Improved naming after TMS treatments in a chronic, global aphasia patient – case report

Naeser, Margaret A.; Martin, Paula I.; Nicholas, Marjorie; Baker, Errol; Seekins, Heidi E.; Helm-Estabrooks, Nancy; Cayer-Meade, Carol; Kobayashi, Masahito; Théoret, Hugo; Fregni, Felipe; Tormos, José; Kurland, Jacquie; Doron, Karl W.; Pascual‐Leone, Álvaro

doi:10.1080/13554790590944663

Cited by 169 publications

(159 citation statements)

References 73 publications

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“…An adaptive up-regulation of the right pIFG after a focal lesion of the left pIFG appears to be in discordance with the results of previous studies showing improved language recovery in aphasic patients after suppression of neuronal processing in the nonlesioned right IFG with noninvasive stimulation techniques (6). The behavioral improvement seen after suppression of neuronal processing in the nonlesioned right IFG has been interpreted as a suppression of maladaptive "overactivation" in the right hemisphere, which in turn may allow for better modulation in the remaining left hemisphere networks (5,6).…”

Section: Discussioncontrasting

confidence: 55%

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Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

Hartwigsen

Saur

Price

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

126

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The role of the right hemisphere in aphasia recovery after left hemisphere damage remains unclear. Increased activation of the right hemisphere has been observed after left hemisphere damage. This may simply reflect a release from transcallosal inhibition that does not contribute to language functions. Alternatively, the right hemisphere may actively contribute to language functions by supporting disrupted processing in the left hemisphere via interhemispheric connections. To test this hypothesis, we applied off-line continuous theta burst stimulation (cTBS) over the left inferior frontal gyrus (IFG) in healthy volunteers, then used functional MRI to investigate acute changes in effective connectivity between the left and right hemispheres during repetition of auditory and visual words and pseudowords. In separate sessions, we applied cTBS over the left anterior IFG (aIFG) or posterior IFG (pIFG) to test the anatomic specificity of the effects of cTBS on speech processing. Compared with cTBS over the aIFG, cTBS over the pIFG suppressed activity in the left pIFG and increased activity in the right pIFG during pseudoword vs. word repetition in both modalities. This effect was associated with a stronger facilitatory drive from the right pIFG to the left pIFG during pseudoword repetition. Critically, response became faster as the influence of the right pIFG on left pIFG increased, indicating that homologous areas in the right hemisphere actively contribute to language function after a focal left hemisphere lesion. Our findings lend further support to the notion that increased activation of homologous right hemisphere areas supports aphasia recovery after left hemisphere damage.transcranial magnetic stimulation | dynamic causal modeling | virtual lesion | Broca's area N umerous functional imaging studies have reported increased language-related activation of the right inferior frontal gyrus (IFG) in aphasic patients with left hemisphere damage (1-3). However, it is still a matter of debate whether the temporary recruitment of homologous right hemisphere areas after left hemisphere stroke is essential for language performance (i.e., adaptive plasticity) (2-4) or represents "maladaptive" overactivation resulting from interhemispheric disinhibition after left hemisphere infarction (5-7).In the present study, we investigated the adaptive short-term plasticity that supports speech production after disruption to left frontal language areas. We induced neural activity related to phonetic encoding by comparing reading and auditory repetition of pseudowords and familiar words. We expected to see common effects in both visual and auditory modalities at the level of phonetic encoding, but not at the sensory input level (8). We applied transient virtual lesions in healthy volunteers to test whether an up-regulation of right hemisphere homologous language regions after a focal perturbation of left hemisphere language areas reflects reduced transcallosal inhibition from the left hemisphere to the right hemisphere or an active righ...

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Section: Discussioncontrasting

confidence: 55%

“…However, it is still a matter of debate whether the temporary recruitment of homologous right hemisphere areas after left hemisphere stroke is essential for language performance (i.e., adaptive plasticity) (2-4) or represents "maladaptive" overactivation resulting from interhemispheric disinhibition after left hemisphere infarction (5)(6)(7).…”

mentioning

confidence: 99%

Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

Hartwigsen

Saur

Price

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

126

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“…114,115 Overall, their findings further support the concept that repeated interventions (in this case, to decrease activity in the contralesional hemisphere) can lead to behavioral gains in speech function that remain stable over lengthy periods, possibly through modulation of inhibitory interhemispheric interactions. Interestingly, prior to the TMS intervention in one patient, 115 speech therapy had been discontinued due to lack of progress and poor prognostic indicators.…”

Section: Decreasing Excitability In the Contralesional Motor Cortexsupporting

confidence: 61%

Noninvasive brain stimulation in stroke rehabilitation

Webster

Celnik

Cohen

2006

NeuroRX

145

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Summary:Stroke is a common disorder that produces a major burden to society, largely through long-lasting motor disability in survivors. Recent studies have broadened our understanding of the processes underlying recovery of motor function after stroke. Bilateral motor regions of the brain experience substantial reorganization after stroke, including changes in the strength of interhemispheric inhibitory interactions. Our understanding of the extent to which different forms of reorganization contribute to behavioral gains in the rehabilitative process, although still limited, has led to the formulation of novel interventional strategies to regain motor function. Transcranial magnetic (TMS) and DC (tDCS) electrical stimulation are noninvasive brain stimulation techniques that modulate cortical excitability in both healthy individuals and stroke patients. These techniques can enhance the effect of training on performance of various motor tasks, including those that mimic activities of daily living. This review looks at the effects of TMS and tDCS on motor cortical function and motor performance in healthy volunteers and in patients with stroke. Both techniques can either enhance or suppress cortical excitability, and may move to the clinical arena as strategies to enhance the beneficial effects of customarily used neurorehabilitative treatments after stroke.

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“…In a study of four aphasics who were 5-11 years post-stroke, 1 Hz rTMS applied daily for 10 days to an anterior portion of Broca's area induced significant and lasting improvement in picture naming [103,104]. In addition to picture naming, rTMS may also be able to inhibit cortical areas responsible for forming concepts such that areas concerned with spatial detail are made directly accessible to conscious perception.…”

Section: Transcranial Magnetic Stimulation (Tms)mentioning

confidence: 99%

Techniques and devices to restore cognition

Serruya

Kahana

2008

Behavioural Brain Research

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Executive planning, the ability to direct and sustain attention, language and several types of memory may be compromised by conditions such as stroke, traumatic brain injury, cancer, autism, cerebral palsy and Alzheimer's disease. No medical devices are currently available to help restore these cognitive functions. Recent findings about the neurophysiology of these conditions in humans coupled with progress in engineering devices to treat refractory neurological conditions imply that the time has arrived to consider the design and evaluation of a new class of devices. Like their neuromotor counterparts, neurocognitive prostheses might sense or modulate neural function in a non-invasive manner or by means of implanted electrodes. In order to paint a vision for future device development, it is essential to first review what can be achieved using behavioral and external modulatory techniques. While non-invasive approaches might strengthen a patient's remaining intact cognitive abilities, neurocognitive prosthetics comprised of direct brain-computer interfaces could in theory physically reconstitute and augment the substrate of cognition itself.

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Improved naming after TMS treatments in a chronic, global aphasia patient – case report

Cited by 169 publications

References 73 publications

Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

Perturbation of the left inferior frontal gyrus triggers adaptive plasticity in the right homologous area during speech production

Noninvasive brain stimulation in stroke rehabilitation

Techniques and devices to restore cognition

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