Hara Takatoshi, Abo Masahiro, Kakita Kiyohito, Mori Yuko, Yoshida Makoto, Sasaki Nobuyuki
Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
Eur Neurol. 2017;77(3-4):186-194. doi: 10.1159/000457901. Epub 2017 Feb 4.
To examine the efficacy of selective repetitive transcranial magnetic stimulation (rTMS) therapy guided by functional near-infrared spectroscopy (fNIRS) combined with intensive speech therapy (iST) on post-stroke patients with aphasia.
Eight right-handed patients with aphasia in the chronic stage after stroke were grouped into left and right hemisphere-activated for a language task based on pre-intervention fNIRS. Those with left hemisphere activation received 1-Hz TMS to the right inferior frontal gyrus (RtIFG; low-frequency rTMS [LFS] group), and those with right hemisphere activation received 10-Hz TMS to the RtIFG (high-frequency rTMS [HFS] group). The patients underwent an 11-day program of rTMS and iST.
Both groups showed a significant improvement in language function as measured by Standard Language Test of Aphasia (SLTA) total score at post-intervention relative to pre-intervention. Furthermore, the pre-to-post SLTA change scores were not statistically different between the groups. Comparison of pre- and post-intervention fNIRS revealed a resolution of the imbalance of interhemispheric inhibition in the LFS group and activation of the target hemisphere in the HFS group.
The administration of fNIRS-guided selective rTMS therapy and iST to post-stroke patients with aphasia induced a significant improvement in language function, with both groups demonstrating a similar degree of improvement.
探讨功能近红外光谱(fNIRS)引导下的选择性重复经颅磁刺激(rTMS)疗法联合强化言语治疗(iST)对脑卒中后失语患者的疗效。
8例脑卒中后慢性期的右利手失语患者,根据干预前fNIRS将其分为左半球激活组和右半球激活组,以进行语言任务。左半球激活的患者接受对右侧额下回(RtIFG)的1Hz经颅磁刺激(低频rTMS [LFS]组),右半球激活的患者接受对RtIFG的10Hz经颅磁刺激(高频rTMS [HFS]组)。患者接受为期11天的rTMS和iST治疗方案。
与干预前相比,两组在干预后通过失语症标准语言测试(SLTA)总分测量的语言功能均有显著改善。此外,两组之间SLTA的前后变化分数无统计学差异。干预前后fNIRS的比较显示,LFS组半球间抑制失衡得到解决,HFS组目标半球被激活。
对脑卒中后失语患者给予fNIRS引导的选择性rTMS疗法和iST可显著改善语言功能,两组改善程度相似。