DIAGNOSTIC AND THERAPEUTIC POTENTIAL OF TRANSCRANIAL MAGNETIC STIMULATION IN APHASIC PATIENTS

Abstract

Speech system is a widely spread and complexly organized system of human brain. Lately new data on morphology, brain cortex functioning and neuroplasticity of speech system have been obtained by using contemporary imaging techniques. Using functional MRI and positron emission tomography (PET) we revealed favorable patterns for recovery of damaged system. The recovery of base speech network realizes through activating perilesional zones and zones of tertiary associative cortex of the dominant hemisphere. The role of right hemispheric homologues of the speech areas in recovery of the communicative function remains equivocal. Transcranial magnetic stimulation (TMS) increased our knowledge about extent and processes of reorganization and functioning of speech system. Repetitive TMS (rTMS) has therapeutic potential. It is a very effective method for recovery of speech disorders. Most professionals use low-frequency inhibiting protocols of rTMS (1-4 Hz). Despite the broad use of this method the best brain areas for application and duration of rTMS procedure are still discussed. Assessment of the degree of brain damage, speech and cognitive status of a patient, type of aphasia, stage of poststroke period, refinement the area for therapeutic application and stimulation type (stimulating or inhibiting) are necessary for application rTMS in the rehabilitation course of patients with poststroke aphasia. Proper use of TMS may positively influence on neuroplasticity, providing functional reorganization of the damaged network and compensation of speech deficiency.