Article

While prior preliminary studies have broadened our understanding of
how repetitive transcranial magnetic stimulation (rTMS) improves language
outcomes in stroke patients with nonfluent aphasia, the evidence base of the
effectiveness of this method remains inadequate.
In this study, we
aimed to strengthen the evidence that this approach improves language performance
and to identify characteristics of patients predisposed to benefit most from this
treatment. METHODS: Fifty-six stroke patients with nonfluent aphasia were
randomly allocated to a real or a sham stimulation group: Group A (n = 33), who
underwent 10 sessions of 1-Hz rTMS over the contralesional pars triangularis
(PTr), and Group B (n = 23), who received sham 1-Hz stimulation. We performed the
Picture Naming Test and the Concise Chinese Aphasia Test (CCAT) at the baseline,
post-rTMS intervention, and at 3-month follow-up. RESULTS: Group A showed
significantly greater improvement than Group B in CCAT scoring (P < .001),
object-naming accuracy (P = .01), and naming reaction time (P = .004). The CCAT
scoring and naming testing changes for Group A were persistent at 3 months
following intervention (P = .008). Patients who had a lower contralesional rest
motor threshold (rMT) were predisposed to a favorable therapeutic outcome (P =
.006), independent of aphasia type, severity, and duration. CONCLUSIONS: The
results of this study provide evidence that inhibitory rTMS, through
downregulating the circuitry of the right pars triangularis (PTr), achieves a
persistent and broadly modulating effect, irrespective of aphasia severity and
subtype. Patients who show lower rMT in the right motor system would seem to
benefit the most from inhibitory rTMS.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS