Effects of Noninvasive Brain Stimulation on Language Networks and Recovery in Early Poststroke Aphasia

BACKGROUND AND PURPOSE—Modulation of activity in language networks using repetitive transcranial magnetic stimulation (rTMS) may possibly support recovery from poststroke aphasia. Case series and feasibility studies seem to indicate a therapeutic effect; however, randomized sham-controlled, proof-of...

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Bibliographic Details
Published in:Stroke (1970) 2013-08, Vol.44 (8), p.2240-2246
Main Authors: Thiel, Alexander, Hartmann, Alexander, Rubi-Fessen, Ilona, Anglade, Carole, Kracht, Lutz, Weiduschat, Nora, Kessler, Josef, Rommel, Thomas, Heiss, Wolf-Dieter
Format: Article
Language:English
Subjects:
Aged
Aphasia - etiology
Aphasia - therapy
Biological and medical sciences
Brain - physiopathology
Combined Modality Therapy
Female
Frontal Lobe - physiopathology
Functional Laterality - physiology
Humans
Language Tests
Male
Medical sciences
Middle Aged
Nerve Net - physiopathology
Neurology
Neuropharmacology
Pharmacology. Drug treatments
Positron-Emission Tomography - instrumentation
Positron-Emission Tomography - methods
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer
Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease)
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Speech Therapy - methods
Stroke - complications
Stroke - therapy
Transcranial Magnetic Stimulation - instrumentation
Transcranial Magnetic Stimulation - methods
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
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Summary:BACKGROUND AND PURPOSE—Modulation of activity in language networks using repetitive transcranial magnetic stimulation (rTMS) may possibly support recovery from poststroke aphasia. Case series and feasibility studies seem to indicate a therapeutic effect; however, randomized sham-controlled, proof-of-principle studies relating clinical effects to activation patterns are missing. METHODS—Twenty-four patients with subacute poststroke aphasia were randomized to a 10-day protocol of 20-minute inhibitory 1 Hz rTMS over the right triangular part of the posterior inferior frontal gyrus or sham stimulation, followed by 45 minutes of speech and language therapy. Activity in language networks was measured with O-15-water positron emission tomography during verb generation before and after treatment. Language performance was assessed using the Aachen Aphasia Test battery. RESULTS—The primary outcome measure, global Aachen Aphasia Test score change, was significantly higher in the rTMS group (t test, P=0.003). Increases were largest for subtest naming (P=0.002) and tended to be higher for comprehension, token test, and writing (P
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.111.000574