Center for Mind/Brain Sciences (CIMeC), University of Trento, Italy.
Center for Neurocognitive Rehabilitation (CeRiN) and Center for Mind/Brain Sciences (CIMeC), University of Trento, Italy.
Neurosci Biobehav Rev. 2019 Jul;102:264-289. doi: 10.1016/j.neubiorev.2019.04.019. Epub 2019 May 8.
In the last decade, the effects of NIBS on language recovery in post-stroke aphasia have been evaluated, but little is known about the long-term effectiveness. To this aim, we conducted a systematic review and meta-analysis to determine whether positive effects, mainly on naming performance, are maintained in time, and rTMS and/or tDCS (either as an add-on therapy to SLT or as monotherapy) can be considered effective and reliable interventions for naming rehabilitation. Sixteen studies met our inclusion criteria and the pooled SMDs showed a medium to large rTMS effect and a small to medium tDCS effect. Critically, the treatment effects were maintained in time. Sub-analyses indicated that while rTMS can be considered effective for both subacute and chronic patients, tDCS seems adequate only for chronic aphasia. Importantly, the level of evidence as qualified with GRADE was moderate to high for rTMS and low for tDCS studies.
在过去的十年中，已经评估了非侵入性脑刺激（NIBS）对中风后失语症语言康复的影响，但对于其长期效果知之甚少。为此，我们进行了系统评价和荟萃分析，以确定主要在命名表现上的积极效果是否能随时间保持，以及 rTMS 和/或 tDCS（无论是作为 SLT 的附加治疗还是作为单一疗法）是否可被视为命名康复的有效且可靠的干预措施。符合纳入标准的有 16 项研究，汇总的标准化均数差（SMD）显示 rTMS 有中到大的效果，tDCS 有小到中的效果。关键是，治疗效果随时间保持。亚分析表明，虽然 rTMS 可被认为对亚急性和慢性患者均有效，但 tDCS 似乎仅对慢性失语症有效。重要的是，rTMS 研究的证据水平为中高度，而 tDCS 研究的证据水平为低。
