Long term language recovery subsequent to low frequency rTMS in chronic non-fluent aphasia

Issue title: Neurobehavioural Disorders after Traumatic Brain Injury: Assessment, Treatment and Outcome

Guest editors: Roger Ll. Wood

Article type: Research Article

Authors: Barwood, Caroline H.S.^{a; *} | Murdoch, Bruce E.^a | Riek, Stephan^b | O'Sullivan, John D.^c | Wong, Andrew^c | Lloyd, David^{a; b} | Coulthard, Alan^d

Affiliations: [a] Centre for Neurogenic Communication Disorders Research, School of Health and Rehabilitation Sciences, The University of Queensland, QLD, Australia | [b] Centre for Sensorimotor Neuroscience, The University of Queensland, QLD, Australia | [c] Department of Neurology, Royal Brisbane and Women's Hospital, QLD, Australia | [d] Department of Medical Imaging, Royal Brisbane and Women's Hospital, QLD, Australia

Correspondence: [*] Address for correspondence: Dr Caroline H.S. Barwood, Centre for Neurogenic Communication Disorders Research, School of Health and Rehabilitation Sciences, The University of Queensland, QLD 4072, Australia. Tel.: +61 7 3365 6162; Fax: +61 7 3365 1877; E-mail: [email protected]

Abstract: Background:Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential therapeutic tool for the rehabilitation of language in chronic non-fluent aphasia post-stroke. Previous studies report that low frequency (1 Hz) rTMS applied to homologous language sites can facilitate behavioural language changes. Improvements in picture naming performance and speech output are frequently reported. Objectives:This study aims to assess the efficacy of inhibitory rTMS to modulate language performance in non-fluent aphasia. Methods:Low-frequency (1 Hz) rTMS was applied to six active stimulation and six placebo patients for 20 min per day over 10 days, as outlined in a previous published investigation. Behavioural language outcome measures were taken at baseline (pre-stimulation) and 1 week, 2 months, 8 months and 12 months post-stimulation. Results:The findings demonstrate treatment-related changes observed in the stimulation group, up to 12 months post-stimulation, when compared to the placebo control group over time for naming performance, expressive language and auditory comprehension. Conclusion:These outcomes provide considerable evidence to support the theory of rTMS modulating mechanisms of transcallosal disinhibition in the aphasic brain, and highlight the potential clinical application of rTMS for language rehabilitation in chronic aphasia.

Keywords: Non-fluent aphasia, aphasia, transcranial magnetic stimulation, TMS, rehabilitation, stroke, language

DOI: 10.3233/NRE-130915

Journal: NeuroRehabilitation, vol. 32, no. 4, pp. 915-928, 2013