, David; Riek, Stephan; Sullivan, J. D. O'; Coulthard, Alan; Wong, Andrew

doi:10.1111/j.1468-1331.2010.03284.x

Cited by 146 publications

(130 citation statements)

References 25 publications

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“…The application of suppressive rTMS in the contralesional PTr to promote language recovery was based on evidence showing that this protocol facilitates naming and propositional speech in certain chronic nonfluent patients. 1,2,6,7,17 Results from Barwood et al 1,18 demonstrated persistent language improvement in naming and picture description lasting for 2 to 8 months after 1-Hz rTMS conditioning. In another study conducted by Weiduschat et al, 8 PET scans showed an amelioration in right PTr overactivity in patients who received real rTMS, which was followed by greater linguistic gains in contrast with those who received the control rTMS over the vertex.…”

Section: Strokementioning

confidence: 99%

“…[1][2][3] Whether recovery from chronic aphasia involves either ipsilesional residual cortical reorganization or contralesional neuroadaptation remains unclear; but as the growing body of research has demonstrated, inhibitory rTMS applied to the contralesional cortex can successfully facilitate language recovery. It is hypothesized that this contralesional neuromodulation improves long-term communication outcomes by alleviating transcallosal disinhibition 4 and after the paradoxical functional facilitation principle, whereby disruption of brain activity by TMS might lead to functional facilitation mediated through distant cortical or subcortical connections.…”

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confidence: 99%

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Efficacy of Synchronous Verbal Training During Repetitive Transcranial Magnetic Stimulation in Patients With Chronic Aphasia

Wang

Hsieh

Tsai

et al. 2014

Stroke

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Background and Purpose-Although multiple studies have suggested that repetitive transcranial magnetic stimulation (rTMS) may facilitate recovery after stroke, the efficacy of synchronous speech therapy integrated with an rTMS protocol has yet to be determined. We investigated language responses to this strategy and determined the longevity of the resulting therapeutic outcomes. Methods-Forty-five patients with stroke who presented with nonfluent aphasia were randomly assigned to the TMS syn group and underwent synchronous picture-naming training together with contralesional 1 Hz-rTMS for 10 daily sessions. The TMS sub group underwent subsequent picture-naming activity after the primed 1 Hz-rTMS, and the TMS sham group received concurrent naming task along with the sham 1 Hz-rTMS. The Concise Chinese Aphasia test and the picturenaming test were performed before, immediately, and after 3 months of the intervention. Results-TMS syn showed significantly superior results in Concise Chinese Aphasia test score (P<0.001), expression and description subtests (P<0.001), and action (P=0.02) and object naming activity (P=0.008); the superior results lasted for 3 months (P=0.005), in comparison with the TMS sub and TMS sham groups. Conclusions-We established a real-time model that involved implementing verbal tasks together with the rTMS protocol.Our results confirmed that the strategy yielded favorable outcomes that were of considerable longevity. The results also indicated that the rTMS protocol and language training can be combined to achieve outcomes superior to those obtained when used separately. we hypothesized that temporal synchronous modulation (online model) in the Broca area through rTMS modulation and concurrent language system activation can result in greater synaptic strength than the separate application of these interventions (offline model).We investigated the efficacy of low-frequency rTMS coupled with a simultaneous picture-naming activity for treating chronic nonfluent aphasic patients and evaluated the resulting effects for a 3-month period. Methods ParticipantsSeventy-six patients with stroke who were admitted to the stroke unit of a tertiary medical center or who attended follow-up visits at outpatient clinics were evaluated consecutively for participation in this study. Three patients approached declined to participate ( Figure 1); and 45 right-handed patients met the inclusion criteria: (1) a diagnosis of nonfluent aphasia resulting from a first-ever left middle cerebral artery infarction that had been confirmed by MRI; (2) >6 months of poststroke duration with a plateau in aphasic condition; (3) no current depression as evaluated using the Aphasic Depression Rating Scale 12 ; (4) an absence of spatial neglect or visual field deficits; and (5) an absence of TMS contraindications. Forty-three patients completed the 3-month assessment. The study was approved by the local institutional review board, and all patients gave their written informed consent before participating.The biographical data of the e...

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Section: Strokementioning

confidence: 99%

mentioning

confidence: 99%

Efficacy of Synchronous Verbal Training During Repetitive Transcranial Magnetic Stimulation in Patients With Chronic Aphasia

Wang

Hsieh

Tsai

et al. 2014

Stroke

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“…На этом основано применение инактивации гомоло-гичных речевым зонам левого полушария отделов правого полушария с помощью ТМС у больных с речевыми расстройствами для восстановления функции речи [32,33]. Как считают A. Thiel и соавт.…”

Section: Discussionunclassified

Dynamics of functional MRI and speech function in patients after resection of frontal and temporal lobe tumors

Буклина

Баталов

et al. 2017

Vopr. neirokhir.

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“…The usefulness of tDCS in chronic stroke was summarized by Stagg [32]. There are controversy results in the long term usefulness of speech therapy in fluent aphasia, but the non-invasive stimulation over the language area can improve [33][34][35][36] and tDCS [37,38]. There is a reversion of the imbalance of interhemispheric inhibition, speech induced activity shifts to the left side instead of both sides or right side and formation of a new language network which may responsible for the better outcome of aphasia several weeks after stimulation.…”

Section: Influence On Different Symptoms Of Stroke With Noninvasive Bmentioning

confidence: 99%

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

2014

Int J Neurorehabilitation Eng

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Two non-invasive brain stimulations have spread all over the world: repetitive trasncranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). TMS is based on the current induction with a changing electromagnetic field in the nervous system [1] while tDCS changes the polarity of cell membranes [2]. General Aspects of TMS and tDCSTMS is widely used in research and daily medical practice. It was introduced as a diagnostic tool about thirty years ago to test functioning of motor pathways [3]. The motor evoked potential (MEP) and the measurement of the central motor conduction time (CMCT) has entered into daily practice. The other parameters of the electrophysiological examination assessed by TMS are mainly used in scientific work [4]. TMS aids the diagnosis of multiple sclerosis, furthermore the prognosis of stroke can be indicated by TMS [5]. Different paired pulse stimulations with TMS give a new insight into the function of the brain. In recent years, sophisticated brain plasticity can be detected by the measurement of intracortical excitability [6,7]. We learnt from these studies how different conditions can modify brain plasticity. It can be changed by different diseases, altered by drugs [8] and strongly influenced by non-invasive stimulations [2,9]. The single TMS and one session of repetitive stimulation have a short after-effect. However the effect of repeated stimulation for days exceeds the stimulation period and many times it lasts for months. This effect of rTMS has made it useful for therapy for the last 20 years. The low and high frequency stimulation, continuous theta burst stimulation (cTBS), intermittent theta burst stimulation (iTBS), anodal or cathodal stimulation are used for therapy. The intensity of rTMS was around the motor threshold and the duration of stimulation was 7-10 days. This paper reviews the most frequently studied symptoms of Parkinson's diseases and stroke although rTMS has been tried to treat all disorders of the central nervous system (CNS). Parkinson's Disease (PD)The first protocol was low frequency, low intensity monophasic stimulation for 7 days which improved the Parkinsonian symptoms and its results were maintained for several months after the stimulation [10,11]. The authors performed a "dose (intensity) response" curve with 1 Hz stimulation and they indicated that there is an optimal intensity using 1 Hz [12]. We learned from these studies that the therapeutic effect of rTMS develops after a delay in time of a few weeks. The improvement can be maintained for several months. The later studies confirmed these observations not only in PD but other diseases. Although, the high frequency stimulations over the primary motor cortex [13,14] had the same effect on the Parkinsonian scores but the after-effect lasted for a shorter time. iTBS over the dorsolateral prefrontal area improved the depression without effecting on bradykinesia [15]. The studies concentrated on varying the frequency which was applied but they did not try to find the optimal in...

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Improved language performance subsequent to low-frequency rTMS in patients with chronic non-fluent aphasia post-stroke

Abstract: These findings provide considerable evidence to support the theory of rTMS modulating mechanisms of transcallosal disinhibition in the aphasic brain and highlight the potential clinical applications for language rehabilitation post-stroke.

Cited by 146 publications

References 25 publications

Efficacy of Synchronous Verbal Training During Repetitive Transcranial Magnetic Stimulation in Patients With Chronic Aphasia

Efficacy of Synchronous Verbal Training During Repetitive Transcranial Magnetic Stimulation in Patients With Chronic Aphasia

Dynamics of functional MRI and speech function in patients after resection of frontal and temporal lobe tumors

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

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