Anagennisi Rehabilitation Center, Thessaloniki, Greece.
Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Adv Exp Med Biol. 2023;1425:619-628. doi: 10.1007/978-3-031-31986-0_60.
Aphasia is a serious consequence of stroke resulting in difficulties in using language for communication with negative effects on patients' quality of life. The use of non-invasive repetitive transcranial magnetic stimulation (rTMS) is a novel approach in aphasia therapy, based on the knowledge gained by functional imaging technics of the brain.
This review evaluates the effectiveness of rTMS on aphasia therapy according to the results of English language studies that have been published in the databases PubMed/Medline, Scopus, and Web of Science from 2011 to 2021.
Twenty-seven studies were included in the review with 672 participants. The studies mainly concern the application of inhibitory rTMS on the right inferior frontal gyrus (rIFG) in the subacute and chronic phase, as well as excitatory rTMS of the unaffected language areas of the left cerebral hemisphere in the chronic phase after stroke. Most of the studies concluded that there was statistically significant improvement in various parameters of language including confrontation naming, repetition, and aphasia quotient. Three studies published results that doubt the effectiveness of rTMS.
rTMS is a safe therapeutic method for aphasia treatment in the subacute and chronic phases after stroke. Its effectiveness is immediate as well as distant with a gradually decreasing therapeutic effect. Moreover, rTMS may supplement speech and language therapy as a priming factor. The most recognized method at this point in time is the application of suppressive rTMS on the right inferior frontal gyrus in combination with speech and language therapy.
失语症是中风的严重后果，导致语言交流困难，对患者的生活质量产生负面影响。非侵入性重复经颅磁刺激（rTMS）是一种新的失语症治疗方法，基于对大脑功能成像技术的了解。
本综述根据 2011 年至 2021 年在 PubMed/Medline、Scopus 和 Web of Science 数据库中发表的英文研究结果，评估 rTMS 对失语症治疗的有效性。
综述共纳入 27 项研究，涉及 672 名参与者。这些研究主要涉及在亚急性期和慢性期应用抑制性 rTMS 于右侧额下回（rIFG），以及在中风后慢性期应用兴奋性 rTMS 于左侧大脑半球未受影响的语言区域。大多数研究得出结论，语言的各种参数（包括命名、重复和失语症商数）均有统计学意义的改善。有 3 项研究发表的结果对 rTMS 的有效性表示怀疑。
rTMS 是中风后亚急性期和慢性期失语症治疗的一种安全治疗方法。其疗效即刻出现，且具有远隔效应，治疗效果逐渐减弱。此外，rTMS 可能作为启动因素补充言语和语言治疗。目前最受认可的方法是将抑制性 rTMS 应用于右侧额下回，并结合言语和语言治疗。
