Combining TMS-EEG with transcranial direct current stimulation language treatment in aphasia

Cipollari, Susanna; Veniero, Domenica; Razzano, Carmela; Caltagirone, Carlo; Koch, Giacomo; Marangolo, Paola

doi:10.1586/14737175.2015.1049998

Cited by 33 publications

(27 citation statements)

References 60 publications

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“…Excitingly, more recent tools like advanced structural imaging, diffusion tensor imaging (DTI), diffusion spectrum imaging (DSI) and computational network modeling can be used to tell us which brain regions are the best candidates for compensation by characterizing their connectivity and network properties, respectively (Dijkhuizen et al, 2012; Ovadia-Caro et al, 2013). Moreover, a recent study by Cipollari and colleagues demonstrated that, in the post-stroke aphasic population, tDCS can be paired with TMS-EEG to target and modulate specific areas of excitability, resulting in specific language improvements (Cipollari et al, 2015). Armed with this knowledge, it may eventually be possible to use focused neuromodulation techniques like TMS and tDCS to entrain optimal regions into networks for language recovery (regions that may be potentially better suited for language processing than those that the brain may have otherwise recruited in the absence of neuromodulation).…”

Section: Discussionmentioning

confidence: 99%

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

Norise

Hamilton

2017

Front. Hum. Neurosci.

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Numerous studies over the span of more than a decade have shown that non-invasive brain stimulation (NIBS) techniques, namely transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), can facilitate language recovery for patients who have suffered from aphasia due to stroke. While stroke is the most common etiology of aphasia, neurodegenerative causes of language impairment—collectively termed primary progressive aphasia (PPA)—are increasingly being recognized as important clinical phenotypes in dementia. Very limited data now suggest that (NIBS) may have some benefit in treating PPAs. However, before applying the same approaches to patients with PPA as have previously been pursued in patients with post-stroke aphasia, it will be important for investigators to consider key similarities and differences between these aphasia etiologies that is likely to inform successful approaches to stimulation. While both post-stroke aphasia and the PPAs have clear overlaps in their clinical phenomenology, the mechanisms of injury and theorized neuroplastic changes associated with the two etiologies are notably different. Importantly, theories of plasticity in post-stroke aphasia are largely predicated on the notion that regions of the brain that had previously been uninvolved in language processing may take on new compensatory roles. PPAs, however, are characterized by slow distributed degeneration of cellular units within the language system; compensatory recruitment of brain regions to subserve language is not currently understood to be an important aspect of the condition. This review will survey differences in the mechanisms of language representation between the two etiologies of aphasia and evaluate properties that may define and limit the success of different neuromodulation approaches for these two disorders.

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Section: Discussionmentioning

confidence: 99%

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

Norise

Hamilton

2017

Front. Hum. Neurosci.

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“…Finally, this work opens an important question on the possibility of implementing novel therapeutic approaches in clinical settings by using, for instance, the transcranial magnetic stimulation (TMS), or the transcranial direct current stimulation (TDCS). These techniques that exploit the unique plasticity of the human brain have already proven their usefulness in modulating brain connectivity and in improving the clinical outcome in various neurological patients [ 51 – 53 ].…”

Section: Discussionmentioning

confidence: 99%

Brain Connectomics’ Modification to Clarify Motor and Nonmotor Features of Myotonic Dystrophy Type 1

et al. 2016

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The adult form of myotonic dystrophy type 1 (DM1) presents with paradoxical inconsistencies between severity of brain damage, relative preservation of cognition, and failure in everyday life. This study, based on the assessment of brain connectivity and mechanisms of plasticity, aimed at reconciling these conflicting issues. Resting-state functional MRI and graph theoretical methods of analysis were used to assess brain topological features in a large cohort of patients with DM1. Patients, compared to controls, revealed reduced connectivity in a large frontoparietal network that correlated with their isolated impairment in visuospatial reasoning. Despite a global preservation of the topological properties, peculiar patterns of frontal disconnection and increased parietal-cerebellar connectivity were also identified in patients' brains. The balance between loss of connectivity and compensatory mechanisms in different brain networks might explain the paradoxical mismatch between structural brain damage and minimal cognitive deficits observed in these patients. This study provides a comprehensive assessment of brain abnormalities that fit well with both motor and nonmotor clinical features experienced by patients in their everyday life. The current findings suggest that measures of functional connectivity may offer the possibility of characterizing individual patients with the potential to become a clinical tool.

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“…There was a diffuse rise of cortical excitability highlighting the spreading of the effects of anodal tDCS over remote cortical regions of stimulated and contralateral hemispheres. In another study, Cipollari and colleagues (Cipollari et al, 2015) studied the TMS-EEG in six chronic aphasics who underwent 3 weeks of language training coupled with tDCS over the right inferior frontal gyrus. The patients improved, and the components of the TMS-EEG from stimulation over the right inferior frontal gyrus were increased in the region of stimulation.…”

Section: Tms-eeg Techniquementioning

confidence: 99%

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

Hallett

Iorio

Rossini

et al. 2017

Clinical Neurophysiology

122

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The goal of this review is to show how transcranial magnetic stimulation (TMS) techniques can make a contribution to the study of brain networks. Brain networks are fundamental in understanding how the brain operates. Effects on remote areas can be directly observed or identified after a period of stimulation, and each section of this review will discuss one method. EEG analyzed following TMS is called TMS-evoked potentials (TEPs). A conditioning TMS can influence the effect of a test TMS given over the motor cortex. A disynaptic connection can be tested also by assessing the effect of a pre-conditioning stimulus on the conditioning-test pair. Basal ganglia-cortical relationships can be assessed using electrodes placed in the process of deep brain stimulation therapy. Cerebellar-cortical relationships can be determined using TMS over the cerebellum. Remote effects of TMS on the brain can be found as well using neuroimaging, including both positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). The methods complement each other since they give different views of brain networks, and it is often valuable to use more than one technique to achieve converging evidence. The final product of this type of work is to show how information is processed and transmitted in the brain.

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Combining TMS-EEG with transcranial direct current stimulation language treatment in aphasia

Cited by 33 publications

References 60 publications

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

Non-invasive Brain Stimulation in the Treatment of Post-stroke and Neurodegenerative Aphasia: Parallels, Differences, and Lessons Learned

Brain Connectomics’ Modification to Clarify Motor and Nonmotor Features of Myotonic Dystrophy Type 1

Contribution of transcranial magnetic stimulation to assessment of brain connectivity and networks

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