ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Department of Cognitive Science, Macquarie University Sydney, NSW, Australia.
ARC Centre of Excellence in Cognition and its Disorders, Macquarie University Sydney, NSW, Australia ; Department of Cognitive Science, Macquarie University Sydney, NSW, Australia ; NHMRC Centre of Clinical Research Excellence in Aphasia Rehabilitation, Macquarie University Sydney, NSW, Australia.
Front Psychol. 2014 Feb 4;5:37. doi: 10.3389/fpsyg.2014.00037. eCollection 2014.
The purpose of this study was to investigate whether or not the right hemisphere can be engaged using Melodic Intonation Therapy (MIT) and excitatory repetitive transcranial magnetic stimulation (rTMS) to improve language function in people with aphasia. The two participants in this study (GOE and AMC) have chronic non-fluent aphasia. A functional Magnetic Resonance Imaging (fMRI) task was used to localize the right Broca's homolog area in the inferior frontal gyrus for rTMS coil placement. The treatment protocol included an rTMS phase, which consisted of 3 treatment sessions that used an excitatory stimulation method known as intermittent theta burst stimulation, and a sham-rTMS phase, which consisted of 3 treatment sessions that used a sham coil. Each treatment session was followed by 40 min of MIT. A linguistic battery was administered after each session. Our findings show that one participant, GOE, improved in verbal fluency and the repetition of phrases when treated with MIT in combination with TMS. However, AMC showed no evidence of behavioral benefit from this brief treatment trial. Post-treatment neural activity changes were observed for both participants in the left Broca's area and right Broca's homolog. These case studies indicate that a combination of MIT and rTMS applied to the right Broca's homolog has the potential to improve speech and language outcomes for at least some people with post-stroke aphasia.
本研究旨在探讨是否可以通过使用旋律语调治疗（MIT）和兴奋性重复经颅磁刺激（rTMS）来激活右半球，以改善失语症患者的语言功能。本研究的两名参与者（GOE 和 AMC）患有慢性非流利性失语症。使用功能磁共振成像（fMRI）任务来定位额下回的右侧布罗卡区，以便在 rTMS 线圈放置时进行刺激。治疗方案包括 rTMS 阶段，包括 3 次治疗，使用称为间歇性 theta 爆发刺激的兴奋性刺激方法，以及 sham-rTMS 阶段，包括 3 次治疗，使用 sham 线圈。每次治疗后都进行 40 分钟的 MIT。每次治疗后都会进行语言测试。我们的研究结果表明，在接受 MIT 与 TMS 联合治疗后，一名参与者 GOE 的言语流畅性和短语重复能力有所提高。然而，AMC 并没有从这个短暂的治疗试验中表现出行为获益的迹象。治疗后，两名参与者的左布罗卡区和右布罗卡区同源区都观察到了神经活动的变化。这些案例研究表明，将 MIT 和 rTMS 联合应用于右布罗卡区同源区可能有潜力改善至少一些中风后失语症患者的言语和语言预后。
