Article

This single-case research-designed study explored whether intermittent
theta-burst stimulation (iTBS) of the right dorsolateral prefrontal cortex (DLPFC) could improve metaphor comprehension in people with Parkinson disease
(PD) and language impairments. A right-handed participant with PD diagnosed 9
years ago, receiving long-term treatment with levodopa, and with metaphor
comprehension impairment was recruited to undergo 10 sessions of sham stimulation
(in 2wk), a washout period (6wk), and then 10 sessions of iTBS
(in 2wk). Clinical
scores of metaphor comprehension and motor evaluation (Unified Parkinson Disease
Rating Scale part III) and transcranial magnetic stimulation to test the
excitability of the primary motor cortex (M1) were used at baseline, postsham,
post-iTBS, and at 3 follow-ups (8, 14, and 20wk post-iTBS). Metaphor
comprehension was improved after iTBS, and the highest scores were obtained 8
weeks later (P=.01). This improvement was correlated with the increase of the
right M1 excitability (r=-.86, P=.03) and with the decrease of transcallosal
inhibition latency from the left to the right hemisphere (r=-.88, P=.02). Sham
yielded no effect (P>.05). Administration of iTBS over the right DLPFC improved
metaphor comprehension likely by a long-term influence on brain synaptic
plasticity, including improvement of interhemispheric dialogue. More studies are
warranted to confirm these findings in larger samples of participants with PD.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

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