Ilkhani Manouchehr, Shojaie Baghini Hassan, Kiamarzi Gohar, Meysamie Alipasha, Ebrahimi Parvin
Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2017 Dec 27;31:137. doi: 10.14196/mjiri.31.137. eCollection 2017.
Aphasia is a common outcome of Cerebrovascular Accident (CVA) in which clinical interventions have limited effectiveness. Some evidence suggests that noninvasive stimulation of the brain can have beneficial effects in the treatment of CVA induced aphasia. In patients with motor aphasia, repetitive Transcranial Magnetic Stimulation (rTMS) is used to facilitate long-term improvement in speech ability. Since identifying effective methods for treating CVA induced aphasia can be very important in subsequent decision-making and treatment interventions, the objective of this study was to evaluate the effect of low-frequency TMS in Broca's area in the right hemisphere on the treatment of CVA induced motor aphasia. This clinical trial enrolled 24 patients with a clinical diagnosis of motor aphasia caused by CVA using convenient sampling. In this study, the effect of stimulation of Broca's area in the right hemisphere was examined by low-frequency rTMS (one Hz) on aphasia caused by CVA. To conduct verbal fluency test in patients, their correct responses to the selected images before and after rTMS during a certain time were recorded and compared by non-parametric Wilcoxon test using SPSS16 and the significance level was considered <0.05. Registration ID of this research in IRCT is IRCT2014052417814N1. The study findings suggested a significant difference between Wilcoxon test results of patients before and after rTMS (z= -4.401), and it was found that using low-frequency rTMS in the right hemisphere was effective on improving dysarthria in the study population with 95 percent confidence interval (p<0.001). According to the findings, low-frequency rTMS has the potential to be considered as a treatment for patients with nonfluent aphasia caused by CVA.
失语症是脑血管意外（CVA）的常见后果，而临床干预对此效果有限。一些证据表明，大脑的非侵入性刺激对CVA所致失语症的治疗可能具有有益效果。对于运动性失语症患者，重复经颅磁刺激（rTMS）被用于促进言语能力的长期改善。由于确定治疗CVA所致失语症的有效方法在后续决策和治疗干预中可能非常重要，本研究的目的是评估右半球布洛卡区低频经颅磁刺激对CVA所致运动性失语症治疗的效果。 这项临床试验采用方便抽样法，纳入了24例临床诊断为CVA所致运动性失语症的患者。在本研究中，通过低频rTMS（1赫兹）检查右半球布洛卡区刺激对CVA所致失语症的影响。为了对患者进行言语流畅性测试，在特定时间内记录并比较他们在rTMS前后对所选图像的正确反应，使用SPSS16软件通过非参数威尔科克森检验进行分析，显著性水平设定为<0.05。本研究在伊朗临床试验注册中心（IRCT）的注册号为IRCT2014052417814N1。 研究结果表明，患者在rTMS前后的威尔科克森检验结果存在显著差异（z = -4.401），并且发现使用右半球低频rTMS对改善研究人群的构音障碍有效，95%置信区间（p<0.001）。根据研究结果，低频rTMS有潜力被视为治疗CVA所致非流利性失语症患者的一种疗法。
