Non-invasive repeated therapeutic stimulation for aphasia recovery: a multilingual, multicenter aphasia trial.
Noninvasive brain stimulation such as repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) has been used in case series and small randomized controlled trials to improve recovery from poststroke aphasia in combination with speech and language therapy. Results of these studies suggest possible clinical efficacy and an excellent safety profile. Therefore, a larger international multicenter proof-of-concept trial was launched, to directly compare the safety and efficacy of rTMS, tDCS, and sham stimulation as adjuvant therapy to speech and language therapy in subacute poststroke aphasia. In the 4 participating centers, subacute stroke patients with aphasia are randomized between 5 and 30 days after ischemic stroke to either receive rTMS, tDCS, or sham stimulation in combination with a daily 45 minutes speech and language therapy session for 10 days. Efficacy is evaluated at 1 and 30 days after the last of the 10 treatment sessions using 3 outcome measures, validated in all participating languages: Boston naming test, Token test, and verbal fluency test. Additionally, adverse events are recorded to prove safety. In this study, a total of 90 patients will be recruited, and data analysis will be completed in 2016. This is the first multilingual and multinational randomized and controlled trial in poststroke aphasia and if positive, will add an effective new strategy for early stage poststroke aphasia rehabilitation.
Department of Neurology & Neurosurgery, Jewish General Hospital, McGill University, Montréal, Canada. Electronic address: Alexander.Thiel@mcgill.ca.
Alexander
A
Thiel
Department of Neurology, Faculty of Medicine, Sunnybrook Hospital, University of Toronto, Toronto, Canada.
Sandra E
SE
Black
Department of Speech-Language Pathology, Faculty of Medicine, Toronto Rehabilitation Institute, University of Toronto, Toronto, Canada.
Elizabeth A
EA
Rochon
Département de Neurosciences, Faculté de Médecine, Hôpital Notre-Dame, Université de Montréal, Montréal, Canada.
Sylvain
S
Lanthier
RehaNova, Rehabilitationsklinik, Cologne, Germany.
Alexander
A
Hartmann
Department of Physical Therapy, Faculty of Medicine, Sunnybrook Hospital, University of Toronto, Toronto, Canada.
Joyce L
JL
Chen
Department of Physical Therapy, Faculty of Medicine, Sunnybrook Hospital, University of Toronto, Toronto, Canada.
George
G
Mochizuki
Lady David Institute for Medical Research, Jewish General Hospital, McGill University, Montréal, Canada.
Anna
A
Zumbansen
Max-Planck Institute for Neurological Research, Cologne, Germany.
Wolf-Dieter
WD
Heiss
D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000628:therapy*; D002170:Canada; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
Aphasia; clinical trial; ischemic stroke; noninvasive brain stimulation; rehabilitation; speech and language therapy