Background: Accumulating evidence from single case studies, small case series and randomized controlled trials seems to suggest that inhibitory noninvasive brain stimulation (NIBS) over the contralesional inferior frontal gyrus (IFG) of right-handers in conjunction with speech and language therapy (SLT) improves recovery from poststroke aphasia. Application of inhibitory NIBS to improve recovery in left-handed patients has not yet been reported.
Methods: A total of 29 right-handed subacute poststroke aphasics were randomized to receive either 10 sessions of SLT following 20 min of inhibitory repetitive transcranial magnetic stimulation (rTMS) over the contralesional IFG or 10 sessions of SLT following sham stimulation; 2 left-handers were treated according to the same protocol with real rTMS. Language activation patterns were assessed with positron emission tomography prior to and after the treatment; 95% confidence intervals for changes in language performance scores and the activated brain volumes in both hemispheres were derived from TMS- and sham-treated right-handed patients and compared to the same parameters in left-handers.
Results: Right-handed patients treated with rTMS showed better recovery of language function in global aphasia test scores (t test, p < 0.002) as well as in picture-naming performance (ANOVA, p = 0.03) than sham-treated right-handers. In treated right-handers, a shift of activation to the ipsilesional hemisphere was observed, while sham-treated patients consolidated network activity in the contralesional hemisphere (repeated-measures ANOVA, p = 0.009). Both left-handed patients also improved, with 1 patient within the confidence limits of TMS-treated right-handers (23 points, 15.9-28.9) and the other patient within the limits of sham-treated subjects (8 points, 2.8-14.5). Both patients exhibited only a very small interhemispheric shift, much less than expected in TMS-treated right-handers, and more or less consolidated initially active networks in both hemispheres.
Conclusion: Inhibitory rTMS over the nondominant IFG appears to be a safe and effective treatment for right-handed poststroke aphasics. In the 2 cases of left-handed aphasics no deterioration of language performance was observed with this protocol. However, therapeutic efficiency is less obvious and seems to be more related to the dominance pattern prior to the stroke than to the TMS intervention.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1159/000355499 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Rehabilitation of post-stroke aphasia by a single protocol targeting phonological, lexical, and semantic deficits with speech output tasks: a randomized controlled trial.
Eur J Phys Rehabil Med
December 2024
Laboratory of Neuropsychology, Department of Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Background: The defective spoken output of persons with aphasia has anomia as a main clinical manifestation. Improving anomia is therefore a main goal of any language treatment.
Aim: This study assessed the effectiveness of a novel, 2-week, rehabilitation protocol (PHOLEXSEM), focused on PHonological, SEmantic, and LExical deficits, aiming at improving lexical retrieval, and, generally, spoken output.
[The effectiveness of drug therapy in the rehabilitation of patients with post-stroke aphasia].
Zh Nevrol Psikhiatr Im S S Korsakova
December 2024
Vladimirsky Moscow Regional Clinical and Research Clinical Institute, Moscow, Russia.
Objective: To evaluate the effectiveness of the restoration of aphasic disorders in patients in the early recovery period of ischemic stroke (IS) who received complex therapy, which included speech therapy and injections of the drug Cellex.
Material And Methods: The study included 62 right-handed patients with aphasia hospitalized in the acute period of IS in Ramenskoye Hospital, who subsequently underwent the second stage of rehabilitation in the neurological department of the Moscow regional clinical institute .a.
[Improving the effectiveness of treatment of patients with post-stroke aphasia].
Zh Nevrol Psikhiatr Im S S Korsakova
November 2024
Vladimirskiy Moscow Regional Research Clinical Institute, Moscow, Russia.
Objective: To evaluate the efficacy of speech therapy in patients with acute ischemic stroke (AIS) who received comprehensive treatment, including speech therapy and Cytoflavin infusions.
Material And Methods: 46 right-handed patients who were hospitalized during the acute phase of AIS in the left middle cerebral artery were included in the study. Patients received comprehensive speech therapy and were randomly assigned to one of two groups.
Predicting recovery following stroke: Deep learning, multimodal data and feature selection using explainable AI.
Neuroimage Clin
September 2024
School of Psychology, University of Birmingham, UK; School of Computer Science, University of Birmingham, UK.
Machine learning offers great potential for automated prediction of post-stroke symptoms and their response to rehabilitation. Major challenges for this endeavour include the very high dimensionality of neuroimaging data, the relatively small size of the datasets available for learning and interpreting the predictive features, as well as, how to effectively combine neuroimaging and tabular data (e.g.
View Article and Find Full Text PDFThe effect of mobile application-based technology on post-stroke aphasia: a systematic review.
Front Neurol
June 2024
Department of Rehabilitation Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
Article Synopsis
- Mobile app-based speech therapy can help people recover from language problems after a stroke, which is called aphasia.
- Researchers looked at many studies and found that these apps can improve talking, understanding, and overall communication skills.
- Although the results are promising, more research is needed to understand how well these apps work and what makes them better than traditional therapy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!