Improved picture naming in chronic aphasia after TMS to part of right Broca?s area: An open-protocol study

Naeser, Margaret A.; Martin, Paula I.; Nicholas, Marjorie; Baker, Errol; Seekins, Heidi E.; Kobayashi, Masahito; Théoret, Hugo; Fregni, Felipe; MARIATORMOS, J; Kurland, Jacquie

doi:10.1016/j.bandl.2004.08.004

Cited by 525 publications

(479 citation statements)

References 69 publications

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“…Why P2 improved on auditory comprehension post-TMS is unknown. Improvement in auditory comprehension lasting out to 6 or 8 months post-TMS has not been an area where significant change was noted in our previous TMS studies with nonfluent aphasia patients (Naeser, Martin, Nicholas, Baker, Seekins, Helm-Estabrooks et al, 2005;Naeser, Martin, Nicholas, Baker, Seekins, Kobayashi et al, 2005). Our fMRI scans only examined overt speech in the present study (not auditory comprehension), therefore no fMRI data are available for auditory comprehension, pre-and post-TMS.…”

Section: Auditory Comprehension Post-tmsmentioning

confidence: 69%

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Overt naming fMRI pre- and post-TMS: Two nonfluent aphasia patients, with and without improved naming post-TMS

Martin

Naeser

et al. 2007

Brain and Language

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Two chronic, nonfluent aphasia patients participated in overt naming fMRI scans, pre-and post-a series of repetitive transcranial magnetic stimulation (rTMS) treatments as part of a TMS study to improve naming. Each patient received ten, 1-Hz rTMS treatments to suppress a part of R pars triangularis. P1 was a 'good responder' with improved naming and phrase length; P2 was a 'poor responder' without improved naming.Pre-TMS (10 yr. poststroke), P1 had significant activation in R and L sensorimotor cortex, R IFG, and in both L and R SMA during overt naming fMRI (28% pictures named. At 3 mo. post-TMS (42% named), P1 showed continued activation in R and L sensorimotor cortex, R IFG, and in R and L SMA. At 16 mo. post-TMS (58% named), he also showed significant activation in R and L sensorimotor cortex mouth and R IFG. He now showed a significant increase in activation in the L SMA compared to pre-TMS and at 3 mo. post-TMS (p<.02; p<.05, respectively). At 16 mo. there was also greater activation in L than R SMA (p<.08). At 46 mo. post-TMS (42% named), this new LH pattern of activation continued. He improved on the Boston Naming Test from 11 pictures named pre-TMS, to scores ranging from 14-18 pictures, post-TMS (2 mo. to 43 mo. post-TMS). His longest phrase length (Cookie Theft picture) improved from 3 words pre-TMS, to 5-6 words post-TMS.Pre-TMS (1.5 yr. poststroke), P2 had significant activation in R IFG (3% pictures named). At 3 and 6 mo. post-TMS, there was no longer significant activation in R IFG, but significant activation was present in R sensorimotor cortex. On all three fMRI scans, P2 had significant activation in both the L and R SMA. There was no new, lasting perilesional LH activation across sessions for this patient. Over time, there was little or no change in his activation. His naming remained only at 1-2 pictures during all three fMRI scans. His BNT score and longest phrase length remained at 1 word, post-TMS.Lesion site may play a role in each patient's fMRI activation pattern and response to TMS treatment. P2, the poor responder, had an atypical frontal lesion in the L motor and premotor cortex that extended Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The fMRI data of our patient who had good response following TMS support the notion that restoration of the LH language network is linked in part, to better recovery of naming and phrase length in nonfluent aphasia. NIH Public Access

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Section: Auditory Comprehension Post-tmsmentioning

confidence: 69%

“…post-treatment (Naeser, Martin, Nicholas, Baker, Seekins, Kobayashi et al, 2005). We hypothesized that 1 Hz rTMS to suppress a targeted RH ROI in nonfluent aphasia, would have an overall modulating effect on elements of the distributed neural network for picture naming, resulting in behavioral improvement.…”

Section: Transcranial Magnetic Stimulationmentioning

confidence: 99%

Overt naming fMRI pre- and post-TMS: Two nonfluent aphasia patients, with and without improved naming post-TMS

Martin

Naeser

et al. 2007

Brain and Language

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“…This will require a better understanding of the mechanisms of recovery as well as the development of new therapies and neural prostheses. For instance, transcranial stimulation techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (Hamilton, Chrysikou, & Coslett, 2011) have been used enhance language functions in both healthy and brain-injured individuals (Marangolo et al, 2013;Naeser et al, 2005;Schlaug, Marchina, & Wan, 2011).…”

Section: Future Possibilitiesmentioning

confidence: 99%

What Do Language Disorders Reveal about Brain–Language Relationships? From Classic Models to Network Approaches

Dronkers

Ivanova

Baldo

2017

J Int Neuropsychol Soc

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Studies of language disorders have shaped our understanding of brain-language relationships over the last two centuries. This article provides a review of this research and how our thinking has changed over the years regarding how the brain processes language. In the 19th century, a series of famous case studies linked distinct speech and language functions to specific portions of the left hemisphere of the brain, regions that later came to be known as Broca's and Wernicke's areas. One hundred years later, the emergence of new brain imaging tools allowed for the visualization of brain injuries in vivo that ushered in a new era of brain-behavior research and greatly expanded our understanding of the neural processes of language. Toward the end of the 20th century, sophisticated neuroimaging approaches allowed for the visualization of both structural and functional brain activity associated with language processing in both healthy individuals and in those with language disturbance. More recently, language is thought to be mediated by a much broader expanse of neural networks that covers a large number of cortical and subcortical regions and their interconnecting fiber pathways. Injury to both grey and white matter has been seen to affect the complexities of language in unique ways that have altered how we think about brain-language relationships. The findings that support this paradigm shift are described here along with the methodologies that helped to discover them, with some final thoughts on future directions, techniques, and treatment interventions for those with communication impairments. (JINS, 2017, 23, 741-754)

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“…With this in mind, the direct manipulation of cortical brain activity by repetitive TMS (rTMS) is posited as an efficacious complimentary rehabilitatory treatment for patients with post-stroke aphasia. Prospectively, rTMS may aid in the alleviation of some language disturbances associated with post-stroke aphasia via the reorganization of neural language networks [1][2][3][4][5][6][7].…”

Section: Future Neurologymentioning

confidence: 99%

Evidence For the Use of Transcranial Magnetic Stimulation As An Effective Therapeutic Option For Aphasia

Murdoch

Barwood

2012

Future Neurol.

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Improved picture naming in chronic aphasia after TMS to part of right Broca?s area: An open-protocol study

Cited by 525 publications

References 69 publications

Overt naming fMRI pre- and post-TMS: Two nonfluent aphasia patients, with and without improved naming post-TMS

Overt naming fMRI pre- and post-TMS: Two nonfluent aphasia patients, with and without improved naming post-TMS

What Do Language Disorders Reveal about Brain–Language Relationships? From Classic Models to Network Approaches

Evidence For the Use of Transcranial Magnetic Stimulation As An Effective Therapeutic Option For Aphasia

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