Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting

Breitenstein, Caterina; Grewe, Tanja; Flöel, Agnes; Ziegler, Wolfram; Springer, Luise; Martus, Peter; Huber, Walter; Willmes, Klaus; Ringelstein, E. B.; Hæusler, Karl Georg; Abel, Stefanie; Glindemann, Ralf; Domahs, Frank; Regenbrecht, Frank; Schlenck, Klaus-Jürgen; Thomas, Marion; Obrig, Hellmuth; Langen, Ernst de; Rocker, Roman; Wigbers, Franziska; Rühmkorf, Christina; Hempen, Indra; List, Jonathan; Baumgaertner, Annette; Villringer, Arno; Bley, Maria; Jöbges, Michael; Halm, K.; Schulz, Juliane; Werner, Cornelius J.; Goldenberg, Georg; Klingenberg, G; König, Eberhard; Müller, F.; Gröne, Berthold; Knecht, Stefan; Baake, Ricarda; Knauss, Janet; Miethe, S; Steller, U; Sudhoff, R; Schillikowski, E; Pfeiffer, G.; Billo, K; Hoffmann, Henry; Ferneding, F-J; Runge, Sören; Keck, Taylor; Middeldorf, V; Krüger, Steffen; Wilde, Ben; Krakow, Karsten; Berghoff, Christopher R.; Reinhuber, F; Maser, Ingeborg; Hofmann, Werner; Sous-Kulke, Christa; Schupp, W.; Oertel, A; Batz, Dan M.; Hamzei, Farsin; Schulz, Karen; Meyer, Anna Maria; Kartmann, A; Som, O'n; Schipke, S-B; Bamborschke, S

doi:10.1016/s0140-6736(17)30067-3

Cited by 256 publications

(171 citation statements)

References 27 publications

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“…As outlined elsewhere, the therapist was blind as to whether individual patients were assigned to the rTMs or to the sham condition. We followed the SLT protocol as proposed and outlined elsewhere [6]. …”

Section: Methodsmentioning

confidence: 99%

“…The authors also observed that SLT at higher intensity and duration produced greater improvement though in these trials the dropout rate was also higher. Breitenstein et al [6] reported results from a multicenter, blinded-end point and controlled trial. They compared 2 conditions, 3 or more weeks of intensive SLT (10 or more hours per week), compared to a 3-week deferral of intensive SLT.…”

Section: Introductionmentioning

confidence: 99%

“…First, following Brady et al [5] and Breitenstein et al [6], we anticipated that SLT would improve speech and language skills. Second, following others [8, 9, 23, 24], we expected that, compared to a sham condition, active treatment with rTMS would lead to greater improvement in aphasia.…”

Section: Introductionmentioning

confidence: 99%

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Further Evidence of the Positive Influence of Repetitive Transcranial Magnetic Stimulation on Speech and Language in Patients with Aphasia after Stroke: Results from a Double-Blind Intervention with Sham Condition

et al. 2017

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Background: After a stroke, up to 20% of patients suffer from aphasia. The preferred treatment for stroke-related aphasia (SRA) is regular speech and language training (SLT). In the present study, we investigated to what extent adjuvant repetitive transcranial magnetic stimulation (rTMS) might enhance recovery. While there is growing evidence of the positive effect of adjuvant rTMS on aphasia, no study has yet been based on an Iranian sample. Method: A total of 12 patients (mean age: 55 years; right-handed; 7 women) underwent treatment for SRA 1 month after stroke. The standard treatment consisted of regular 45-min SLT sessions 5 times a week for 2 consecutive weeks. Additionally, patients were randomly assigned either to adjuvant rTMS (5 times a week for 30 min) or to a sham condition (5 times a week for 30 min). At baseline and after 2 weeks of intervention, the degree of aphasia was assessed with the Farsi version of the Western Aphasia Battery. rTMS was applied to the inferior posterior frontal gyrus of the right hemisphere. Results: Speech and language improved over time, but more so in the rTMS than in the sham condition. Large effect sizes were observed for content, fluency, and the aphasia quotient; medium effect sizes were observed for command comprehension and repetition, while effect sizes were small for auditory comprehension and naming. Conclusions: Among patients with SRA, compared to a sham condition, adjuvant rTMS improved speech and language skills. The present results add to the accumulating evidence that rTMS as a neuromodulation technique has the capacity to enhance the effect of conventional SLT.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Further Evidence of the Positive Influence of Repetitive Transcranial Magnetic Stimulation on Speech and Language in Patients with Aphasia after Stroke: Results from a Double-Blind Intervention with Sham Condition

et al. 2017

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“…Although none of the clinical RCTs conducted in chronic aphasia comprised measurement of brain correlates before and after therapy, a promising heuristic is provided by efficient intensive interventions in chronic PSA patients. In fact, some intensive interventions have proved to lead to significant and consistent improvements of language performance (Brady et al, 2016; Breitenstein et al, 2017) and may therefore be good candidates to study neuroplasticity.…”

Section: Understanding the Neuronal Mechanisms Underlying Language Rementioning

confidence: 99%

Neuroplasticity and Functional Recovery after Intensive Language Therapy in Chronic Post Stroke Aphasia: Which Factors Are Relevant?

Mohr

2017

Front. Hum. Neurosci.

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“…, Breitenstein et al . ). It is well known that therapy leads to the most favourable outcomes when delivered at high frequency (Bhogal et al .…”

Section: Introductionmentioning

confidence: 97%

The novel language‐systematic aphasia screening SAPS: screening‐based therapy in combination with computerised home training

Krzok

Rieger

Niemann

et al. 2017

Intl J Lang & Comm Disor

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Intensive speech and language therapy in patients with chronic aphasia after stroke: a randomised, open-label, blinded-endpoint, controlled trial in a health-care setting

Abstract: German Federal Ministry of Education and Research and the German Society for Aphasia Research and Treatment.

Cited by 256 publications

References 27 publications

Further Evidence of the Positive Influence of Repetitive Transcranial Magnetic Stimulation on Speech and Language in Patients with Aphasia after Stroke: Results from a Double-Blind Intervention with Sham Condition

Further Evidence of the Positive Influence of Repetitive Transcranial Magnetic Stimulation on Speech and Language in Patients with Aphasia after Stroke: Results from a Double-Blind Intervention with Sham Condition

Neuroplasticity and Functional Recovery after Intensive Language Therapy in Chronic Post Stroke Aphasia: Which Factors Are Relevant?

The novel language‐systematic aphasia screening SAPS: screening‐based therapy in combination with computerised home training

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