title: Augmenting melodic intonation therapy with non-invasive brain stimulation to treat impaired left-hemisphere function: two case studies.
abstract: The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia.
authors.affiliation: ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Department of Cognitive Science, Macquarie University Sydney, NSW, Australia.
authors.forename: Shahd
authors.initials: S
authors.lastname: Al-Janabi
authors.affiliation: ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Department of Cognitive Science, Macquarie University Sydney, NSW, Australia ; NHMRC Centre of Clinical Research Excellence in Aphasia Rehabilitation, Macquarie University Sydney, NSW, Australia.
authors.forename: Lyndsey A
authors.initials: LA
authors.lastname: Nickels
authors.affiliation: ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Department of Cognitive Science, Macquarie University Sydney, NSW, Australia.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Sowman
authors.affiliation: ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Centre for Advanced Imaging, The University of Queensland Sydney, NSW, Australia.
authors.forename: Hana
authors.initials: H
authors.lastname: Burianová
authors.affiliation: Melbourne School of Psychological Sciences, The University of Melbourne Melbourne, VIC, Australia.
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Merrett
authors.affiliation: ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Department of Psychology, Macquarie University Sydney, NSW, Australia.
authors.forename: William F
authors.initials: WF
authors.lastname: Thompson
keywords: aphasia; fMRI; rTMS; rehabilitation; stroke