Kakuda Wataru, Abo Masahiro, Momosaki Ryo, Morooka Azusa
Department of Rehabilitation Medicine, Jikei University School of Medicine, Tokyo, Japan.
Brain Inj. 2011;25(12):1242-8. doi: 10.3109/02699052.2011.608212. Epub 2011 Sep 8.
To clarify the safety, feasibility and efficacy of 6-Hz-primed low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive speech therapy (ST) for post-stroke aphasic patients.
Four adult patients with history of left hemispheric stroke and with motor-dominant aphasia were studied. During 11-day hospitalization, each patient received 18 treatment sessions consisting of 10-min 6-Hz priming stimulation followed by 20-min 1-Hz low-frequency rTMS and intensive ST for 60 min daily. Both the priming stimulation and low-frequency rTMS were applied to the right frontal lobe. The intensive ST was provided on one-to-one basis. Language function was assessed by Standard Language Test of Aphasia (SLTA), Supplementary Test of SLTA (SLTA-ST), and the Japanese version of Western Aphasia Battery (WAB) within 2 weeks prior to the admission and on the day of discharge.
The in-patient protocol was successfully completed by all patients without any adverse effects. Each patient showed an increase in the correct answer rate after the intervention. Improvement was found in both expressive and recessive language modalities in all patients.
The protocol of 6-Hz-primed low-frequency rTMS and intensive ST for post-stroke aphasia was safe and feasible, suggesting its potential usefulness in the treatment of this population.
阐明6赫兹预刺激低频重复经颅磁刺激(rTMS)联合强化言语治疗(ST)对脑卒中后失语患者的安全性、可行性和疗效。
对4例有左侧半球脑卒中病史且为运动性失语为主的成年患者进行研究。在为期11天的住院期间,每位患者每天接受18次治疗,包括先进行10分钟的6赫兹预刺激,随后进行20分钟的1赫兹低频rTMS,并进行60分钟的强化言语治疗。预刺激和低频rTMS均作用于右侧额叶。强化言语治疗采用一对一的方式。在入院前2周内及出院当天,通过失语症标准语言测试(SLTA)、SLTA补充测试(SLTA-ST)和日语版西方失语症成套测验(WAB)对语言功能进行评估。
所有患者均成功完成住院治疗方案,且未出现任何不良反应。每位患者在干预后正确回答率均有所提高。所有患者的表达性和隐性语言模式均有改善。
6赫兹预刺激低频rTMS联合强化言语治疗方案对脑卒中后失语症是安全可行的,表明其在治疗该人群方面具有潜在的应用价值。