title: Language improvements after TMS plus modified CILT: Pilot, open-protocol study with two, chronic nonfluent aphasia cases.
abstract: OBJECTIVE
  The purpose of this study was to investigate: 1) the feasibilty of administering a modified CILT (mCILT) treatment session immediately after TMS; and 2) if this combined therapy could improve naming and elicited propositional speech in chronic, nonfluent aphasia.
  
  
  METHODS
  Two chronic stroke patients with nonfluent aphasia (mild-moderate and severe) each received twenty minutes of rTMS to suppress the right pars triangularis, followed immediately by three hours of mCILT (5 days/week, 2 weeks). (Each patient had received TMS alone, 2-6 years prior.) Language evaluations were performed pre- TMS+mCILT, and post- at 1-2 months, and 6 or 16 months.
  
  
  RESULTS
  Both patients showed significant improvements in naming pictures, and elicited propositional speech at 1-2 months post- TMS+mCILT. The improved naming was still present at 6 months post- TMS+mCILT for P2; but not at 16 months post- TMS+mCILT for P1.
  
  
  CONCLUSIONS
  It is feasible to administer mCILT for three hours immediately after a TMS session. It is unknown if the significant improvements in naming pictures, and elicited propositional speech were associated with the second series of TMS, or this first series of mCILT, or a combination of both. A larger, sham controlled clinical trial is warranted.
authors.affiliation: Veterans Affairs Boston Healthcare System and the Harold Goodglass Boston University Aphasia Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Paula I
authors.initials: PI
authors.lastname: Martin
authors.affiliation: Veterans Affairs Boston Healthcare System and the Harold Goodglass Boston University Aphasia Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Treglia
authors.affiliation: Veterans Affairs Boston Healthcare System and the Harold Goodglass Boston University Aphasia Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Naeser
authors.affiliation: Veterans Affairs Boston Healthcare System and the Harold Goodglass Boston University Aphasia Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Ho
authors.affiliation: Veterans Affairs Boston Healthcare System and the Harold Goodglass Boston University Aphasia Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Errol H
authors.initials: EH
authors.lastname: Baker
authors.affiliation: Veterans Affairs Boston Healthcare System and the Harold Goodglass Boston University Aphasia Research Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Martin
authors.affiliation: Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Shahid
authors.initials: S
authors.lastname: Bashir
authors.affiliation: Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, Spain.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pascual-Leone
mesh_terms: D000328:Adult; D001039:Aphasia, Broca / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007808:Language Therapy / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation
keywords: TMS; aphasia; constraint-induced language therapy; speech therapy; stroke rehabilitation