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
| Autor: | Motoi Watanabe, Azusa Morooka, Masahiro Abo, Katsuya Kawakami, Atsushi Senoo, Wataru Kakuda |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Pilot Projects Speech Therapy Speech therapy Physical medicine and rehabilitation Aphasia medicine Humans Clinical efficacy Stroke Aged Brain Mapping Rehabilitation business.industry Stroke Rehabilitation Middle Aged equipment and supplies medicine.disease Magnetic Resonance Imaging Transcranial Magnetic Stimulation Clinical trial Transcranial magnetic stimulation Neurology Female Neurology (clinical) medicine.symptom business human activities |
| Zdroj: | European Neurology. 68:199-208 |
| ISSN: | 1421-9913 0014-3022 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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