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Chai L, Huang Y, Guo X, Xiong A, Lin B, Huang J. Does SLT combined with NIBS enhance naming recovery in post-stroke aphasia? A meta-analysis and systematic review. NeuroRehabilitation 2024:NRE240065. [PMID: 38875053 DOI: 10.3233/nre-240065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
BACKGROUND Non-invasive brain stimulation has been widely used as an adjunctive treatment for aphasia following stroke. OBJECTIVE The aim of this study was to investigate the effect of non-invasive brain stimulation as an adjunctive treatment on naming function in aphasia following stroke. METHODS This review included randomized controlled trials (RCTs) involving 5 databases (Web of Science, Embase, Cochrane Library, OVID and PubMed) that investigated the effects of electrical stimulation on stroke patients. The search included literature published up to November 2023. RESULTS We identified 18 studies, and the standardized mean differences (SMDs) showed that the effect sizes of TMS and tDCS were small to medium. Moreover, the treatment effects persisted over time, indicating long-term efficacy. CONCLUSION This study suggested that NIBS combined with speech and language therapy can effectively promote the recovery of naming function in patients with post-stroke aphasia (PSA) and that the effects are long lasting.
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Affiliation(s)
- Linsong Chai
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yunshi Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xinqi Guo
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ailing Xiong
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Bingbing Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Rehabilitation Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Rehabilitation Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Cheng J, Jiang Y, Rao T, Yang Y, Liu Y, Zhan Y, Yang S. Repetitive transcranial magnetic stimulation for post-stroke non-fluent aphasia: a systematic review and meta-analysis of randomized controlled trials. Front Neurol 2024; 15:1348695. [PMID: 38751884 PMCID: PMC11094331 DOI: 10.3389/fneur.2024.1348695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
Objective To systematically evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) on language function in patients with non-fluent aphasia post-stroke. Methods We selected randomized clinical trials (RCT) that involved stroke patients with non-fluent aphasia, whose intervention was rTMS vs. no therapy or other therapy. Two researchers autonomously reviewed the literature based on the specified criteria for inclusion and exclusion and completed the process of data extraction, data verification, and quality evaluation. Meta-analysis was performed using RevMan 5.4 and Stata MP 17, while the assessment of risk of bias was carried out utilizing the Risk of Bias version 2 tool (RoB2). Results The meta-analysis involved 47 RCTs, encompassing 2,190 patients overall. The indexes indicated that rTMS has the potential to decrease the severity of non-fluent aphasia in stroke patients, including improvement of the capability of repetition, naming, and spontaneous language. The determination of BDNF in the serum of patients was also increased. In addition, rTMS reduced the likelihood of depression in stroke patients. Conclusion To summarize the relevant studies, rTMS has significant effects on improving the language abilities of stroke patients suffering from non-fluent aphasia, including the abilities of repetition, naming, and spontaneous language.
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Affiliation(s)
- Jing Cheng
- First School of Clinical Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yijing Jiang
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ting Rao
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yihan Yang
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yanping Liu
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Ying Zhan
- School of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shanli Yang
- Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Williams EER, Sghirripa S, Rogasch NC, Hordacre B, Attrill S. Non-invasive brain stimulation in the treatment of post-stroke aphasia: a scoping review. Disabil Rehabil 2023:1-22. [PMID: 37828899 DOI: 10.1080/09638288.2023.2259299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 09/10/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE Aphasia is an acquired language impairment that commonly results from stroke. Non-invasive brain stimulation (NIBS) might accelerate aphasia recovery trajectories and has seen mounting popularity in recent aphasia rehabilitation research. The present review aimed to: (1) summarise all existing literature on NIBS as a post-stroke aphasia treatment; and (2) provide recommendations for future NIBS-aphasia research. MATERIALS AND METHODS Databases for published and grey literature were searched using scoping review methodology. 278 journal articles, conference abstracts/posters, and books, and 38 items of grey literature, were included for analysis. RESULTS Quantitative analysis revealed that ipsilesional anodal transcranial direct current stimulation and contralesional 1-Hz repetitive transcranial magnetic stimulation were the most widely used forms of NIBS, while qualitative analysis identified four key themes including: the roles of the hemispheres in aphasia recovery and their relationship with NIBS; heterogeneity of individuals but homogeneity of subpopulations; individualisation of stimulation parameters; and much remains under-explored in the NIBS-aphasia literature. CONCLUSIONS Taken together, these results highlighted systemic challenges across the field such as small sample sizes, inter-individual variability, lack of protocol optimisation/standardisation, and inadequate focus on aphasiology. Four key recommendations are outlined herein to guide future research and refine NIBS methods for post-stroke aphasia treatment.
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Affiliation(s)
- Ellen E R Williams
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Sabrina Sghirripa
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
| | - Nigel C Rogasch
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Brenton Hordacre
- Innovation, IMPlementation and Clinical Translation (IIMPACT) in Health, Allied Health and Human Performance, The University of South Australia, Adelaide, Australia
| | - Stacie Attrill
- Speech Pathology, School of Allied Health Science and Practice, The University of Adelaide, Adelaide, Australia
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Li H, Liu J, Tian S, Fan S, Wang T, Qian H, Liu G, Zhu Y, Wu Y, Hu R. Language reorganization patterns in global aphasia-evidence from fNIRS. Front Neurol 2023; 13:1025384. [PMID: 36686505 PMCID: PMC9853054 DOI: 10.3389/fneur.2022.1025384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023] Open
Abstract
Background Exploring the brain reorganization patterns associated with language recovery would promote the treatment of global aphasia. While functional near-infrared spectroscopy (fNIRS) has been widely used in the study of speech and language impairment, its application in the field of global aphasia is still limited. Aims We aimed to identify cortical activation patterns of patients with global aphasia during naming and repetition tasks. Methods and procedures We recruited patients with post-stroke aphasia from the Department of Rehabilitation Medicine at Huashan Hospital. These individuals were diagnosed with global aphasia without cognitive impairments, as assessed by speech-language pathology evaluations. Age- and sex-matched healthy controls were recruited from the greater Shanghai area. During fNIRS measurement, patients and healthy controls completed the picture-naming and phrase repetition task. Cortical activation patterns on each of these language tasks were then compared between groups. Outcomes and results A total of nine patients with global aphasia and 14 healthy controls were included in this study. Compared with the healthy subjects, patients with global aphasia showed increased activation in the left Broca's area, middle temporal gyrus (MTG), superior temporal gyrus (STG), and pre-motor and supplementary motor cortex (SMA) (p < 0.05) in the picture-naming task. Furthermore, the latency of the oxyhemoglobin (HbO) concentration in the left supramarginal gyrus (SMG) region had a strong negative correlation with their score of the naming task (p < 0.01). In the phrase repetition task, decreased activation was detected in the left SMA and SMG (p < 0.05) of patients relative to controls. Conclusion The left SMG plays a critical role in the language function of patients with global aphasia, especially in their abilities to name and repeat. fNIRS is a promising approach to revealing the changes in brain activities in patients with aphasia, and we believe it will contribute to a deeper understanding of the neurological mechanisms and the establishment of a novel treatment approach for global aphasia.
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Affiliation(s)
- Haozheng Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianju Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shan Tian
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shunjuan Fan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tingwei Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Qian
- Department of Rehabilitation Medicine, Shanghai Fifth Rehabilitation Hospital, Shanghai, China
| | - Gang Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulian Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,*Correspondence: Yi Wu ✉
| | - Ruiping Hu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,Ruiping Hu ✉
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Griff JR, Langlie J, Bencie NB, Cromar ZJ, Mittal J, Memis I, Wallace S, Marcillo AE, Mittal R, Eshraghi AA. Recent advancements in noninvasive brain modulation for individuals with autism spectrum disorder. Neural Regen Res 2022; 18:1191-1195. [PMID: 36453393 PMCID: PMC9838164 DOI: 10.4103/1673-5374.360163] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Autism spectrum disorder is classified as a spectrum of neurodevelopmental disorders with an unknown definitive etiology. Individuals with autism spectrum disorder show deficits in a variety of areas including cognition, memory, attention, emotion recognition, and social skills. With no definitive treatment or cure, the main interventions for individuals with autism spectrum disorder are based on behavioral modulations. Recently, noninvasive brain modulation techniques including repetitive transcranial magnetic stimulation, intermittent theta burst stimulation, continuous theta burst stimulation, and transcranial direct current stimulation have been studied for their therapeutic properties of modifying neuroplasticity, particularly in individuals with autism spectrum disorder. Preliminary evidence from small cohort studies, pilot studies, and clinical trials suggests that the various noninvasive brain stimulation techniques have therapeutic benefits for treating both behavioral and cognitive manifestations of autism spectrum disorder. However, little data is available for quantifying the clinical significance of these findings as well as the long-term outcomes of individuals with autism spectrum disorder who underwent transcranial stimulation. The objective of this review is to highlight the most recent advancements in the application of noninvasive brain modulation technology in individuals with autism spectrum disorder.
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Affiliation(s)
- Jessica R. Griff
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jake Langlie
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nathalie B. Bencie
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Zachary J. Cromar
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jeenu Mittal
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Idil Memis
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steven Wallace
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alexander E. Marcillo
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Rahul Mittal
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Adrien A. Eshraghi
- Hearing Research and Communication Disorders Laboratory, Department of Otolaryngology, Neurotology Division, University of Miami Miller School of Medicine, Miami, FL, USA,Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA,Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA,Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA,Correspondence to: Adrien A. Eshraghi, .
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Stockbridge MD, Bunker LD, Hillis AE. Reversing the Ruin: Rehabilitation, Recovery, and Restoration After Stroke. Curr Neurol Neurosci Rep 2022; 22:745-755. [PMID: 36181577 PMCID: PMC9525934 DOI: 10.1007/s11910-022-01231-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Stroke is a common cause of disability in aging adults. A given individual's needs after stroke vary as a function of the stroke extent and location. The purpose of this review was to discuss recent clinical investigations addressing rehabilitation of an array of overlapping functional domains. RECENT FINDINGS Research is ongoing in the domains of movement, cognition, attention, speech, language, swallowing, and mental health. To best assist patients' recovery, innovative research has sought to develop and evaluate behavioral approaches, identify and refine synergistic approaches that augment the response to behavioral therapy, and integrate technology where appropriate, particularly to introduce and titrate real-world complexity and improve the overall experience of therapy. Recent and ongoing trials have increasingly adopted a multidisciplinary nature - augmenting refined behavioral therapy approaches with methods for increasing their potency, such as pharmaceutical or electrical interventions. The integration of virtual reality, robotics, and other technological advancements has generated immense excitement, but has not resulted in consistent improvements over more universally accessible, lower technology therapy.
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Affiliation(s)
- Melissa D Stockbridge
- Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 4, Suite 446, Baltimore, MD, 21287, USA.
| | - Lisa D Bunker
- Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 4, Suite 446, Baltimore, MD, 21287, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 4, Suite 446, Baltimore, MD, 21287, USA
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