Transcranial magnetic stimulation in the treatment of lateral fissure aphasia / 中华物理医学与康复杂志

ABSTRACT

Objective To use functional magnetic resonance imaging (BOLD-fMRI) to observe the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with speech training in treating those with lateral fissure aphasia.Methods Forty-eight persons with lateral fissure aphasia were divided randomly into a control group and a treatment group,each of 24.The treatment group was treated with repetitive transcranial magnetic stimulation combined with speech training,while the control group was given only speech training.Before the treatment and 2 weeks and 8 weeks after the treatment,BOLD-fMRI images were collected to observe any changes in the language areas of the brain activated.A Chinese aphasia examination (CRRCAE) was used to assess speech function before and after treatment for both groups.Results The average CRRCAE scores of the two groups were not significantly different right before the treatment and at the end of 2 weeks of treatment,but at the end of 8 weeks of treatment the average score of the treatment group was significantly better.The biggest improvement was among those with Broca's aphasia,followed by those with Wernicke aphasia and conduction aphasia.No such differences were observed in the control group.After the 8 weeks of treatment,the average CRRCAE score of the treatment group patients had improved significantly,but in the control group only those with Broca's aphasia had improved significantly.In the treatment group,after 2 weeks and 8 weeks of treatment the activated language areas of the right hemisphere were significantly smaller than before treatment and significantly smaller than the activated areas in the left hemisphere at the same time points.Conclusions Low-frequency,repetitive transcranial magnetic stimulation combined with speech therapy is an early intervention which may promote recovery from lateral fissure aphasia through restoring lingual function after stroke.