Anomia training and brain stimulation in chronic aphasia.
Recent studies have reported enhanced performance on language tasks induced by non-invasive brain stimulation, i.e., repetitive transcranial magnetic stimulation (rTMS), or transcranial direct current stimulation (tDCS), in patients with aphasia due to stroke or Alzheimer's disease (AD). The first part of this article reviews brain stimulation studies related to language recovery in aphasic patients. The second part reports results from a pilot study with three chronic stroke patients who had non-fluent aphasia, where real or placebo rTMS was immediately followed by 25 minutes of individualised speech therapy. Real rTMS consisted of high-frequency rTMS over the left dorsolateral prefrontal cortex (BA 8/9) for 25 minutes. Each patient underwent a total of four weeks of intervention. P1 underwent four weeks of real rTMS (5 days/week) where individualised speech therapy was provided for 25 minutes immediately following each rTMS session. P2 and P3 each underwent two weeks of placebo rTMS, followed immediately by individualised speech therapy; then two weeks of real rTMS, followed immediately by individualised speech therapy. Assessments took place at 2, 4, 12, 24 and 48 weeks post-entry/baseline testing. Relative to entry/baseline testing, a significant improvement in object naming was observed at all testing times, from two weeks post-intervention in real rTMS plus speech therapy, or placebo rTMS plus speech therapy. Our findings suggest beneficial effects of targeted behavioural training in combination with brain stimulation in chronic aphasic patients. However, further work is required in order to verify whether optimal combination parameters (rTMS alone or speech therapy alone) and length of rTMS treatment may be found.
IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy. mcotelli@fatebenefratelli.it
Maria
M
Cotelli
Anna
A
Fertonani
Antonio
A
Miozzo
Sandra
S
Rosini
Rosa
R
Manenti
Alessandro
A
Padovani
Ana Ines
AI
Ansaldo
Stefano F
SF
Cappa
Carlo
C
Miniussi
D000328:Adult; D000368:Aged; D000849:Anomia / Q000209:etiology / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D001037:Aphasia / Q000209:etiology / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020127:Recovery of Function; D013070:Speech Therapy / Q000379:methods; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods