IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Neuropsychol Rehabil. 2011 Oct;21(5):717-41. doi: 10.1080/09602011.2011.621275.
Recent studies have reported enhanced performance on language tasks induced by non-invasive brain stimulation, i.e., repetitive transcranial magnetic stimulation (rTMS), or transcranial direct current stimulation (tDCS), in patients with aphasia due to stroke or Alzheimer's disease (AD). The first part of this article reviews brain stimulation studies related to language recovery in aphasic patients. The second part reports results from a pilot study with three chronic stroke patients who had non-fluent aphasia, where real or placebo rTMS was immediately followed by 25 minutes of individualised speech therapy. Real rTMS consisted of high-frequency rTMS over the left dorsolateral prefrontal cortex (BA 8/9) for 25 minutes. Each patient underwent a total of four weeks of intervention. P1 underwent four weeks of real rTMS (5 days/week) where individualised speech therapy was provided for 25 minutes immediately following each rTMS session. P2 and P3 each underwent two weeks of placebo rTMS, followed immediately by individualised speech therapy; then two weeks of real rTMS, followed immediately by individualised speech therapy. Assessments took place at 2, 4, 12, 24 and 48 weeks post-entry/baseline testing. Relative to entry/baseline testing, a significant improvement in object naming was observed at all testing times, from two weeks post-intervention in real rTMS plus speech therapy, or placebo rTMS plus speech therapy. Our findings suggest beneficial effects of targeted behavioural training in combination with brain stimulation in chronic aphasic patients. However, further work is required in order to verify whether optimal combination parameters (rTMS alone or speech therapy alone) and length of rTMS treatment may be found.
最近的研究报告称，在因中风或阿尔茨海默病（AD）导致失语症的患者中，非侵入性脑刺激（即重复经颅磁刺激（rTMS）或经颅直流电刺激（tDCS））可提高语言任务的表现。本文的第一部分回顾了与失语症患者语言恢复相关的脑刺激研究。第二部分报告了一项针对 3 名慢性中风后非流利性失语症患者的初步研究结果，其中真实或安慰剂 rTMS 立即紧随 25 分钟的个体化言语治疗。真实 rTMS 由左背外侧前额叶皮质（BA 8/9）的高频 rTMS 组成，持续 25 分钟。每位患者接受了总共四周的干预。P1 接受了四周的真实 rTMS（每周 5 天），其中个体化言语治疗在每次 rTMS 后立即进行 25 分钟。P2 和 P3 分别接受了两周的安慰剂 rTMS，随后立即进行个体化言语治疗；然后是两周的真实 rTMS，紧随其后的是个体化言语治疗。评估在入组/基线测试后的 2、4、12、24 和 48 周进行。与入组/基线测试相比，在真实 rTMS 加言语治疗或安慰剂 rTMS 加言语治疗后的两周内，所有测试时间的物体命名均有显著改善。我们的研究结果表明，在慢性失语症患者中，靶向行为训练与脑刺激相结合具有有益效果。然而，还需要进一步的工作来验证是否可以找到最佳的组合参数（rTMS 单独或言语治疗单独）和 rTMS 治疗的长度。
