title: Add-on Effects of Repetitive Transcranial Magnetic Stimulation on Subacute Aphasia Therapy: Enhanced Improvement of Functional Communication and Basic Linguistic Skills. A Randomized Controlled Study.
abstract: OBJECTIVE
  To determine to what extent repetitive transcranial magnetic stimulation (rTMS) combined with speech and language therapy improves functional communication and basic linguistic skills of individuals with subacute aphasia.
  
  
  METHODS
  Randomized, blinded, and sham-controlled study.
  
  
  METHODS
  Neurologic rehabilitation hospital.
  
  
  METHODS
  Participants (N=30) with subacute aphasia after stroke.
  
  
  METHODS
  During a 2-week treatment period, half of the participants received 10 sessions of 20-minute inhibitory 1-Hz rTMS over the right inferior frontal gyrus (Brodmann area 45), and the other half received sham stimulation. Directly thereafter, all the participants underwent 45 minutes of speech and language therapy.
  
  
  METHODS
  Aachen Aphasia Test, Amsterdam-Nijmegen Everyday Language Test (ANELT), a naming screening, and subscales of the FIM, all assessed the day before and the day after treatment period.
  
  
  RESULTS
  The participants who received real rTMS significantly improved with respect to all 10 measures of basic linguistic skills and functional communication, whereas sham-treated participants significantly improved in only 6 of 10 measures (paired t tests, P<.05). There was a significant difference in the gains made by the 2 groups on 5 of 10 measures including functional communication (ANELT) (repeated-measures analysis of variance, P≤.05).
  
  
  CONCLUSIONS
  For the first time, this study has demonstrated that basic linguistic skills as well as functional communication are bolstered by combining rTMS and behavioral language therapy in patients with subacute aphasia.
authors.affiliation: RehaNova Rehabilitation Hospital, Cologne, Germany. Electronic address: rubi-fessen@rehanova.de.
authors.forename: Ilona
authors.initials: I
authors.lastname: Rubi-Fessen
authors.affiliation: RehaNova Rehabilitation Hospital, Cologne, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Department of Neurology, RWTH Aachen University, Aachen, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Huber
authors.affiliation: Department of Neurology, RWTH Aachen University, Aachen, Germany.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fimm
authors.affiliation: RehaNova Rehabilitation Hospital, Cologne, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rommel
authors.affiliation: Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Thiel
authors.affiliation: Max Planck Institute for Metabolism Research, Cologne, Germany.
authors.forename: Wolf-Dieter
authors.initials: WD
authors.lastname: Heiss
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D016037:Single-Blind Method; D013070:Speech Therapy / Q000379:methods*; D020521:Stroke / Q000150:complications*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*
keywords: Aphasia; Language therapy; Rehabilitation; Transcranial magnetic stimulation