Dual-Hemisphere Repetitive Transcranial Magnetic Stimulation for Rehabilitation of Poststroke Aphasia

Khedr, Eman M.; El-Fetoh, Noha Abo; Ali, Azza M. M.; El-Hammady, Dina H.; Khalifa, Hosam; Atta, Haisam; Karim, Ahmed A.

doi:10.1177/1545968314521009

Cited by 96 publications

(64 citation statements)

References 36 publications

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“…After evaluating the full texts for more details, 12 RCTs satisfied the inclusion criteria. However, after excluding 8 studies (16-23) with duplicate publication (19)(20)(21)(22)(23) and no response to the request for data (16)(17)(18), 4 RCTs (24-27) with a total of 132 patients were included in the analyses. A flow chart of the structured review is shown in Fig.…”

Section: Selected Studies and Characteristicsmentioning

confidence: 99%

Low-frequency repetitive transcranial magnetic stimulation for patients with aphasia after stoke: A meta-analysis

Li¹,

Qu²,

Yuan³

et al. 2015

J Rehabil Med

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Section: Selected Studies and Characteristicsmentioning

confidence: 99%

Low-frequency repetitive transcranial magnetic stimulation for patients with aphasia after stoke: A meta-analysis

Li¹,

Qu²,

Yuan³

et al. 2015

J Rehabil Med

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“…Therefore, we believe that a more effective rTMS method is needed for individuals whose right hemisphere is activated during a pre-intervention language localization task. Khedr et al [10] suggested, in their report of dual-hemisphere rTMS on patients with aphasia, that high-frequency rTMS (HFS) to the right hemisphere may be effective for patients with an extensive infarction and left middle cerebral artery occlusion because there may be significant compensation within the right homologous regions of the language area.…”

Section: Introductionmentioning

confidence: 99%

“…NIRS can be used to probe brain function through an intact skull by detecting changes in blood hemoglobin concentrations associated with neural activity. NIRS is one of the alternative noninvasive methods used to observe changes in the cerebral function [10]. In addition, it is used to assess the efficacy of TMS.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia

Hara

Abo²,

Kakita³

et al. 2017

Eur Neurol

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Purpose: To examine the efficacy of selective repetitive transcranial magnetic stimulation (rTMS) therapy guided by functional near-infrared spectroscopy (fNIRS) combined with intensive speech therapy (iST) on post-stroke patients with aphasia. Material and Methods: Eight right-handed patients with aphasia in the chronic stage after stroke were grouped into left and right hemisphere-activated for a language task based on pre-intervention fNIRS. Those with left hemisphere activation received 1-Hz TMS to the right inferior frontal gyrus (RtIFG; low-frequency rTMS [LFS] group), and those with right hemisphere activation received 10-Hz TMS to the RtIFG (high-frequency rTMS [HFS] group). The patients underwent an 11-day program of rTMS and iST. Results: Both groups showed a significant improvement in language function as measured by Standard Language Test of Aphasia (SLTA) total score at post-intervention relative to pre-intervention. Furthermore, the pre-to-post SLTA change scores were not statistically different between the groups. Comparison of pre- and post-intervention fNIRS revealed a resolution of the imbalance of interhemispheric inhibition in the LFS group and activation of the target hemisphere in the HFS group. Conclusions: The administration of fNIRS-guided selective rTMS therapy and iST to post-stroke patients with aphasia induced a significant improvement in language function, with both groups demonstrating a similar degree of improvement.

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“…In this way, besides the improvements in expressive language, rTMS can improve receptive language performance as well [31]. Some authors reported an association between changes in brain activity induced by rTMS and language improvement [4,33,34], while others did not [12]. Barwood et al [32], Chieffo et al [11] and Seniów et al [5] observed that the patients that obtained larger improvements were those with global aphasia and more severe deficits, suggesting that this tool can modulate language performance even in individuals with quite significant lesions.…”

Section: Tms Interventions In Aphasiamentioning

confidence: 99%

Transcranial Magnetic Stimulation as an Intervention Tool to Recover from Language, Swallowing and Attentional Deficits after Stroke: A Systematic Review

2018

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Background: Following a stroke event, patients often are severely affected by disabilities that hinder their quality-of-life. There are currently several rehabilitative options and strategies, and it is crucial to find the most effective interventions. The applicability of transcranial magnetic stimulation (TMS) to the recovery of nonmotor functions such as communication skills, swallowing ability and spatial attention after stroke remains important clinical questions. Summary: We searched PubMed and ISI Web of Science for articles that used repetitive TMS protocols to rehabilitate post-stroke deficits. We analysed qualitatively 38 articles that met the eligibility criteria; of these, 21 dealt with aphasia, 8 with dysphagia, 8 with neglect and 1 with visual extinction. The efficacy of TMS as an intervention for post-stroke rehabilitation of these nonmotor deficits was studied as well as the current limitations were assessed. Key Messages: Most part of the included studies reported statistically significant functional improvements, supporting the use of TMS for the rehabilitation of aphasia, dysphagia and neglect. Future research, with larger sample sizes, is mandatory to confirm its efficacy, determine the optimal stimulation parameters and investigate inter-subject variability.

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Dual-Hemisphere Repetitive Transcranial Magnetic Stimulation for Rehabilitation of Poststroke Aphasia

Abstract: This is the first clinical study of dual-hemisphere rTMS in poststroke aphasia. Combining dual-hemisphere rTMS with language training might be a feasible treatment for nonfluent aphasia; further multicenter studies are needed to confirm this result.

Cited by 96 publications

References 36 publications

Low-frequency repetitive transcranial magnetic stimulation for patients with aphasia after stoke: A meta-analysis

Low-frequency repetitive transcranial magnetic stimulation for patients with aphasia after stoke: A meta-analysis

The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia

Transcranial Magnetic Stimulation as an Intervention Tool to Recover from Language, Swallowing and Attentional Deficits after Stroke: A Systematic Review

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