Functional MRI-Based Therapeutic rTMS Strategy for Aphasic Stroke Patients: A Case Series Pilot Study

Kakuda, Wataru; Abo, Masahiro; Kaito, Nobuyoshi; Watanabe, Motoi; Senoo, Atsushi

doi:10.3109/00207450903445628

Cited by 57 publications

(42 citation statements)

References 14 publications

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“…5 Another uncontrolled case-series presented a clinical improvement in patients with chronic aphasia who were treated with low-frequency rTMS over the area that was homologous to the most activated one during word repetition, arguing that transcallosal inhibition of the compensating region should be suppressed irrespective of the hemisphere. 36 However, the lack of a control group in all of these studies does not allow a final conclusion.…”

Section: Discussion Rationalementioning

confidence: 95%

Effects of Repetitive Transcranial Magnetic Stimulation in Aphasic Stroke

Weiduschat

Thiel

Rubi-Fessen

et al. 2011

Stroke

172

184

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Background and Purpose-Although functional imaging studies suggest that recruitment of contralesional areas hinders optimal functional reorganization in patients with aphasic stroke, only limited evidence is available on the efficacy of noninvasive brain stimulation such as repetitive transcranial magnetic stimulation aimed at suppression of contralateral overactivation. Methods-In this randomized, controlled, blinded pilot study, the effect of 1-Hz repetitive transcranial magnetic stimulation over right-hemispheric Broca homolog in subjects with poststroke aphasia in the subacute stage was examined. According to their group allocation, patients received, in addition to conventional speech and language therapy, multiple sessions of repetitive transcranial magnetic stimulation either over the right-hemispheric inferior frontal gyrus (intervention group) or over the vertex (control group). The primary outcome parameter was the change in laterality indices as quantified by activation positron emission tomography before and after the 2-week intervention period. The clinical efficacy was evaluated with the Aachen Aphasia Test. Results-At baseline, no group differences were discovered for age, laterality indices, or mean Aachen Aphasia Test scores. Four patients were lost to follow-up, but none due to side effects of the transcranial magnetic stimulation. Positron emission tomography revealed an activation shift toward the right hemisphere in the control group (Pϭ0.0165), which was absent in the intervention group. Furthermore, the latter improved significantly clinically by a mean of 19.8 points in the Aachen Aphasia Test total score (Pϭ0.002), whereas the control group did not. There was however no clear linear relationship between the extent of laterality shift and clinical improvement (rϭ0.193, Pϭnonsignificant). Conclusions-Repetitive

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Section: Discussion Rationalementioning

confidence: 95%

Effects of Repetitive Transcranial Magnetic Stimulation in Aphasic Stroke

Weiduschat

Thiel

Rubi-Fessen

et al. 2011

Stroke

172

184

View full text Add to dashboard Cite

show abstract

“…The technique proved to be feasible and a potentially useful neurorehabilitative approach with little or no risk of symptomatic deterioration [8,9,10]. However, recent reports have emphasized the need for the selection of the cerebral hemisphere most appropriate for therapeutic stimulation prior to the application of LF-rTMS or transcranial direct current stimulation for aphasic patients [11,12].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Low-Frequency rTMS and Intensive Speech Therapy in Poststroke Patients with Aphasia: A Pilot Study Based on Evaluation by fMRI in Relation to Type of Aphasia

Abo¹,

Kakuda²,

Watanabe³

et al. 2012

Eur Neurol

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Aim: To assess the safety and clinical efficacy of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with intensive speech therapy (ST) in poststroke patients with aphasia. Subjects and Methods: Twenty-four patients with left-hemispheric stroke and aphasia were subjected. During 11-day hospitalization, each patient received 10 treatment sessions consisting of 40-min 1-Hz LF-rTMS and 60-min intensive ST, excluding Sundays. The scalp area for stimulation was selected based on the findings of fMRI with language tasks and the type of aphasia. LF-rTMS was applied to the inferior frontal gyrus (IGF) for patients with nonfluent aphasia and to the superior temporal gyrus (STG) for patients with fluent aphasia. Results: On pretreatment fMRI, the most activated areas were in the left hemisphere (n = 16) and right hemisphere (n = 8). The types of aphasia were nonfluent (n = 14) and fluent (n = 10). The LF-rTMS was applied to the right STG (n = 5), left STG (n = 5), right IFG (n = 11) and left IFG (n = 3). Nonfluent aphasic patients showed significant improvement of auditory comprehension, reading comprehension and repetition. Fluent aphasic patients showed significant improvement in spontaneous speech only. Conclusion: The fMRI with aphasic type-based therapeutic LF-rTMS/intensive ST for chronic aphasia seems feasible and a potentially useful neurorehabilitative protocol.

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“…Существуют некоторые доказательства в поддержку этой точки зрения [2][3][4][5][6][7][8]. Другие исследователи высказывают предположение, что некоторые лекарственные препараты, такие как ингибиторы холинэстеразы, декстроамфетамин, кофе-ин [9][10][11][12][13][14], или дополнительные методы воздействия -транскраниальная магнитная стимуляция [15] или прямая стимуляция коры головного мозга [16] -могут усиливать эффективность логопедической терапии. Простым способом демонстрации дополнительных преимуществ этих вмешательств является построение графика улучшений показателей у лиц, получавших вспомогательное лечение параллельно с графиком, который R.M.…”

Section: литератураunclassified

The ‘Standard’ for Poststroke Aphasia Recovery

Hillis

2010

Stroke

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Functional MRI-Based Therapeutic rTMS Strategy for Aphasic Stroke Patients: A Case Series Pilot Study

Cited by 57 publications

References 14 publications

Effects of Repetitive Transcranial Magnetic Stimulation in Aphasic Stroke

Effects of Repetitive Transcranial Magnetic Stimulation in Aphasic Stroke

Effectiveness of Low-Frequency rTMS and Intensive Speech Therapy in Poststroke Patients with Aphasia: A Pilot Study Based on Evaluation by fMRI in Relation to Type of Aphasia

The ‘Standard’ for Poststroke Aphasia Recovery

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