title: Effect of low-frequency repetitive transcranial magnetic stimulation on naming abilities in early-stroke aphasic patients: a prospective, randomized, double-blind sham-controlled study.
abstract: OBJECTIVE
  Functional brain imaging studies with aphasia patients have shown increased cortical activation in the right hemisphere language homologues, which hypothetically may represent a maladaptive strategy that interferes with aphasia recovery. The aim of this study was to investigate whether low-frequency repetitive transcranial magnetic stimulation (rTMS) over the Broca's homologues in combination with speech/language therapy improves naming in early-stroke aphasia patients.
  
  
  METHODS
  26 right-handed aphasic patients in the early stage (up to 12 weeks) of a first-ever left hemisphere ischemic stroke were randomized to receive speech and language therapy combined with real or sham rTMS. Prior to each 45-minute therapeutic session (15 sessions, 5 days a week), 30 minutes of 1-Hz rTMS was applied. Outcome measures were obtained at baseline, immediately after 3 weeks of experimental treatment and 15 weeks; posttreatment using the Computerized Picture Naming Test.
  
  
  RESULTS
  Although both groups significantly improved their naming abilities after treatment, no significant differences were noted between the rTMS and sham stimulation groups. The additional analyses have revealed that the rTMS subgroup with a lesion including the anterior part of language area showed greater improvement primarily in naming reaction time 15 weeks after completion of the therapeutic treatment. Improvement was also demonstrated in functional communication abilities.
  
  
  CONCLUSIONS
  Inhibitory rTMS of the unaffected right inferior frontal gyrus area in combination with speech and language therapy cannot be assumed as an effective method for all poststroke aphasia patients. The treatment seems to be beneficial for patients with frontal language area damage, mostly in the distant time after finishing rTMS procedure.
authors.affiliation: Second Department of Neurology, Institute of Psychiatry and Neurology, 9 Sobieskiego St., 02-957 Warsaw, Poland. kwaldow@ipin.edu.pl
authors.forename: Konrad
authors.initials: K
authors.lastname: Waldowski
authors.forename: Joanna
authors.initials: J
authors.lastname: Seniów
authors.forename: Marcin
authors.initials: M
authors.lastname: Leśniak
authors.forename: Szczepan
authors.initials: S
authors.lastname: Iwański
authors.forename: Anna
authors.initials: A
authors.lastname: Członkowska
mesh_terms: D000328:Adult; D000368:Aged; D001037:Aphasia / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015990:Placebo Effect; D011446:Prospective Studies; D013070:Speech Therapy / Q000379:methods*; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014825:Vocabulary