Fahmy Ebtesam Mohamed, Elshebawy Haidy Mohamed
Professor of neurology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Lecturer of neurology, Faculty of Medicine, Cairo University, Cairo, Egypt.
J Stroke Cerebrovasc Dis. 2021 Aug;30(8):105855. doi: 10.1016/j.jstrokecerebrovasdis.2021.105855. Epub 2021 May 25.
Both hemispheres have role in post-stroke aphasia recovery but better recovery is expected with the restoration of function by the left hemisphere. Transcranial stimulation has been used to favor recruitment of left-hemispheric language networks and increase activity of the left hemisphere, thus helps aphasia recovery .
The aim of this study is to evaluate the effect of excitatory repetitive transcranial magnetic stimulation (rTMS) on recovery of post stroke aphasic patients .
Twenty patients with post stroke chronic aphasia were enrolled in the study. Aphasia severity was assessed using Aphasia Severity Rating Scale (ASRS). Linguistic deficits were assessed using Kasr Al-Aini Arabic Aphasia test (KAAT). Real rTMS was applied three for 10 sessions of 10-Hz stimulation, positioned over the left Broca's area of the affected hemisphere. All patients were evaluated before, after the end of treatment sessions and one month later .
There was a significant improvement in the mean total score and mean scores of components of KAAT scale before, immediately after and after one month of rTMS (P< 0.05). Moreover, there was a significant improvement in mean scores of ASRS before, immediately after and after one month of rTMS (P= 0.000). There was a significant difference in mean scores of ASRS and KAAT before, immediately after the last session and after one month between small, medium and large brain infarcts. (P< 0.05).
Excitatory rTMS is a beneficial adjuvant therapy that improves language skills in patients with chronic post-stroke non-fluent aphasia in short and long term. The protocol of this observational study was registered in clinical trial registration: www.ClinicalTrials.gov, identifier: NCT04708197.
两个半球在中风后失语症恢复中都发挥作用，但左半球功能恢复有望带来更好的恢复。经颅刺激已被用于促进左半球语言网络的募集并增加左半球的活动，从而有助于失语症恢复。
本研究旨在评估兴奋性重复经颅磁刺激（rTMS）对中风后失语症患者恢复的影响。
20例中风后慢性失语症患者纳入本研究。使用失语症严重程度评定量表（ASRS）评估失语症严重程度。使用卡斯尔·阿尼阿拉伯失语症测试（KAAT）评估语言缺陷。对受影响半球的左侧布洛卡区进行10次10赫兹刺激，共3次施加真正的rTMS。所有患者在治疗疗程结束前、结束后及1个月后进行评估。
rTMS治疗前、治疗结束后即刻及治疗后1个月，KAAT量表的平均总分及各成分平均得分均有显著改善（P<0.05）。此外，rTMS治疗前、治疗结束后即刻及治疗后1个月，ASRS平均得分也有显著改善（P = 0.000）。小、中、大面积脑梗死患者在最后一次治疗前、治疗结束后即刻及治疗后1个月的ASRS和KAAT平均得分存在显著差异（P<0.05）。
兴奋性rTMS是一种有益的辅助治疗方法，可在短期和长期内改善中风后慢性非流利性失语症患者的语言技能。本观察性研究方案已在临床试验注册中心：www.ClinicalTrials.gov注册，标识符：NCT04708197。
