Journal
EUROPEAN NEUROLOGY
Volume 77, Issue 3-4, Pages 186-194Publisher
KARGER
DOI: 10.1159/000457901
Keywords
Aphasia; Neuroimaging; Stroke; Near-infrared spectroscopy; Transcranial magnetic stimulation
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Funding
- Grants-in-Aid for Scientific Research [15K16371] Funding Source: KAKEN
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Purpose: To examine the efficacy of selective repetitive transcranial magnetic stimulation (rTMS) therapy guided by functional near-infrared spectroscopy (fNIRS) combined with intensive speech therapy (iST) on post-stroke patients with aphasia. Material and Methods: Eight right-handed patients with aphasia in the chronic stage after stroke were grouped into left and right hemisphere-activated for a language task based on pre-intervention fNIRS. Those with left hemisphere activation received 1-Hz TMS to the right inferior frontal gyrus (RtIFG; low-frequency rTMS [LFS] group), and those with right hemisphere activation received 10-Hz TMS to the RtIFG (high-frequency rTMS [HFS] group). The patients underwent an 11-day program of rTMS and iST. Results: Both groups showed a significant improvement in language function as measured by Standard Language Test of Aphasia (SLTA) total score at post-intervention relative to pre-intervention. Furthermore, the pre-to-post SLTA change scores were not statistically different between the groups. Comparison of pre- and post-intervention fNIRS revealed a resolution of the imbalance of interhemispheric inhibition in the LFS group and activation of the target hemisphere in the HFS group. Conclusions: The administration of fNIRS-guided selective rTMS therapy and iST to post-stroke patients with aphasia induced a significant improvement in language function, with both groups demonstrating a similar degree of improvement. (C) 2017 S. Karger AG, Basel
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