The Effect of Selective Transcranial Magnetic Stimulation with Functional Near-Infrared Spectroscopy and Intensive Speech Therapy on Individuals with Post-Stroke Aphasia

Eur Neurol. 2017;77(3-4):186-194. doi: 10.1159/000457901. Epub 2017 Feb 4.

Abstract

Purpose: To examine the efficacy of selective repetitive transcranial magnetic stimulation (rTMS) therapy guided by functional near-infrared spectroscopy (fNIRS) combined with intensive speech therapy (iST) on post-stroke patients with aphasia.

Material and methods: Eight right-handed patients with aphasia in the chronic stage after stroke were grouped into left and right hemisphere-activated for a language task based on pre-intervention fNIRS. Those with left hemisphere activation received 1-Hz TMS to the right inferior frontal gyrus (RtIFG; low-frequency rTMS [LFS] group), and those with right hemisphere activation received 10-Hz TMS to the RtIFG (high-frequency rTMS [HFS] group). The patients underwent an 11-day program of rTMS and iST.

Results: Both groups showed a significant improvement in language function as measured by Standard Language Test of Aphasia (SLTA) total score at post-intervention relative to pre-intervention. Furthermore, the pre-to-post SLTA change scores were not statistically different between the groups. Comparison of pre- and post-intervention fNIRS revealed a resolution of the imbalance of interhemispheric inhibition in the LFS group and activation of the target hemisphere in the HFS group.

Conclusions: The administration of fNIRS-guided selective rTMS therapy and iST to post-stroke patients with aphasia induced a significant improvement in language function, with both groups demonstrating a similar degree of improvement.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aphasia / etiology
  • Aphasia / rehabilitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Spectroscopy, Near-Infrared / methods
  • Speech Therapy / methods*
  • Stroke / complications
  • Stroke Rehabilitation / methods*
  • Transcranial Magnetic Stimulation / methods*
  • Treatment Outcome